|
MS-DRG 42.00: HEART FAILURE AND SHOCK WITH CC
|
Facility
|
IP
|
$37,087.51
|
|
|
Service Code
|
MSDRG 292
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,087.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,108.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,087.51
|
| Rate for Payer: EPIC Health Plan Senior |
$27,472.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,472.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,472.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,812.79
|
| Rate for Payer: Multiplan WC |
$16,088.46
|
| Rate for Payer: Prime Health Services WC |
$15,924.30
|
| 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: HEART FAILURE AND SHOCK WITH MCC
|
Facility
|
IP
|
$43,386.50
|
|
|
Service Code
|
MSDRG 291
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$43,386.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,556.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,386.50
|
| Rate for Payer: EPIC Health Plan Senior |
$32,138.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,138.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,138.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,065.12
|
| Rate for Payer: Multiplan WC |
$24,375.56
|
| Rate for Payer: Prime Health Services WC |
$24,126.83
|
| 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: HEART FAILURE AND SHOCK WITHOUT CC/MCC
|
Facility
|
IP
|
$32,650.11
|
|
|
Service Code
|
MSDRG 293
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$32,650.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,634.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,650.11
|
| Rate for Payer: EPIC Health Plan Senior |
$24,185.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,185.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,185.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,408.26
|
| Rate for Payer: Multiplan WC |
$10,250.52
|
| Rate for Payer: Prime Health Services WC |
$10,145.92
|
| 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: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC
|
Facility
|
IP
|
$853,950.18
|
|
|
Service Code
|
MSDRG 001
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$853,950.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$272,940.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$853,950.18
|
| Rate for Payer: Blue Distinction Transplant |
$247,615.00
|
| Rate for Payer: Blue Shield of California Transplant |
$140,000.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$424,840.60
|
| Rate for Payer: EPIC Health Plan Senior |
$314,696.74
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$125,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$242,950.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$314,696.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$314,696.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$421,693.63
|
| Rate for Payer: Multiplan WC |
$526,224.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$264,401.00
|
| Rate for Payer: Prime Health Services WC |
$520,855.16
|
| 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: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$334,073.23
|
|
|
Service Code
|
MSDRG 002
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$334,073.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$272,940.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$334,073.23
|
| Rate for Payer: Blue Distinction Transplant |
$247,615.00
|
| Rate for Payer: Blue Shield of California Transplant |
$140,000.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$181,335.35
|
| Rate for Payer: EPIC Health Plan Senior |
$134,322.48
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$125,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$242,950.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134,322.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134,322.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$179,992.12
|
| Rate for Payer: Multiplan WC |
$205,864.01
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$264,401.00
|
| Rate for Payer: Prime Health Services WC |
$203,763.36
|
| 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: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
|
IP
|
$49,645.48
|
|
|
Service Code
|
MSDRG 421
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$49,645.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,645.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,112.18
|
| Rate for Payer: EPIC Health Plan Senior |
$35,638.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,638.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,638.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,755.79
|
| Rate for Payer: Multiplan WC |
$30,592.75
|
| Rate for Payer: Prime Health Services WC |
$30,280.58
|
| 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: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$107,000.32
|
|
|
Service Code
|
MSDRG 420
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$107,000.32 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107,000.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,976.61
|
| Rate for Payer: EPIC Health Plan Senior |
$55,538.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,538.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,538.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,421.23
|
| Rate for Payer: Multiplan WC |
$65,936.19
|
| Rate for Payer: Prime Health Services WC |
$65,263.38
|
| 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: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$45,723.78
|
|
|
Service Code
|
MSDRG 422
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$45,723.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,546.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,723.78
|
| Rate for Payer: EPIC Health Plan Senior |
$33,869.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,869.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,869.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,385.09
|
| Rate for Payer: Multiplan WC |
$27,450.53
|
| Rate for Payer: Prime Health Services WC |
$27,170.42
|
| 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: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC
