|
MS-DRG 42.00: FRACTURES OF FEMUR WITH MCC
|
Facility
|
IP
|
$46,510.20
|
|
|
Service Code
|
MSDRG 533
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$46,510.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,228.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,510.20
|
| Rate for Payer: EPIC Health Plan Senior |
$34,452.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,452.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,452.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,165.68
|
| Rate for Payer: Multiplan WC |
$28,487.35
|
| Rate for Payer: Prime Health Services WC |
$28,196.66
|
| 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: FRACTURES OF FEMUR WITHOUT MCC
|
Facility
|
IP
|
$36,415.64
|
|
|
Service Code
|
MSDRG 534
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,415.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,677.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,415.64
|
| Rate for Payer: EPIC Health Plan Senior |
$26,974.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,974.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,974.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,145.90
|
| Rate for Payer: Multiplan WC |
$15,206.70
|
| Rate for Payer: Prime Health Services WC |
$15,051.53
|
| 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: FRACTURES OF HIP AND PELVIS WITH MCC
|
Facility
|
IP
|
$43,741.26
|
|
|
Service Code
|
MSDRG 535
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$43,741.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,317.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,741.26
|
| Rate for Payer: EPIC Health Plan Senior |
$32,400.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,400.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,400.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,417.25
|
| Rate for Payer: Multiplan WC |
$24,844.47
|
| Rate for Payer: Prime Health Services WC |
$24,590.96
|
| 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: FRACTURES OF HIP AND PELVIS WITHOUT MCC
|
Facility
|
IP
|
$36,371.63
|
|
|
Service Code
|
MSDRG 536
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,371.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,583.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,371.63
|
| Rate for Payer: EPIC Health Plan Senior |
$26,941.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,941.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,941.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,102.21
|
| Rate for Payer: Multiplan WC |
$15,148.79
|
| Rate for Payer: Prime Health Services WC |
$14,994.21
|
| 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: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC
|
Facility
|
IP
|
$45,638.33
|
|
|
Service Code
|
MSDRG 562
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$45,638.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,367.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,638.33
|
| Rate for Payer: EPIC Health Plan Senior |
$33,806.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,806.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,806.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,300.27
|
| Rate for Payer: Multiplan WC |
$27,340.30
|
| Rate for Payer: Prime Health Services WC |
$27,061.32
|
| 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: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC
|
Facility
|
IP
|
$37,548.79
|
|
|
Service Code
|
MSDRG 563
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,548.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,096.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,548.79
|
| Rate for Payer: EPIC Health Plan Senior |
$27,813.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,813.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,813.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,270.65
|
| Rate for Payer: Multiplan WC |
$16,697.49
|
| Rate for Payer: Prime Health Services WC |
$16,527.10
|
| 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: FULL TERM NEONATE WITH MAJOR PROBLEMS
|
Facility
|
IP
|
$126,432.88
|
|
|
Service Code
|
MSDRG 793
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$126,432.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$126,432.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$84,077.00
|
| Rate for Payer: EPIC Health Plan Senior |
$62,279.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62,279.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62,279.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83,454.21
|
| Rate for Payer: Multiplan WC |
$77,911.00
|
| Rate for Payer: Prime Health Services WC |
$77,115.99
|
| 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: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY
|
Facility
|
IP
|
$65,052.07
|
|
|
Service Code
|
MSDRG 934
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$65,052.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,052.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,326.81
|
| Rate for Payer: EPIC Health Plan Senior |
$40,982.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,982.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,982.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,916.98
|
| Rate for Payer: Multiplan WC |
$40,086.66
|
| Rate for Payer: Prime Health Services WC |
$39,677.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC
|
Facility
|
IP
|
$202,477.53
|
|
|
Service Code
|
MSDRG 928
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$202,477.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$202,477.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$119,695.55
|
| Rate for Payer: EPIC Health Plan Senior |
$88,663.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$88,663.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$88,663.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$118,808.92
|
| Rate for Payer: Multiplan WC |
$124,771.56
|
| Rate for Payer: Prime Health Services WC |
$123,498.38
|
| 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: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC
|
Facility
|
IP
|
$96,417.01
|
|
|
Service Code
|
MSDRG 929
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$96,417.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96,417.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,017.84
|
| Rate for Payer: EPIC Health Plan Senior |
$51,865.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,865.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,865.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,499.19
|
| Rate for Payer: Multiplan WC |
$59,414.50
|
| Rate for Payer: Prime Health Services WC |
$58,808.23
|
| 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: GASTROINTESTINAL HEMORRHAGE WITH CC
|
Facility
|
IP
|
$38,856.56
|
|
|
Service Code
|
MSDRG 378
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,856.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,888.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,856.56
|
| Rate for Payer: EPIC Health Plan Senior |
$28,782.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,782.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,782.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,568.74
|
| Rate for Payer: Multiplan WC |
$18,418.04
|
| Rate for Payer: Prime Health Services WC |
$18,230.10
|
| 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: GASTROINTESTINAL HEMORRHAGE WITH MCC
|
Facility
|
IP
|
$55,120.55
|
|
|
Service Code
|
MSDRG 377
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$55,120.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,120.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,674.98
|
| Rate for Payer: EPIC Health Plan Senior |
$37,537.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,537.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,537.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,299.61
|
| Rate for Payer: Multiplan WC |
$33,966.62
|
| Rate for Payer: Prime Health Services WC |
