|
MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$60,180.29
|
|
|
Service Code
|
MSDRG 585
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$60,180.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,180.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,044.92
|
| Rate for Payer: EPIC Health Plan Senior |
$39,292.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,292.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,292.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,651.99
|
| Rate for Payer: Multiplan WC |
$37,084.55
|
| Rate for Payer: Prime Health Services WC |
$36,706.14
|
| 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: BRONCHITIS AND ASTHMA WITH CC/MCC
|
Facility
|
IP
|
$38,583.92
|
|
|
Service Code
|
MSDRG 202
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,583.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,306.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,583.92
|
| Rate for Payer: EPIC Health Plan Senior |
$28,580.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,580.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,580.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,298.11
|
| Rate for Payer: Multiplan WC |
$18,059.36
|
| Rate for Payer: Prime Health Services WC |
$17,875.08
|
| 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: BRONCHITIS AND ASTHMA WITHOUT CC/MCC
|
Facility
|
IP
|
$34,748.60
|
|
|
Service Code
|
MSDRG 203
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,748.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,118.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,748.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25,739.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,739.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,739.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,491.20
|
| Rate for Payer: Multiplan WC |
$13,013.50
|
| Rate for Payer: Prime Health Services WC |
$12,880.71
|
| 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: CARDIAC ARREST, UNEXPLAINED WITH CC
|
Facility
|
IP
|
$34,859.35
|
|
|
Service Code
|
MSDRG 297
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,859.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,354.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,859.35
|
| Rate for Payer: EPIC Health Plan Senior |
$25,821.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,821.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,821.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,601.13
|
| Rate for Payer: Multiplan WC |
$13,159.21
|
| Rate for Payer: Prime Health Services WC |
$13,024.94
|
| 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: CARDIAC ARREST, UNEXPLAINED WITH MCC
|
Facility
|
IP
|
$49,669.73
|
|
|
Service Code
|
MSDRG 296
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$49,669.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,669.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,121.90
|
| Rate for Payer: EPIC Health Plan Senior |
$35,645.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,645.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,645.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,765.44
|
| Rate for Payer: Multiplan WC |
$30,607.69
|
| Rate for Payer: Prime Health Services WC |
$30,295.37
|
| 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: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC
|
Facility
|
IP
|
$31,129.08
|
|
|
Service Code
|
MSDRG 298
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$31,129.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,390.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,129.08
|
| Rate for Payer: EPIC Health Plan Senior |
$23,058.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,058.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,058.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,898.50
|
| Rate for Payer: Multiplan WC |
$8,251.60
|
| Rate for Payer: Prime Health Services WC |
$8,167.40
|
| 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: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC
|
Facility
|
IP
|
$35,354.91
|
|
|
Service Code
|
MSDRG 309
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,354.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,412.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,354.91
|
| Rate for Payer: EPIC Health Plan Senior |
$26,188.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,188.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,188.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,093.02
|
| Rate for Payer: Multiplan WC |
$13,811.20
|
| Rate for Payer: Prime Health Services WC |
$13,670.27
|
| 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: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC
|
Facility
|
IP
|
$41,980.49
|
|
|
Service Code
|
MSDRG 308
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$41,980.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,558.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,980.49
|
| Rate for Payer: EPIC Health Plan Senior |
$31,096.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,096.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,096.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,669.52
|
| Rate for Payer: Multiplan WC |
$22,527.97
|
| Rate for Payer: Prime Health Services WC |
$22,298.09
|
| 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: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$32,801.81
|
|
|
Service Code
|
MSDRG 310
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$32,801.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,961.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,801.81
|
| Rate for Payer: EPIC Health Plan Senior |
$24,297.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,297.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,297.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,558.84
|
| Rate for Payer: Multiplan WC |
$10,452.28
|
| Rate for Payer: Prime Health Services WC |
$10,345.62
|
| 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: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$46,119.71
|
|
|
Service Code
|
MSDRG 306
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$46,119.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,395.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,119.71
|
| Rate for Payer: EPIC Health Plan Senior |