|
Facility
|
IP
|
$51,570.55
|
|
|
Service Code
|
MSDRG 354
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$51,570.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,570.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,013.86
|
| Rate for Payer: EPIC Health Plan Senior |
$36,306.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,306.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,306.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,650.79
|
| Rate for Payer: Multiplan WC |
$31,779.02
|
| Rate for Payer: Prime Health Services WC |
$31,454.74
|
| 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: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC
|
Facility
|
IP
|
$88,916.83
|
|
|
Service Code
|
MSDRG 353
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$88,916.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$88,916.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,506.49
|
| Rate for Payer: EPIC Health Plan Senior |
$49,264.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,264.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,264.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,013.85
|
| Rate for Payer: Multiplan WC |
$54,792.70
|
| Rate for Payer: Prime Health Services WC |
$54,233.59
|
| 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: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC
|
Facility
|
IP
|
$43,789.79
|
|
|
Service Code
|
MSDRG 355
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,789.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,417.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,789.79
|
| Rate for Payer: EPIC Health Plan Senior |
$32,436.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,436.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,436.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,465.42
|
| Rate for Payer: Multiplan WC |
$24,906.11
|
| Rate for Payer: Prime Health Services WC |
$24,651.97
|
| 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: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$74,534.00
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$21,830.00 |
| Max. Negotiated Rate |
$74,534.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,902.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,321.71
|
| Rate for Payer: EPIC Health Plan Senior |
$40,238.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,238.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,238.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,919.32
|
| Rate for Payer: Multiplan WC |
$38,762.15
|
| Rate for Payer: Prime Health Services WC |
$38,366.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$74,534.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31,364.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,828.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,830.00
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
|
IP
|
$89,159.36
|
|
|
Service Code
|
MSDRG 480
|
| Min. Negotiated Rate |
$24,564.00 |
| Max. Negotiated Rate |
$89,159.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,159.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,620.10
|
| Rate for Payer: EPIC Health Plan Senior |
$49,348.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,348.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,348.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,126.61
|
| Rate for Payer: Multiplan WC |
$54,942.15
|
| Rate for Payer: Prime Health Services WC |
$54,381.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,679.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40,772.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,970.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,371.00
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
|
IP
|
$60,760.00
|
|
|
Service Code
|
MSDRG 482
|
| Min. Negotiated Rate |
$18,472.00 |
| Max. Negotiated Rate |
$60,760.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,093.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,385.16
|
| Rate for Payer: EPIC Health Plan Senior |
$35,100.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,100.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,100.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,034.16
|
| Rate for Payer: Multiplan WC |
$29,636.26
|
| Rate for Payer: Prime Health Services WC |
$29,333.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,760.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,545.00
|
| Rate for Payer: United Healthcare HMO Rider |
$20,163.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18,472.00
|
|
|
MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
|
IP
|
$88,362.05
|
|
|
Service Code
|
MSDRG 521
|
| Min. Negotiated Rate |
$49,071.59 |
| Max. Negotiated Rate |
$88,362.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$88,362.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,246.65
|
| Rate for Payer: EPIC Health Plan Senior |
$49,071.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,071.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,071.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,755.93
|
| Rate for Payer: Multiplan WC |
$54,450.84
|
| Rate for Payer: Prime Health Services WC |
$53,895.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$59,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$57,548.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,441.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,540.00
|
|
|
MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
|
IP
|
$75,160.00
|
|
|
Service Code
|
MSDRG 522
|
| Min. Negotiated Rate |
$32,854.00 |
| Max. Negotiated Rate |
$75,160.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,909.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,793.14
|
| Rate for Payer: EPIC Health Plan Senior |
$40,587.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,587.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,587.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,387.26
|
| Rate for Payer: Multiplan WC |
$39,382.37
|
| Rate for Payer: Prime Health Services WC |
$38,980.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$75,160.00
|
