|
MS-DRG 42.00: DYSEQUILIBRIUM
|
Facility
|
IP
|
$35,473.02
|
|
|
Service Code
|
MSDRG 149
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,473.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,661.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,473.02
|
| Rate for Payer: EPIC Health Plan Senior |
$26,276.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,276.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,276.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,210.26
|
| Rate for Payer: Multiplan WC |
$13,964.38
|
| Rate for Payer: Prime Health Services WC |
$13,821.89
|
| 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: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC
|
Facility
|
IP
|
$42,534.54
|
|
|
Service Code
|
MSDRG 147
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,534.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,737.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,534.54
|
| Rate for Payer: EPIC Health Plan Senior |
$31,507.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,507.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,507.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,219.47
|
| Rate for Payer: Multiplan WC |
$23,254.67
|
| Rate for Payer: Prime Health Services WC |
$23,017.38
|
| 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: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC
|
Facility
|
IP
|
$69,547.94
|
|
|
Service Code
|
MSDRG 146
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$69,547.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,547.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,434.29
|
| Rate for Payer: EPIC Health Plan Senior |
$42,543.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,543.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,543.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,008.85
|
| Rate for Payer: Multiplan WC |
$42,857.12
|
| Rate for Payer: Prime Health Services WC |
$42,419.81
|
| 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: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$36,228.42
|
|
|
Service Code
|
MSDRG 148
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,228.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,274.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,228.42
|
| Rate for Payer: EPIC Health Plan Senior |
$26,835.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,835.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,835.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,960.07
|
| Rate for Payer: Multiplan WC |
$14,958.24
|
| Rate for Payer: Prime Health Services WC |
$14,805.60
|
| 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: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES
|
Facility
|
IP
|
$649,720.39
|
|
|
Service Code
|
MSDRG 003
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$649,720.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$649,720.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$329,181.38
|
| Rate for Payer: EPIC Health Plan Senior |
$243,838.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$243,838.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243,838.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$326,743.00
|
| Rate for Payer: Multiplan WC |
$400,373.44
|
| Rate for Payer: Prime Health Services WC |
$396,288.00
|
| 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: ENDOCRINE DISORDERS WITH CC
|
Facility
|
IP
|
$39,532.71
|
|
|
Service Code
|
MSDRG 644
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,532.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,328.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,532.71
|
| Rate for Payer: EPIC Health Plan Senior |
$29,283.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,283.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,283.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,239.88
|
| Rate for Payer: Multiplan WC |
$19,305.41
|
| Rate for Payer: Prime Health Services WC |
$19,108.42
|
| 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: ENDOCRINE DISORDERS WITH MCC
|
Facility
|
IP
|
$50,242.71
|
|
|
Service Code
|
MSDRG 643
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$50,242.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,242.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,391.92
|
| Rate for Payer: EPIC Health Plan Senior |
$35,845.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,845.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,845.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,033.47
|
| Rate for Payer: Multiplan WC |
$30,960.78
|
| Rate for Payer: Prime Health Services WC |
$30,644.85
|
| 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: ENDOCRINE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$35,916.06
|
|
|
Service Code
|
MSDRG 645
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,916.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,607.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,916.06
|
| Rate for Payer: EPIC Health Plan Senior |
$26,604.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,604.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,604.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,650.02
|
| Rate for Payer: Multiplan WC |
$14,547.25
|
| Rate for Payer: Prime Health Services WC |
$14,398.81
|
| 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: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$216,703.00
|
|
|
Service Code
|
MSDRG 266
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$216,703.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$181,617.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$109,926.38
|
| Rate for Payer: EPIC Health Plan Senior |
$81,426.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$81,426.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,426.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,112.11
|
| Rate for Payer: Multiplan WC |
$111,916.85
|
| Rate for Payer: Prime Health Services WC |
$110,774.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$216,703.00
|
| Rate for Payer: United Healthcare All Other HMO |
$204,544.00
|
| Rate for Payer: United Healthcare HMO Rider |
$155,367.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142,342.00
|
|
|
MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$162,712.00
|
|
|
Service Code
|
MSDRG 267
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$162,712.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$142,627.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$91,664.15
|
| Rate for Payer: EPIC Health Plan Senior |
$67,899.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67,899.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,899.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,985.16
|
| Rate for Payer: Multiplan WC |
$87,890.63
|
| Rate for Payer: Prime Health Services WC |
$86,993.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$162,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$153,580.00
|
| Rate for Payer: United Healthcare HMO Rider |
$116,659.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106,879.00
|
|
|
MS-DRG 42.00: EPISTAXIS WITH MCC
|
Facility
|
IP
|
$44,485.56
|
|
|
Service Code
|
MSDRG 150
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$44,485.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,902.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,485.56
|
| Rate for Payer: EPIC Health Plan Senior |
$32,952.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,952.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,952.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,156.04
|
| Rate for Payer: Multiplan WC |
$25,821.50
|
| Rate for Payer: Prime Health Services WC |
$25,558.02
|
| 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: EPISTAXIS WITHOUT MCC
|
Facility
|
IP
|
$35,622.11
|
|
|
Service Code
|
MSDRG 151
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,622.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,979.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,622.11
|
| Rate for Payer: EPIC Health Plan Senior |
$26,386.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,386.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,386.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,358.25
|
| Rate for Payer: Multiplan WC |
$14,160.54
|
| Rate for Payer: Prime Health Services WC |
$14,016.04
|
| 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: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC
|
Facility
|
IP
|
$43,098.26
|
|
|
Service Code
|
MSDRG 391
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$43,098.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,940.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,098.26
