|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
|
Facility
|
IP
|
$126,135.78
|
|
|
Service Code
|
MSDRG 269
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$126,135.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$126,135.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$83,939.48
|
| Rate for Payer: EPIC Health Plan Senior |
$62,177.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62,177.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62,177.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83,317.70
|
| Rate for Payer: Multiplan WC |
$77,727.93
|
| Rate for Payer: Prime Health Services WC |
$76,934.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$79,046.00
|
| Rate for Payer: United Healthcare All Other HMO |
$69,501.00
|
| Rate for Payer: United Healthcare HMO Rider |
$52,792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48,365.00
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH CC
|
Facility
|
IP
|
$46,345.76
|
|
|
Service Code
|
MSDRG 398
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$46,345.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,874.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,345.76
|
| Rate for Payer: EPIC Health Plan Senior |
$34,330.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,330.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,330.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,002.45
|
| Rate for Payer: Multiplan WC |
$28,268.78
|
| Rate for Payer: Prime Health Services WC |
$27,980.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC
|
Facility
|
IP
|
$75,116.98
|
|
|
Service Code
|
MSDRG 397
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$75,116.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$75,116.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,042.78
|
| Rate for Payer: EPIC Health Plan Senior |
$44,476.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,476.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,476.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,598.01
|
| Rate for Payer: Multiplan WC |
$46,288.91
|
| Rate for Payer: Prime Health Services WC |
$45,816.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,816.37
|
|
|
Service Code
|
MSDRG 399
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$40,816.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,069.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,816.37
|
| Rate for Payer: EPIC Health Plan Senior |
$30,234.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,234.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,234.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,514.03
|
| Rate for Payer: Multiplan WC |
$20,994.22
|
| Rate for Payer: Prime Health Services WC |
$20,779.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: ARTHROSCOPY
|
Facility
|
IP
|
$53,256.12
|
|
|
Service Code
|
MSDRG 509
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$53,256.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,803.36
|
| Rate for Payer: EPIC Health Plan Senior |
$36,891.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,891.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,891.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,434.45
|
| Rate for Payer: Multiplan WC |
$32,817.71
|
| Rate for Payer: Prime Health Services WC |
$32,482.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC
|
Facility
|
IP
|
$41,377.26
|
|
|
Service Code
|
MSDRG 302
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$41,377.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,266.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,377.26
|
| Rate for Payer: EPIC Health Plan Senior |
$30,649.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,649.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,649.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,070.76
|
| Rate for Payer: Multiplan WC |
$21,732.14
|
| Rate for Payer: Prime Health Services WC |
$21,510.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC
|
Facility
|
IP
|
$34,406.61
|
|
|
Service Code
|
MSDRG 303
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,406.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,384.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,406.61
|
| Rate for Payer: EPIC Health Plan Senior |
$25,486.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,486.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,486.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,151.75
|
| Rate for Payer: Multiplan WC |
$12,561.40
|
| Rate for Payer: Prime Health Services WC |
$12,433.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC
|
Facility
|
IP
|
$182,984.34
|
|
|
Service Code
|
MSDRG 016
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$182,984.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$182,984.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$130,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$110,566.81
|
| Rate for Payer: EPIC Health Plan Senior |
$81,901.34
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$90,244.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,901.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,747.80
|
| Rate for Payer: Multiplan WC |
$112,759.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$142,800.00
|
| Rate for Payer: Prime Health Services WC |
$111,608.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$182,984.34
|
|
|
Service Code
|
MSDRG 017
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$182,984.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$182,984.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$130,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$110,566.81
|
| Rate for Payer: EPIC Health Plan Senior |
$81,901.34
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$90,244.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,901.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,747.80
|
| Rate for Payer: Multiplan WC |
$112,759.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$142,800.00
|
| Rate for Payer: Prime Health Services WC |
$111,608.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
|
Facility
|
IP
|
$59,780.12
|
|
|
Service Code
|
MSDRG 519
|
| Min. Negotiated Rate |
$14,908.00 |
| Max. Negotiated Rate |
$59,780.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,780.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,859.14
|
| Rate for Payer: EPIC Health Plan Senior |
$39,154.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,154.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,154.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,467.59
|
| Rate for Payer: Multiplan WC |
$36,837.96
|
| Rate for Payer: Prime Health Services WC |
$36,462.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,257.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,273.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,908.00
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
|
Facility
|
IP
|
$108,652.54
|
|
|
Service Code
|
MSDRG 518
|
| Min. Negotiated Rate |
$14,908.00 |
| Max. Negotiated Rate |
$108,652.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$108,652.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$75,750.51
|
| Rate for Payer: EPIC Health Plan Senior |
$56,111.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$56,111.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,111.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75,189.40
|
| Rate for Payer: Multiplan WC |
$66,954.34
|
| Rate for Payer: Prime Health Services WC |
$66,271.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,257.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,273.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,908.00
|
|
|
MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$45,209.76
|
|
|
Service Code
|
MSDRG 520
|
| Min. Negotiated Rate |
$11,314.00 |
| Max. Negotiated Rate |
$45,209.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,448.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,209.76
|
| Rate for Payer: EPIC Health Plan Senior |
$33,488.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,488.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,488.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,874.87
|
| Rate for Payer: Multiplan WC |
$26,774.26
|
| Rate for Payer: Prime Health Services WC |
$26,501.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,329.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,260.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,349.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,314.00
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC
|
Facility
|
IP
|
$72,673.52
|
|
|
Service Code
|
MSDRG 095
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$72,673.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,673.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,898.29
|
| Rate for Payer: EPIC Health Plan Senior |
$43,628.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,628.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,628.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,462.00
|
| Rate for Payer: Multiplan WC |
$44,783.18
|
| Rate for Payer: Prime Health Services WC |
$44,326.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC
|
Facility
|
IP
|
$110,613.99
|
|
|
Service Code
|
MSDRG 094
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$110,613.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$110,613.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$76,669.24
|
| Rate for Payer: EPIC Health Plan Senior |
$56,792.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$56,792.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,792.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,101.32
|
| Rate for Payer: Multiplan WC |
$68,163.02
|
| Rate for Payer: Prime Health Services WC |
$67,467.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$72,673.52
|
|
|
Service Code
|
MSDRG 096
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$72,673.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,673.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,898.29
|
| Rate for Payer: EPIC Health Plan Senior |
$43,628.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,628.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,628.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,462.00
|
| Rate for Payer: Multiplan WC |
$44,783.18
|
| Rate for Payer: Prime Health Services WC |
$44,326.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: BEHAVIORAL AND DEVELOPMENTAL DISORDERS
|
Facility
|
IP
|
$54,462.69
|
|
|
Service Code
|
MSDRG 886
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$54,462.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,462.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,368.51
|
| Rate for Payer: EPIC Health Plan Senior |
$37,310.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,310.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,310.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,995.41
|
| Rate for Payer: Multiplan WC |
$33,561.23
|
| Rate for Payer: Prime Health Services WC |
$33,218.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITH MCC
|
Facility
|
IP
|
$42,787.29
|
|
|
Service Code
|
MSDRG 725
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,787.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,276.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,787.29
|
| Rate for Payer: EPIC Health Plan Senior |
$31,694.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,694.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,694.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,470.35
|
| Rate for Payer: Multiplan WC |
$23,587.21
|
| Rate for Payer: Prime Health Services WC |
$23,346.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC
|
Facility
|
IP
|
$35,428.98
|
|
|
Service Code
|
MSDRG 726
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,428.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,567.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,428.98
|
| Rate for Payer: EPIC Health Plan Senior |
$26,243.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,243.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,243.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,166.54
|
| Rate for Payer: Multiplan WC |
$13,906.47
|
| Rate for Payer: Prime Health Services WC |
$13,764.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
|
IP
|
$186,040.20
|
|
|
Service Code
|
MSDRG 461
|
| Min. Negotiated Rate |
$45,279.00 |
| Max. Negotiated Rate |
$186,040.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$186,040.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$111,998.12
|
| Rate for Payer: EPIC Health Plan Senior |
$82,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,961.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,961.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111,168.50
|
| Rate for Payer: Multiplan WC |
$114,642.48
|
| Rate for Payer: Prime Health Services WC |
$113,472.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$64,494.00
|
| Rate for Payer: United Healthcare All Other HMO |
$65,063.00
|
| Rate for Payer: United Healthcare HMO Rider |
$49,424.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45,279.00
|
|
|
MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$86,818.96
|
|
|
Service Code
|
MSDRG 462
|
| Min. Negotiated Rate |
$36,596.00 |
| Max. Negotiated Rate |
$86,818.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$86,818.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,523.87
|
| Rate for Payer: EPIC Health Plan Senior |
$48,536.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,536.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,536.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,038.51
|
| Rate for Payer: Multiplan WC |
$53,499.94
|
| Rate for Payer: Prime Health Services WC |
$52,954.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$52,127.00
|
| Rate for Payer: United Healthcare All Other HMO |
$52,587.00
|
| Rate for Payer: United Healthcare HMO Rider |
$39,944.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36,596.00
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$63,557.49
|
|
|
Service Code
|
MSDRG 409
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$63,557.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,557.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,628.43
|
| Rate for Payer: EPIC Health Plan Senior |
$40,465.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,465.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,465.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,223.77
|
| Rate for Payer: Multiplan WC |
$39,165.67
|
| Rate for Payer: Prime Health Services WC |
$38,766.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$106,145.41
|
|
|
Service Code
|
MSDRG 408
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$106,145.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$106,145.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,576.17
|
| Rate for Payer: EPIC Health Plan Senior |
$55,241.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,241.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,241.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,023.76
|
| Rate for Payer: Multiplan WC |
$65,409.37
|
| Rate for Payer: Prime Health Services WC |
$64,741.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$47,023.15
|
|
|
Service Code
|
MSDRG 410
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$47,023.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,023.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,883.91
|
| Rate for Payer: EPIC Health Plan Senior |
$34,728.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,728.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,728.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,536.62
|
| Rate for Payer: Multiplan WC |
$28,976.81
|
| Rate for Payer: Prime Health Services WC |
$28,681.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$70,897.00
|
|
|
Service Code
|
MSDRG 478
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$70,897.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70,897.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,066.19
|
| Rate for Payer: EPIC Health Plan Senior |
$43,011.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,011.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,011.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,636.07
|
| Rate for Payer: Multiplan WC |
$43,688.45
|
| Rate for Payer: Prime Health Services WC |
$43,242.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$104,256.72
|
|
|
Service Code
|
MSDRG 477
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$104,256.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,256.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,691.55
|
| Rate for Payer: EPIC Health Plan Senior |
$54,586.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,586.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,586.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,145.68
|
| Rate for Payer: Multiplan WC |
$64,245.52
|
| Rate for Payer: Prime Health Services WC |
$63,589.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