$34,162.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,162.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,162.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,778.08
|
| Rate for Payer: Multiplan WC |
$27,973.61
|
| Rate for Payer: Prime Health Services WC |
$27,688.17
|
| 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: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$38,011.68
|
|
|
Service Code
|
MSDRG 307
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,011.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,084.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,011.68
|
| Rate for Payer: EPIC Health Plan Senior |
$28,156.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,156.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,156.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,730.11
|
| Rate for Payer: Multiplan WC |
$17,306.50
|
| Rate for Payer: Prime Health Services WC |
$17,129.90
|
| 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: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
|
IP
|
$214,243.17
|
|
|
Service Code
|
MSDRG 275
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$214,243.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$214,243.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$125,206.45
|
| Rate for Payer: EPIC Health Plan Senior |
$92,745.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$92,745.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92,745.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$124,279.00
|
| Rate for Payer: Multiplan WC |
$132,021.84
|
| Rate for Payer: Prime Health Services WC |
$130,674.68
|
| 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: CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR
|
Facility
|
IP
|
$187,789.43
|
|
|
Service Code
|
MSDRG 276
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$187,789.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$187,789.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$112,815.79
|
| Rate for Payer: EPIC Health Plan Senior |
$83,567.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$83,567.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$83,567.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111,980.12
|
| Rate for Payer: Multiplan WC |
$115,720.40
|
| Rate for Payer: Prime Health Services WC |
$114,539.58
|
| 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: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
|
IP
|
$141,027.00
|
|
|
Service Code
|
MSDRG 277
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$141,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$141,027.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$90,912.73
|
| Rate for Payer: EPIC Health Plan Senior |
$67,342.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67,342.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,342.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,239.30
|
| Rate for Payer: Multiplan WC |
$86,904.25
|
| Rate for Payer: Prime Health Services WC |
$86,017.48
|
| 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: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$85,051.54
|
|
|
Service Code
|
MSDRG 258
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$85,051.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,051.54
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$64,694.38
|
| Rate for Payer: EPIC Health Plan Senior |
$47,921.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,921.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,921.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,215.16
|
| Rate for Payer: Multiplan WC |
$52,410.82
|
| Rate for Payer: Prime Health Services WC |
$51,876.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$38,532.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31,946.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,768.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,774.00
|
|
|
MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
|
IP
|
$53,286.43
|
|
|
Service Code
|
MSDRG 259
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$53,286.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,286.43
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,815.90
|
| Rate for Payer: EPIC Health Plan Senior |
$36,900.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,900.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,900.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,446.90
|
| Rate for Payer: Multiplan WC |
$32,836.39
|
| Rate for Payer: Prime Health Services WC |
$32,501.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$38,532.00
|
| Rate for Payer: United Healthcare All Other HMO |
$30,540.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,768.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,774.00
|
|
|
MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
|
IP
|
$57,527.64
|
|
|
Service Code
|
MSDRG 261
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$57,527.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,527.64
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,802.44
|
| Rate for Payer: EPIC Health Plan Senior |
$38,372.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,372.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,372.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,418.72
|
| Rate for Payer: Multiplan WC |
$35,449.92
|
| Rate for Payer: Prime Health Services WC |
$35,088.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$51,377.00
|
| Rate for Payer: United Healthcare All Other HMO |
$42,600.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,691.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29,035.00
|
|
|
MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$103,262.36
|
|
|
Service Code
|
MSDRG 260
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$103,262.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$103,262.36
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,224.15
|
| Rate for Payer: EPIC Health Plan Senior |
$54,240.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,240.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,240.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,681.75
|
| Rate for Payer: Multiplan WC |
$63,632.77
|
| Rate for Payer: Prime Health Services WC |
