2200 E WASHINGTON, BLOOMINGTON, IL, 140162
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| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 13 | — | — | $40.6 | $11,585 | $22,702 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 13 | — | — | $40.6 | $16,449 | $32,685 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 13 | — | — | $40.6 | $8,523.9 | $16,420 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 13 | — | — | $40.6 | $5,943.06 | $11,124 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 13 | — | — | $40.6 | $12,898 | $25,399 |
| COPD w MCC | MS-DRG | 190 | 13 | — | — | $40.6 | $9,295.22 | $18,003 |
| COPD w CC | MS-DRG | 191 | 13 | — | — | $40.6 | $7,199.03 | $13,701 |
| COPD w/o CC/MCC | MS-DRG | 192 | 13 | — | — | $40.6 | $5,607.3 | $10,434 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 13 | — | — | $40.6 | $6,905.24 | $13,098 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 13 | — | — | $40.6 | $5,500.38 | $10,215 |
| AMI discharged alive w MCC | MS-DRG | 280 | 13 | — | — | $40.6 | $13,226 | $26,071 |
| AMI discharged alive w CC | MS-DRG | 281 | 13 | — | — | $40.6 | $7,801.67 | $14,938 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 13 | — | — | $40.6 | $6,249.53 | $11,753 |
| Heart failure & shock w MCC | MS-DRG | 291 | 13 | — | — | $40.6 | $10,690 | $20,866 |
| Heart failure & shock w CC | MS-DRG | 292 | 13 | — | — | $40.6 | $7,246.55 | $13,799 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 13 | — | — | $40.6 | $5,005.44 | $9,199.2 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 13 | — | — | $40.6 | $10,058 | $19,569 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 13 | — | — | $40.6 | $6,349.32 | $11,957 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 13 | — | — | $40.6 | $5,006.23 | $9,200.82 |
| GI hemorrhage w CC | MS-DRG | 378 | 13 | — | — | $40.6 | $8,289.49 | $15,939 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 13 | — | — | $40.6 | $5,515.43 | $10,246 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 13 | — | — | $40.6 | $6,696.96 | $12,671 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 13 | — | — | $40.6 | $12,938 | $25,480 |
| Kidney/UTI w MCC | MS-DRG | 689 | 13 | — | — | $40.6 | $9,711.77 | $18,858 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 13 | — | — | $40.6 | $6,933.75 | $13,157 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 13 | — | — | $40.6 | $15,906 | $31,571 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 13 | — | — | $40.6 | $8,626.84 | $16,632 |
| maternity | ||||||||
| Cesarean section w CC/MCC | MS-DRG | 765 | 1 | — | — | $40.6 | $40.6 | $40.6 |
| Cesarean section w/o CC/MCC | MS-DRG | 766 | 1 | — | — | $40.6 | $40.6 | $40.6 |
| Vaginal delivery w complicating dx | MS-DRG | 774 | 1 | — | — | $40.6 | $40.6 | $40.6 |
| Vaginal delivery w/o complicating dx | MS-DRG | 775 | 1 | — | — | $40.6 | $40.6 | $40.6 |
| surgery | ||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $40.6 | $40.6 | $40.6 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $40.6 | $40.6 | $40.6 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 13 | — | — | $40.6 | $36,923 | $74,707 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 13 | — | — | $40.6 | $19,507 | $38,962 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 13 | — | — | $40.6 | $13,850 | $27,352 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 13 | — | — | $40.6 | $13,919 | $27,494 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 13 | — | — | $40.6 | $11,339 | $22,198 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 13 | — | — | $40.6 | $27,504 | $55,376 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $40.6 | $40.6 | $40.6 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $40.6 | $40.6 | $40.6 |
| Major joint replacement w MCC | MS-DRG | 469 | 13 | — | — | $40.6 | $24,543 | $49,299 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 13 | — | — | $40.6 | $15,798 | $31,350 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 13 | — | — | $40.6 | $23,586 | $47,334 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 13 | — | — | $40.6 | $17,110 | $34,042 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 13 | — | — | $40.6 | $13,439 | $26,509 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 13 | — | — | $40.6 | $23,389 | $46,929 |
| OR procedure for obesity w CC | MS-DRG | 620 | 13 | — | — | $40.6 | $13,196 | $26,010 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 13 | — | — | $40.6 | $12,468 | $24,516 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 13 | — | — | $40.6 | $10,348 | $20,165 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 13 | — | — | $40.6 | $16,750 | $33,304 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 51 | $11,017 |
| caterpillar | 43 | $17,657 |
| Cigna | 43 | $20,866 |
| health alliance plan | 43 | $15,182 |
| healthlink | 43 | $20,040 |
| healthspring | 43 | $10,480 |
| Humana | 43 | $10,480 |
| medica | 43 | $10,480 |
| meridian | 43 | $10,480 |
| Molina | 43 | $10,480 |
| UnitedHealthcare | 43 | $13,511 |
| Aetna | 43 | $11,471 |
| WellCare | 43 | $10,585 |
