|
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 |
$49,801.70
|
| Rate for Payer: EPIC Health Plan Senior |
$36,890.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,890.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,890.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,432.80
|
| 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
|
$41,375.60
|
|
|
Service Code
|
MSDRG 302
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$41,375.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,266.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,375.60
|
| Rate for Payer: EPIC Health Plan Senior |
$30,648.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,648.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,648.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,069.11
|
| 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
|
$34,404.95
|
|
|
Service Code
|
MSDRG 303
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,404.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,384.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,404.95
|
| Rate for Payer: EPIC Health Plan Senior |
$25,485.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,485.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,485.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,150.10
|
| 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 |
$110,565.15
|
| Rate for Payer: EPIC Health Plan Senior |
$81,900.11
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$90,244.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,900.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,746.15
|
| 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 |
$110,565.15
|
| Rate for Payer: EPIC Health Plan Senior |
$81,900.11
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$90,244.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,900.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,746.15
|
| 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 |
$52,857.48
|
| Rate for Payer: EPIC Health Plan Senior |
$39,153.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,153.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,153.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,465.94
|
| 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 |
$75,748.85
|
| Rate for Payer: EPIC Health Plan Senior |
$56,110.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$56,110.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,110.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75,187.75
|
| 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
|
$45,208.10
|
|
|
Service Code
|
MSDRG 520
|
| Min. Negotiated Rate |
$11,314.00 |
| Max. Negotiated Rate |
$45,208.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,448.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,208.10
|
| Rate for Payer: EPIC Health Plan Senior |
$33,487.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,487.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,487.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,873.22
|
| 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 |
$58,896.63
|
| Rate for Payer: EPIC Health Plan Senior |
$43,627.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,627.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,627.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,460.35
|
| 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 |
$76,667.58
|
| Rate for Payer: EPIC Health Plan Senior |
$56,790.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$56,790.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,790.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,099.67
|
| 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 |
$58,896.63
|
| Rate for Payer: EPIC Health Plan Senior |
$43,627.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,627.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,627.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,460.35
|
| 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 |
$50,366.85
|
| Rate for Payer: EPIC Health Plan Senior |
$37,308.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,308.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,308.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,993.77
|
| 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
|
$42,785.63
|
|
|
Service Code
|
MSDRG 725
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,785.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,276.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,785.63
|
| Rate for Payer: EPIC Health Plan Senior |
$31,693.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,693.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,693.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,468.70
|
| 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
|
$35,427.32
|
|
|
Service Code
|
MSDRG 726
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,427.32 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,567.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,427.32
|
| Rate for Payer: EPIC Health Plan Senior |
$26,242.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,242.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,242.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,164.90
|
| 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 |
$111,996.46
|
| Rate for Payer: EPIC Health Plan Senior |
$82,960.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,960.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,960.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111,166.86
|
| 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 |
$65,522.21
|
| Rate for Payer: EPIC Health Plan Senior |
$48,534.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,534.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,534.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,036.86
|
| 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 |
$54,626.76
|
| Rate for Payer: EPIC Health Plan Senior |
$40,464.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,464.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,464.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,222.12
|
| 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 |
$74,574.51
|
| Rate for Payer: EPIC Health Plan Senior |
$55,240.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,240.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,240.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,022.11
|
| 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 |
$46,882.25
|
| Rate for Payer: EPIC Health Plan Senior |
$34,727.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,727.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,727.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,534.97
|
| 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 |
$58,064.53
|
| Rate for Payer: EPIC Health Plan Senior |
$43,010.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,010.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,010.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,634.42
|
| 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 |
$73,689.88
|
| Rate for Payer: EPIC Health Plan Senior |
$54,585.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,585.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,585.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,144.03
|
| 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
|
|
|
MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$53,835.15
|
|
|
Service Code
|
MSDRG 479
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$53,835.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,835.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,072.92
|
| Rate for Payer: EPIC Health Plan Senior |
$37,091.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,091.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,091.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,702.01
|
| Rate for Payer: Multiplan WC |
$33,174.53
|
| Rate for Payer: Prime Health Services WC |
$32,836.01
|
| 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: BONE DISEASES AND ARTHROPATHIES WITH MCC
|
Facility
|
IP
|
$43,401.91
|
|
|
Service Code
|
MSDRG 553
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$43,401.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,592.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,401.91
|
| Rate for Payer: EPIC Health Plan Senior |
$32,149.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,149.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,149.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,080.41
|
| Rate for Payer: Multiplan WC |
$24,397.98
|
| Rate for Payer: Prime Health Services WC |
$24,149.02
|
| 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: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC
|
Facility
|
IP
|
$36,708.13
|
|
|
Service Code
|
MSDRG 554
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,708.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,301.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,708.13
|
| Rate for Payer: EPIC Health Plan Senior |
$27,191.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,191.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,191.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,436.22
|
| Rate for Payer: Multiplan WC |
$15,591.55
|
| Rate for Payer: Prime Health Services WC |
$15,432.45
|
| 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: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$62,068.98
|
|
|
Service Code
|
MSDRG 584
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$62,068.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,068.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,929.57
|
| Rate for Payer: EPIC Health Plan Senior |
$39,947.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,947.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,947.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,530.09
|
| Rate for Payer: Multiplan WC |
$38,248.41
|
| Rate for Payer: Prime Health Services WC |
$37,858.12
|
| 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
|
|