$62,983.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$51,377.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,266.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,691.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29,035.00
|
|
|
MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$51,377.00
|
|
|
Service Code
|
MSDRG 262
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$51,377.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,013.62
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,409.40
|
| Rate for Payer: EPIC Health Plan Senior |
$34,377.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,377.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,377.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,065.62
|
| Rate for Payer: Multiplan WC |
$28,354.71
|
| Rate for Payer: Prime Health Services WC |
$28,065.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$51,377.00
|
| Rate for Payer: United Healthcare All Other HMO |
$42,600.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,691.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29,035.00
|
|
|
MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$195,777.70
|
|
|
Service Code
|
MSDRG 217
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$195,777.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$195,777.70
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$116,557.41
|
| Rate for Payer: EPIC Health Plan Senior |
$86,338.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$86,338.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86,338.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$115,694.02
|
| Rate for Payer: Multiplan WC |
$120,642.96
|
| Rate for Payer: Prime Health Services WC |
$119,411.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$126,798.00
|
| Rate for Payer: United Healthcare All Other HMO |
$128,643.00
|
| Rate for Payer: United Healthcare HMO Rider |
$97,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$89,522.00
|
|
|
MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$292,582.75
|
|
|
Service Code
|
MSDRG 216
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$292,582.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$292,582.75
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$161,899.94
|
| Rate for Payer: EPIC Health Plan Senior |
$119,925.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$119,925.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$119,925.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$160,700.68
|
| Rate for Payer: Multiplan WC |
$180,296.58
|
| Rate for Payer: Prime Health Services WC |
$178,456.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$155,615.00
|
| Rate for Payer: United Healthcare All Other HMO |
$157,872.00
|
| Rate for Payer: United Healthcare HMO Rider |
$119,917.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109,864.00
|
|
|
MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$180,358.98
|
|
|
Service Code
|
MSDRG 218
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$180,358.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$180,358.98
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$109,335.43
|
| Rate for Payer: EPIC Health Plan Senior |
$80,989.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$80,989.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$80,989.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108,525.54
|
| Rate for Payer: Multiplan WC |
$111,141.57
|
| Rate for Payer: Prime Health Services WC |
$110,007.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$164,634.00
|
| Rate for Payer: United Healthcare All Other HMO |
$116,390.00
|
| Rate for Payer: United Healthcare HMO Rider |
$88,410.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$80,997.00
|
|
|
MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$160,574.76
|
|
|
Service Code
|
MSDRG 220
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$160,574.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$160,574.76
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100,068.71
|
| Rate for Payer: EPIC Health Plan Senior |
$74,124.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$74,124.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74,124.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,327.46
|
| Rate for Payer: Multiplan WC |
$98,950.06
|
| Rate for Payer: Prime Health Services WC |
$97,940.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$117,371.00
|
| Rate for Payer: United Healthcare All Other HMO |
$146,353.00
|
| Rate for Payer: United Healthcare HMO Rider |
$111,169.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101,848.00
|
|
|
MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$234,570.05
|
|
|
Service Code
|
MSDRG 219
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$234,570.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$234,570.05
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$134,727.37
|
| Rate for Payer: EPIC Health Plan Senior |
$99,798.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$99,798.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$99,798.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$133,729.39
|
| Rate for Payer: Multiplan WC |
$144,547.75
|
| Rate for Payer: Prime Health Services WC |
$143,072.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$147,690.00
|
| Rate for Payer: United Healthcare All Other HMO |
$146,353.00
|
| Rate for Payer: United Healthcare HMO Rider |
$111,169.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101,848.00
|
|
|
MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$171,252.00
|
|
|
Service Code
|
MSDRG 221
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$171,252.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$139,229.26
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$90,070.68
|
| Rate for Payer: EPIC Health Plan Senior |
$66,719.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$66,719.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66,719.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$89,403.49
|
| Rate for Payer: Multiplan WC |
$85,796.44
|
| Rate for Payer: Prime Health Services WC |
$84,920.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$171,252.00
|
| Rate for Payer: United Healthcare All Other HMO |
$146,353.00
|
| Rate for Payer: United Healthcare HMO Rider |
$111,169.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101,848.00
|
|