|
| Rate for Payer: EPIC Health Plan Senior |
$31,924.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,924.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,924.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,779.02
|
| Rate for Payer: Multiplan WC |
$23,996.33
|
| Rate for Payer: Prime Health Services WC |
$23,751.47
|
| 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: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$35,938.75
|
|
|
Service Code
|
MSDRG 392
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,938.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,655.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,938.75
|
| Rate for Payer: EPIC Health Plan Senior |
$26,621.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,621.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,621.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,672.54
|
| Rate for Payer: Multiplan WC |
$14,577.14
|
| Rate for Payer: Prime Health Services WC |
$14,428.39
|
| 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: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT
|
Facility
|
IP
|
$131,174.30
|
|
|
Service Code
|
MSDRG 933
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$131,174.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$131,174.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$86,299.48
|
| Rate for Payer: EPIC Health Plan Senior |
$63,925.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$63,925.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63,925.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,660.22
|
| Rate for Payer: Multiplan WC |
$80,832.78
|
| Rate for Payer: Prime Health Services WC |
$80,007.96
|
| 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: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT
|
Facility
|
IP
|
$719,180.40
|
|
|
Service Code
|
MSDRG 927
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$719,180.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$719,180.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$361,715.79
|
| Rate for Payer: EPIC Health Plan Senior |
$267,937.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267,937.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267,937.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$359,036.41
|
| Rate for Payer: Multiplan WC |
$443,176.39
|
| Rate for Payer: Prime Health Services WC |
$438,654.19
|
| 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: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC
|
Facility
|
IP
|
$74,222.66
|
|
|
Service Code
|
MSDRG 982
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$74,222.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$74,222.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,623.88
|
| Rate for Payer: EPIC Health Plan Senior |
$44,165.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,165.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,165.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,182.23
|
| Rate for Payer: Multiplan WC |
$45,737.81
|
| Rate for Payer: Prime Health Services WC |
$45,271.09
|
| 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: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$144,119.23
|
|
|
Service Code
|
MSDRG 981
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$144,119.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$144,119.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$92,362.76
|
| Rate for Payer: EPIC Health Plan Senior |
$68,416.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$68,416.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68,416.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91,678.59
|
| Rate for Payer: Multiplan WC |
$88,809.77
|
| Rate for Payer: Prime Health Services WC |
$87,903.54
|
| 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: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$50,573.15
|
|
|
Service Code
|
MSDRG 983
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$50,573.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,573.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,546.69
|
| Rate for Payer: EPIC Health Plan Senior |
$35,960.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,960.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,960.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,187.08
|
| Rate for Payer: Multiplan WC |
$31,164.40
|
| Rate for Payer: Prime Health Services WC |
$30,846.40
|
| 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: EXTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$48,848.17
|
|
|
Service Code
|
MSDRG 038
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$48,848.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,848.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,738.73
|
| Rate for Payer: EPIC Health Plan Senior |
$35,362.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,362.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,362.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,385.11
|
| Rate for Payer: Multiplan WC |
$30,101.43
|
| Rate for Payer: Prime Health Services WC |
$29,794.27
|
| 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: EXTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$100,676.40
|
|
|
Service Code
|
MSDRG 037
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$100,676.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$100,676.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,014.56
|
| Rate for Payer: EPIC Health Plan Senior |
$53,344.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$53,344.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,344.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,481.12
|
| Rate for Payer: Multiplan WC |
$62,039.24
|
| Rate for Payer: Prime Health Services WC |
$61,406.19
|
| 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: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$41,020.84
|
|
|
Service Code
|
MSDRG 039
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$41,020.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,505.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,020.84
|
| Rate for Payer: EPIC Health Plan Senior |
$30,385.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,385.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,385.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,716.99
|
| Rate for Payer: Multiplan WC |
$21,263.23
|
| Rate for Payer: Prime Health Services WC |
$21,046.25
|
| 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: EXTRAOCULAR PROCEDURES EXCEPT ORBIT
|
Facility
|
IP
|
$46,598.49
|
|
|
Service Code
|
MSDRG 115
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$46,598.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,413.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,598.49
|
| Rate for Payer: EPIC Health Plan Senior |
$34,517.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,517.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,517.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,253.32
|
| Rate for Payer: Multiplan WC |
$28,601.31
|
| Rate for Payer: Prime Health Services WC |
$28,309.46
|
| 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: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE
|
Facility
|
IP
|
$180,222.56
|
|
|
Service Code
|
MSDRG 790
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$180,222.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$180,222.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$109,273.20
|
| Rate for Payer: EPIC Health Plan Senior |
$80,943.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$80,943.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$80,943.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108,463.77
|
| Rate for Payer: Multiplan WC |
$111,057.51
|
| Rate for Payer: Prime Health Services WC |
$109,924.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,809.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,601.00
|
| 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: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
|
Facility
|
IP
|
$44,203.00
|
|
|
Service Code
|
MSDRG 748
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$44,203.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,299.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,203.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32,742.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,742.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,742.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,875.57
|
| Rate for Payer: Multiplan WC |
$25,449.75
|
| Rate for Payer: Prime Health Services WC |
$25,190.06
|
| 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
|
|
