5666 EAST STATE STREET, ROCKFORD, IL, 140233
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| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 17 | — | — | $56.3 | $11,682 | $25,065 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 17 | — | — | $56.3 | $16,584 | $36,086 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 17 | — | — | $56.3 | $8,597.5 | $18,129 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 17 | — | — | $56.3 | $5,996.38 | $12,281 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 17 | — | — | $56.3 | $13,006 | $28,042 |
| COPD w MCC | MS-DRG | 190 | 17 | — | — | $56.3 | $9,374.88 | $19,877 |
| COPD w CC | MS-DRG | 191 | 17 | — | — | $56.3 | $7,262.22 | $15,127 |
| COPD w/o CC/MCC | MS-DRG | 192 | 17 | — | — | $56.3 | $5,657.97 | $11,520 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 17 | — | — | $56.3 | $6,966.11 | $14,461 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 17 | — | — | $56.3 | $5,550.22 | $11,278 |
| AMI discharged alive w MCC | MS-DRG | 280 | 17 | — | — | $56.3 | $13,337 | $28,784 |
| AMI discharged alive w CC | MS-DRG | 281 | 17 | — | — | $56.3 | $7,869.6 | $16,493 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 17 | — | — | $56.3 | $6,305.25 | $12,975 |
| Heart failure & shock w MCC | MS-DRG | 291 | 17 | — | — | $56.3 | $10,780 | $23,037 |
| Heart failure & shock w CC | MS-DRG | 292 | 17 | — | — | $56.3 | $7,310.1 | $15,235 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 17 | — | — | $56.3 | $5,051.39 | $10,156 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 17 | — | — | $56.3 | $10,143 | $21,605 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 17 | — | — | $56.3 | $6,405.82 | $13,202 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 17 | — | — | $56.3 | $5,052.19 | $10,158 |
| GI hemorrhage w CC | MS-DRG | 378 | 17 | — | — | $56.3 | $8,361.25 | $17,598 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 17 | — | — | $56.3 | $5,565.39 | $11,312 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 17 | — | — | $56.3 | $6,756.2 | $13,989 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 17 | — | — | $56.3 | $13,046 | $28,131 |
| Kidney/UTI w MCC | MS-DRG | 689 | 17 | — | — | $56.3 | $9,794.7 | $20,821 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 17 | — | — | $56.3 | $6,994.84 | $14,526 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 17 | — | — | $56.3 | $16,038 | $34,857 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 17 | — | — | $56.3 | $8,701.25 | $18,362 |
| maternity | ||||||||
| Cesarean section w CC/MCC | MS-DRG | 765 | 4 | — | — | $56.3 | $60 | $6,735.75 |
| Cesarean section w/o CC/MCC | MS-DRG | 766 | 4 | — | — | $56.3 | $60 | $4,665.75 |
| Vaginal delivery w complicating dx | MS-DRG | 774 | 4 | — | — | $56.3 | $60 | $4,095 |
| Vaginal delivery w/o complicating dx | MS-DRG | 775 | 4 | — | — | $56.3 | $60 | $2,700 |
| surgery | ||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 12 | — | — | $56.3 | $37,961 | $53,750 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 12 | — | — | $56.3 | $24,199 | $34,265 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 17 | — | — | $56.3 | $37,220 | $82,481 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 17 | — | — | $56.3 | $19,667 | $43,016 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 17 | — | — | $56.3 | $13,966 | $30,198 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 17 | — | — | $56.3 | $14,035 | $30,355 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 17 | — | — | $56.3 | $11,435 | $24,508 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 17 | — | — | $56.3 | $27,727 | $61,138 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 12 | — | — | $56.3 | $84,051 | $119,012 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 12 | — | — | $56.3 | $46,357 | $65,638 |
| Major joint replacement w MCC | MS-DRG | 469 | 17 | — | — | $56.3 | $24,743 | $54,429 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 17 | — | — | $56.3 | $15,929 | $34,613 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 17 | — | — | $56.3 | $23,778 | $52,259 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 17 | — | — | $56.3 | $17,251 | $37,584 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 17 | — | — | $56.3 | $13,552 | $29,267 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 17 | — | — | $56.3 | $23,579 | $51,812 |
| OR procedure for obesity w CC | MS-DRG | 620 | 17 | — | — | $56.3 | $13,306 | $28,716 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 17 | — | — | $56.3 | $12,573 | $27,067 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 17 | — | — | $56.3 | $10,436 | $22,263 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 17 | — | — | $56.3 | $16,889 | $36,770 |
| Payer | Codes covered | Median rate |
|---|---|---|
| phcs | 51 | $9,628.5 |
| hfn | 51 | $67.85 |
| ecoh | 51 | $60 |
| Blue Cross Blue Shield | 51 | $10,842 |
| dean health plan | 47 | $20,374 |
| caterpillar | 47 | $19,135 |
| alliance | 47 | $25,065 |
| Humana | 47 | $14,540 |
| direct access network | 47 | $24,508 |
| UnitedHealthcare | 47 | $15,236 |
| Cigna | 47 | $24,403 |
| Aetna | 47 | $12,962 |
| zing | 43 | $11,152 |
| health alliance plan | 43 | $10,621 |
| meridian | 43 | $10,621 |
| Molina | 43 | $10,621 |
| WellCare | 43 | $10,727 |
