|
MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION
|
Facility
|
IP
|
$187,546.90
|
|
|
Service Code
|
MSDRG 317
|
| Min. Negotiated Rate |
$83,484.33 |
| Max. Negotiated Rate |
$187,546.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$187,546.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$112,703.85
|
| Rate for Payer: EPIC Health Plan Senior |
$83,484.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$83,484.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$83,484.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111,869.00
|
| Rate for Payer: Multiplan WC |
$115,570.95
|
| Rate for Payer: Prime Health Services WC |
$114,391.65
|
|
|
MS-DRG 42.00: CONCUSSION WITH CC
|
Facility
|
IP
|
$40,082.24
|
|
|
Service Code
|
MSDRG 089
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$40,082.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,501.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,082.24
|
| Rate for Payer: EPIC Health Plan Senior |
$29,690.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,690.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,690.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,785.34
|
| Rate for Payer: Multiplan WC |
$20,028.39
|
| Rate for Payer: Prime Health Services WC |
$19,824.02
|
| 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: CONCUSSION WITH MCC
|
Facility
|
IP
|
$44,890.25
|
|
|
Service Code
|
MSDRG 088
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$44,890.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,766.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,890.25
|
| Rate for Payer: EPIC Health Plan Senior |
$33,252.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,252.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,252.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,557.73
|
| Rate for Payer: Multiplan WC |
$26,353.92
|
| Rate for Payer: Prime Health Services WC |
$26,085.01
|
| 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: CONCUSSION WITHOUT CC/MCC
|
Facility
|
IP
|
$37,032.13
|
|
|
Service Code
|
MSDRG 090
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,032.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,989.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,032.13
|
| Rate for Payer: EPIC Health Plan Senior |
$27,431.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,431.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,431.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,757.82
|
| Rate for Payer: Multiplan WC |
$16,015.61
|
| Rate for Payer: Prime Health Services WC |
$15,852.19
|
| 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: CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$41,297.74
|
|
|
Service Code
|
MSDRG 546
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$41,297.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,096.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,297.74
|
| Rate for Payer: EPIC Health Plan Senior |
$30,590.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,590.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,590.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,991.83
|
| Rate for Payer: Multiplan WC |
$21,627.52
|
| Rate for Payer: Prime Health Services WC |
$21,406.83
|
| 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: CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$76,605.50
|
|
|
Service Code
|
MSDRG 545
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$76,605.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$76,605.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,739.97
|
| Rate for Payer: EPIC Health Plan Senior |
$44,992.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,992.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,992.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,290.04
|
| Rate for Payer: Multiplan WC |
$47,206.17
|
| Rate for Payer: Prime Health Services WC |
$46,724.47
|
| 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: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$35,454.56
|
|
|
Service Code
|
MSDRG 547
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,454.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,621.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,454.56
|
| Rate for Payer: EPIC Health Plan Senior |
$26,262.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,262.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,262.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,191.94
|
| Rate for Payer: Multiplan WC |
$13,940.10
|
| Rate for Payer: Prime Health Services WC |
$13,797.85
|
| 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: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC
|
Facility
|
IP
|
$236,961.98
|
|
|
Service Code
|
MSDRG 233
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$236,961.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$236,961.98
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$135,849.39
|
| Rate for Payer: EPIC Health Plan Senior |
$100,629.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$100,629.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$100,629.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$134,843.10
|
| Rate for Payer: Multiplan WC |
$146,021.71
|
| Rate for Payer: Prime Health Services WC |
$144,531.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$143,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$106,219.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,682.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,919.00
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC
|
Facility
|
IP
|
$161,287.18
|
|
|
Service Code
|
MSDRG 234
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$161,287.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$161,287.18
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100,404.06
|
| Rate for Payer: EPIC Health Plan Senior |
$74,373.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$74,373.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74,373.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,660.33
|
| Rate for Payer: Multiplan WC |
$99,389.07
|
| Rate for Payer: Prime Health Services WC |
$98,374.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,054.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,568.00
|
| Rate for Payer: United Healthcare HMO Rider |
$74,111.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$67,897.00
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$178,385.41
|
|
|
Service Code
|
MSDRG 235
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$178,385.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$178,385.41
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$108,412.71
|
| Rate for Payer: EPIC Health Plan Senior |
$80,305.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$80,305.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$80,305.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$107,609.65
|
| Rate for Payer: Multiplan WC |
$109,925.41
|
| Rate for Payer: Prime Health Services WC |
$108,803.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$83,791.00
|
| Rate for Payer: United Healthcare All Other HMO |
$74,237.00
|
| Rate for Payer: United Healthcare HMO Rider |
$56,388.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51,660.00
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$124,662.42
|
|
|
Service Code
|
MSDRG 236
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$124,662.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124,662.42
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$83,249.38
|
| Rate for Payer: EPIC Health Plan Senior |
$61,666.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$61,666.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61,666.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82,632.72
|
| Rate for Payer: Multiplan WC |
$76,820.00
|
| Rate for Payer: Prime Health Services WC |
$76,036.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$76,448.00
|
| Rate for Payer: United Healthcare All Other HMO |
$68,582.00
|
| Rate for Payer: United Healthcare HMO Rider |
$52,096.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47,726.00
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
|
IP
|
$256,894.75
|
|
|
Service Code
|
MSDRG 231
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$256,894.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$256,894.75
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$145,185.71
|
| Rate for Payer: EPIC Health Plan Senior |
$107,544.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$107,544.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$107,544.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$144,110.26
|
| Rate for Payer: Multiplan WC |
$158,304.77
|
| Rate for Payer: Prime Health Services WC |
$156,689.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$107,429.00
|
| Rate for Payer: United Healthcare All Other HMO |
$102,631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$94,080.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86,191.00
