Plan Payment Calculators

 

Payments to Hospitals

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NC AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Select a hospital service from these examples:

Top 10 hospitalizations Normal newborn Heart failure/shock without complications Pneumonia, adult with major complications Cesarean section Chest pain Rehabilitation Digestive disorders, adult with complications Vaginal delivery, uncomplicated Cardiac catheterization Full-term infant with other problems Bones, joints, and muscles Back and neck Non-surgical back problems Surgical Upper spinal fusion Upper spinal fusion with us Hip, knee, ankle, foot, upper arm Joint replacement or reattachment Lower extremity & humerus procedures except hip, foot, femur With major complications With complications No complications Hip & femur procedures except major joint replacement Without major complications With complications With major complications Pathological fractures & muscle tissue malignant wiht complications Childbirth and newborns Baby's hospital stay Full-term infant Normal With complications Premature birth Extreme low birth weight With major complications Without major complications Mother's hospital stay Vaginal delivery With complications Without complications With surgical procedure and sterilization With other surgical procedure Cesarean section With complications Without complications Heart/cardiovascular Insertion of cardiac catheter With bypass With major heart disease diagnosis Without major heart disease diagnosis With complications With heart valve procedure Bypass surgeries With insertion of cardiac catheter With major heart diagnosis Without major heart diagnosis Without insertion of catheter With angioplasty With major heart diagnosis Without complications Without major heart diagnosis complications Stomach/digestive Esophagitis and gastrointestinal disorders With complications Without complications Small and large bowel procedures Major procedures With major complications Without major complications Minor procedures With major complications Without major complications Rehabilitation Psychiatric Severe adjustment or social disorder Personality disorders Nervous diseases other than depression Severe psychological disorders, including schizophrenia Mental retardation Childhood mental disorders Other mental disorders Depression Surgeries related to diagnosis of mental illness

St: NC   DRG:392 - Esophagitis, gastroent & misc digest disorders w/o MCC You pay: Healthgram pays: $250 $ 6,298   Healthgram Pays   6,298   You Pay   250   Healthgram Pays   6,298

Hospitalizations require a per-admission copay of $250.  The amounts are for North Carolina hospitals only.  Payments may vary based on geographic area.  See Advanced Search for specific reimbursement rates.