$33,620.03
|
| 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: GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC
|
Facility
|
IP
|
$33,898.01
|
|
|
Service Code
|
MSDRG 379
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$33,898.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,302.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,898.01
|
| Rate for Payer: EPIC Health Plan Senior |
$25,109.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,109.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,109.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,646.92
|
| Rate for Payer: Multiplan WC |
$11,894.49
|
| Rate for Payer: Prime Health Services WC |
$11,773.11
|
| 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: GASTROINTESTINAL OBSTRUCTION WITH CC
|
Facility
|
IP
|
$36,239.55
|
|
|
Service Code
|
MSDRG 389
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,239.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,301.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,239.55
|
| Rate for Payer: EPIC Health Plan Senior |
$26,844.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,844.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,844.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,971.11
|
| Rate for Payer: Multiplan WC |
$14,975.06
|
| Rate for Payer: Prime Health Services WC |
$14,822.25
|
| 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: GASTROINTESTINAL OBSTRUCTION WITH MCC
|
Facility
|
IP
|
$45,729.22
|
|
|
Service Code
|
MSDRG 388
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$45,729.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,561.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,729.22
|
| Rate for Payer: EPIC Health Plan Senior |
$33,873.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,873.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,873.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,390.49
|
| Rate for Payer: Multiplan WC |
$27,459.86
|
| Rate for Payer: Prime Health Services WC |
$27,179.66
|
| 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: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC
|
Facility
|
IP
|
$32,627.15
|
|
|
Service Code
|
MSDRG 390
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$32,627.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,588.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,627.15
|
| Rate for Payer: EPIC Health Plan Senior |
$24,168.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,168.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,168.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,385.47
|
| Rate for Payer: Multiplan WC |
$10,222.49
|
| Rate for Payer: Prime Health Services WC |
$10,118.18
|
| 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: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$46,236.16
|
|
|
Service Code
|
MSDRG 513
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$46,236.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,643.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,236.16
|
| Rate for Payer: EPIC Health Plan Senior |
$34,249.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,249.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,249.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,893.67
|
| Rate for Payer: Multiplan WC |
$28,126.79
|
| Rate for Payer: Prime Health Services WC |
$27,839.79
|
| 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: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$39,335.10
|
|
|
Service Code
|
MSDRG 514
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$39,335.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,910.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,335.10
|
| Rate for Payer: EPIC Health Plan Senior |
$29,137.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,137.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,137.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,043.73
|
| Rate for Payer: Multiplan WC |
$19,047.61
|
| Rate for Payer: Prime Health Services WC |
$18,853.25
|
| 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: HAND PROCEDURES FOR INJURIES
|
Facility
|
IP
|
$66,164.67
|
|
|
Service Code
|
MSDRG 906
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$66,164.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66,164.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,847.95
|
| Rate for Payer: EPIC Health Plan Senior |
$41,368.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,368.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,368.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,434.26
|
| Rate for Payer: Multiplan WC |
$40,772.27
|
| Rate for Payer: Prime Health Services WC |
$40,356.23
|
| 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: HEADACHES WITH MCC
|
Facility
|
IP
|
$41,321.64
|
|
|
Service Code
|
MSDRG 102
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$41,321.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,151.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,321.64
|
| Rate for Payer: EPIC Health Plan Senior |
$30,608.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,608.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,608.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,015.55
|
| Rate for Payer: Multiplan WC |
$21,661.15
|
| Rate for Payer: Prime Health Services WC |
$21,440.11
|
| 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: HEADACHES WITHOUT MCC
|
Facility
|
IP
|
$36,929.67
|
|
|
Service Code
|
MSDRG 103
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,929.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,774.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,929.67
|
| Rate for Payer: EPIC Health Plan Senior |
$27,355.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,355.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,355.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,656.12
|
| Rate for Payer: Multiplan WC |
$15,882.97
|
| Rate for Payer: Prime Health Services WC |
$15,720.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: HEART FAILURE AND SHOCK WITH CC
|
Facility
|
IP
|
$37,085.85
|
|
|
Service Code
|
MSDRG 292
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,085.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,108.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,085.85
|
| Rate for Payer: EPIC Health Plan Senior |
$27,471.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,471.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,471.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,811.14
|
| 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
|
$43,384.84
|
|
|
Service Code
|
MSDRG 291
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$43,384.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,556.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,384.84
|
| Rate for Payer: EPIC Health Plan Senior |
$32,136.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,136.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,136.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,063.47
|
| 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
|
$32,648.45
|
|
|
Service Code
|
MSDRG 293
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$32,648.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,634.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,648.45
|
| Rate for Payer: EPIC Health Plan Senior |
$24,184.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,184.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,184.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,406.61
|
| 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 |
$424,838.94
|
| Rate for Payer: EPIC Health Plan Senior |
$314,695.51
|
| 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 |
$314,695.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$314,695.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$421,691.98
|
| 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
|
|