| Rate for Payer: United Healthcare All Other HMO |
$47,209.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,860.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,854.00
|
|
|
MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$191,727.48
|
|
|
Service Code
|
MSDRG 969
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$191,727.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$191,727.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$114,661.99
|
| Rate for Payer: EPIC Health Plan Senior |
$84,934.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$84,934.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84,934.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$113,812.65
|
| Rate for Payer: Multiplan WC |
$118,147.11
|
| Rate for Payer: Prime Health Services WC |
$116,941.53
|
| 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: HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$80,437.44
|
|
|
Service Code
|
MSDRG 970
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$80,437.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$80,437.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,534.83
|
| Rate for Payer: EPIC Health Plan Senior |
$46,322.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$46,322.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,322.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,071.61
|
| Rate for Payer: Multiplan WC |
$49,567.50
|
| Rate for Payer: Prime Health Services WC |
$49,061.71
|
| 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: HIV WITH MAJOR RELATED CONDITION WITH CC
|
Facility
|
IP
|
$45,042.20
|
|
|
Service Code
|
MSDRG 975
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$45,042.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,091.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,042.20
|
| Rate for Payer: EPIC Health Plan Senior |
$33,364.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,364.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,364.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,708.55
|
| Rate for Payer: Multiplan WC |
$26,553.82
|
| Rate for Payer: Prime Health Services WC |
$26,282.86
|
| 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: HIV WITH MAJOR RELATED CONDITION WITH MCC
|
Facility
|
IP
|
$90,529.64
|
|
|
Service Code
|
MSDRG 974
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$90,529.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,529.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,261.91
|
| Rate for Payer: EPIC Health Plan Senior |
$49,823.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,823.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,823.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,763.68
|
| Rate for Payer: Multiplan WC |
$55,786.56
|
| Rate for Payer: Prime Health Services WC |
$55,217.31
|
| 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: HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC
|
Facility
|
IP
|
$39,101.04
|
|
|
Service Code
|
MSDRG 976
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,101.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,406.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,101.04
|
| Rate for Payer: EPIC Health Plan Senior |
$28,963.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,963.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,963.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,811.40
|
| Rate for Payer: Multiplan WC |
$18,737.50
|
| Rate for Payer: Prime Health Services WC |
$18,546.30
|
| 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: HIV WITH OR WITHOUT OTHER RELATED CONDITION
|
Facility
|
IP
|
$45,333.30
|
|
|
Service Code
|
MSDRG 977
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$45,333.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,712.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,333.30
|
| Rate for Payer: EPIC Health Plan Senior |
$33,580.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,580.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,580.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,997.49
|
| Rate for Payer: Multiplan WC |
$26,936.79
|
| Rate for Payer: Prime Health Services WC |
$26,661.92
|
| 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: HYPERTENSION WITH MCC
|
Facility
|
IP
|
$41,540.55
|
|
|
Service Code
|
MSDRG 304
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$41,540.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,615.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,540.55
|
| Rate for Payer: EPIC Health Plan Senior |
$30,770.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,770.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,770.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,232.85
|
| Rate for Payer: Multiplan WC |
$21,946.97
|
| Rate for Payer: Prime Health Services WC |
$21,723.02
|
| 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: HYPERTENSION WITHOUT MCC
|
Facility
|
IP
|
$35,518.45
|
|
|
Service Code
|
MSDRG 305
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,518.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,758.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,518.45
|
| Rate for Payer: EPIC Health Plan Senior |
$26,309.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,309.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,309.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,255.35
|
| Rate for Payer: Multiplan WC |
$14,024.16
|
| Rate for Payer: Prime Health Services WC |
$13,881.06
|
| 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: HYPERTENSIVE ENCEPHALOPATHY WITH CC
|
Facility
|
IP
|
$39,028.61
|
|
|
Service Code
|
MSDRG 078
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,028.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,252.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,028.61
|
| Rate for Payer: EPIC Health Plan Senior |
$28,910.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,910.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,910.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,739.51
|
| Rate for Payer: Multiplan WC |
$18,642.23
|
| Rate for Payer: Prime Health Services WC |
$18,452.00
|
| 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
|
|