|
|
|
MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
|
IP
|
$185,191.35
|
|
|
Service Code
|
MSDRG 232
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$185,191.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$185,191.35
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$111,600.54
|
| Rate for Payer: EPIC Health Plan Senior |
$82,667.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,667.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,667.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$110,773.87
|
| Rate for Payer: Multiplan WC |
$114,119.39
|
| Rate for Payer: Prime Health Services WC |
$112,954.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$94,061.00
|
| Rate for Payer: United Healthcare All Other HMO |
$87,101.00
|
| Rate for Payer: United Healthcare HMO Rider |
$79,841.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,147.00
|
|
|
MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$129,127.97
|
|
|
Service Code
|
MSDRG 323
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$129,127.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$129,127.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$85,340.99
|
| Rate for Payer: EPIC Health Plan Senior |
$63,215.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$63,215.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63,215.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84,708.84
|
| Rate for Payer: Multiplan WC |
$79,571.79
|
| Rate for Payer: Prime Health Services WC |
$78,759.83
|
| 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: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$96,862.65
|
|
|
Service Code
|
MSDRG 324
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$96,862.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96,862.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,228.26
|
| Rate for Payer: EPIC Health Plan Senior |
$52,020.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,020.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,020.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,708.05
|
| Rate for Payer: Multiplan WC |
$59,689.11
|
| Rate for Payer: Prime Health Services WC |
$59,080.04
|
| 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: CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$86,767.42
|
|
|
Service Code
|
MSDRG 325
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$86,767.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$86,767.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,499.73
|
| Rate for Payer: EPIC Health Plan Senior |
$48,518.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,518.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,518.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,014.55
|
| Rate for Payer: Multiplan WC |
$53,468.19
|
| Rate for Payer: Prime Health Services WC |
$52,922.60
|
| 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: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC
|
Facility
|
IP
|
$46,856.41
|
|
|
Service Code
|
MSDRG 073
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$46,856.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,856.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,805.80
|
| Rate for Payer: EPIC Health Plan Senior |
$34,670.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,670.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,670.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,459.09
|
| Rate for Payer: Multiplan WC |
$28,874.05
|
| Rate for Payer: Prime Health Services WC |
$28,579.42
|
| 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: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$39,660.50
|
|
|
Service Code
|
MSDRG 074
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,660.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,601.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,660.50
|
| Rate for Payer: EPIC Health Plan Senior |
$29,378.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,378.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,378.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,366.72
|
| Rate for Payer: Multiplan WC |
$19,473.55
|
| Rate for Payer: Prime Health Services WC |
$19,274.84
|
| 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: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$92,724.52
|
|
|
Service Code
|
MSDRG 026
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$92,724.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92,724.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,289.98
|
| Rate for Payer: EPIC Health Plan Senior |
$50,585.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,585.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,585.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,784.13
|
| Rate for Payer: Multiplan WC |
$57,139.10
|
| Rate for Payer: Prime Health Services WC |
$56,556.04
|
| 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: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$135,582.25
|
|
|
Service Code
|
MSDRG 025
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$135,582.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$135,582.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$88,364.12
|
| Rate for Payer: EPIC Health Plan Senior |
$65,454.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$65,454.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65,454.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87,709.57
|
| Rate for Payer: Multiplan WC |
$83,549.07
|
| Rate for Payer: Prime Health Services WC |
$82,696.53
|
| 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: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$74,813.82
|
|
|
Service Code
|
MSDRG 027
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$74,813.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$74,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,900.77
|
| Rate for Payer: EPIC Health Plan Senior |
$44,370.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,370.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,370.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,457.06
|
| Rate for Payer: Multiplan WC |
$46,102.09
|
| Rate for Payer: Prime Health Services WC |
$45,631.66
|
| 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: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$207,006.74
|
|
|
Service Code
|
MSDRG 955
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$207,006.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$207,006.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$121,818.65
|
| Rate for Payer: EPIC Health Plan Senior |
$90,236.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$90,236.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90,236.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$120,916.29
|
| Rate for Payer: Multiplan WC |
$127,562.57
|
| Rate for Payer: Prime Health Services WC |
$126,260.91
|
| 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: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$172,955.81
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$172,955.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$172,955.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$105,869.54
|
| Rate for Payer: EPIC Health Plan Senior |
$78,421.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$78,421.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78,421.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$105,085.32
|
| Rate for Payer: Multiplan WC |
$106,579.57
|
| Rate for Payer: Prime Health Services WC |
$105,492.02
|
| 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: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$115,252.34
|
|
|
Service Code
|
MSDRG 024
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$115,252.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$115,252.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$78,841.78
|
| Rate for Payer: EPIC Health Plan Senior |
$58,401.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58,401.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,401.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,257.77
|
| Rate for Payer: Multiplan WC |
$71,021.29
|
| Rate for Payer: Prime Health Services WC |
$70,296.58
|
| 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: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC
|
Facility
|
IP
|
$59,237.46
|
|
|
Service Code
|
MSDRG 744
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$59,237.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,237.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,604.96
|
| Rate for Payer: EPIC Health Plan Senior |
$38,966.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,966.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,966.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,215.30
|
| Rate for Payer: Multiplan WC |
$36,503.56
|
| Rate for Payer: Prime Health Services WC |
$36,131.07
|
| 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
|
|
