|
MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$41,296.08
|
|
|
Service Code
|
MSDRG 546
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$41,296.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,096.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,296.08
|
| Rate for Payer: EPIC Health Plan Senior |
$30,589.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,589.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,589.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,990.18
|
| 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 |
$60,738.31
|
| Rate for Payer: EPIC Health Plan Senior |
$44,991.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,991.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,991.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,288.40
|
| 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
|
$35,452.90
|
|
|
Service Code
|
MSDRG 547
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,452.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,621.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,452.90
|
| Rate for Payer: EPIC Health Plan Senior |
$26,261.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,261.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,261.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,190.29
|
| 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 |
$135,847.73
|
| Rate for Payer: EPIC Health Plan Senior |
$100,627.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$100,627.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$100,627.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$134,841.45
|
| 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 |
$100,402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$74,372.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$74,372.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74,372.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,658.68
|
| 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 |
$108,411.05
|
| Rate for Payer: EPIC Health Plan Senior |
$80,304.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$80,304.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$80,304.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$107,608.00
|
| 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 |
$83,247.72
|
| Rate for Payer: EPIC Health Plan Senior |
$61,664.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$61,664.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61,664.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82,631.07
|
| 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 |
$145,184.05
|
| Rate for Payer: EPIC Health Plan Senior |
$107,543.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$107,543.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$107,543.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$144,108.61
|
| 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 |
$111,598.88
|
| Rate for Payer: EPIC Health Plan Senior |
$82,665.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,665.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,665.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$110,772.23
|
| 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 |
$85,339.33
|
| Rate for Payer: EPIC Health Plan Senior |
$63,214.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$63,214.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63,214.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84,707.19
|
| 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 |
$70,226.60
|
| Rate for Payer: EPIC Health Plan Senior |
$52,019.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,019.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,019.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,706.40
|
| 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 |
$65,498.07
|
| Rate for Payer: EPIC Health Plan Senior |
$48,517.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,517.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,517.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,012.90
|
| 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 |
$46,804.14
|
| Rate for Payer: EPIC Health Plan Senior |
$34,669.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,669.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,669.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,457.44
|
| 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
|
$39,658.84
|
|
|
Service Code
|
MSDRG 074
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,658.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,601.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,658.84
|
| Rate for Payer: EPIC Health Plan Senior |
$29,376.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,376.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,376.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,365.07
|
| 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 |
$68,288.32
|
| Rate for Payer: EPIC Health Plan Senior |
$50,583.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,583.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,583.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,782.48
|
| 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 |
$88,362.45
|
| Rate for Payer: EPIC Health Plan Senior |
$65,453.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$65,453.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65,453.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87,707.92
|
| 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 |
$59,899.11
|
| Rate for Payer: EPIC Health Plan Senior |
$44,369.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,369.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,369.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,455.41
|
| 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 |
$121,816.99
|
| Rate for Payer: EPIC Health Plan Senior |
$90,234.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$90,234.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90,234.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$120,914.65
|
| 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 |
$105,867.88
|
| Rate for Payer: EPIC Health Plan Senior |
$78,420.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$78,420.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78,420.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$105,083.67
|
| 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 |
$78,840.12
|
| Rate for Payer: EPIC Health Plan Senior |
$58,400.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58,400.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,400.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,256.12
|
| 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 |
$52,603.30
|
| Rate for Payer: EPIC Health Plan Senior |
$38,965.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,965.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,965.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,213.65
|
| 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
|
|
|
MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC
|
Facility
|
IP
|
$39,408.93
|
|
|
Service Code
|
MSDRG 745
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$39,408.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,067.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,408.93
|
| Rate for Payer: EPIC Health Plan Senior |
$29,191.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,191.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,191.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,117.01
|
| Rate for Payer: Multiplan WC |
$19,144.75
|
| Rate for Payer: Prime Health Services WC |
$18,949.40
|
| 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: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC
|
Facility
|
IP
|
$42,294.33
|
|
|
Service Code
|
MSDRG 294
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,294.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,228.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,294.33
|
| Rate for Payer: EPIC Health Plan Senior |
$31,329.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,329.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,329.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,981.03
|
| Rate for Payer: Multiplan WC |
$22,940.83
|
| Rate for Payer: Prime Health Services WC |
$22,706.74
|
| 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: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$36,072.01
|
|
|
Service Code
|
MSDRG 295
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,072.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,943.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,072.01
|
| Rate for Payer: EPIC Health Plan Senior |
$26,720.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,720.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,720.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,804.81
|
| Rate for Payer: Multiplan WC |
$14,754.62
|
| Rate for Payer: Prime Health Services WC |
$14,604.06
|
| 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: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC
|
Facility
|
IP
|
$75,914.30
|
|
|
Service Code
|
MSDRG 056
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$75,914.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$75,914.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,414.57
|
| Rate for Payer: EPIC Health Plan Senior |
$44,751.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,751.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,751.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,967.05
|
| Rate for Payer: Multiplan WC |
$46,780.23
|
| Rate for Payer: Prime Health Services WC |
$46,302.88
|
| 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
|
|
