|
MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC
|
Facility
|
IP
|
$97,596.30
|
|
|
Service Code
|
MSDRG 485
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$97,596.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97,596.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,571.88
|
| Rate for Payer: EPIC Health Plan Senior |
$52,275.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,275.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,275.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70,049.13
|
| Rate for Payer: Multiplan WC |
$60,141.21
|
| Rate for Payer: Prime Health Services WC |
$59,527.52
|
| 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: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$47,905.34
|
|
|
Service Code
|
MSDRG 487
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$47,905.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,905.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,297.11
|
| Rate for Payer: EPIC Health Plan Senior |
$35,034.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,034.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,034.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,946.77
|
| Rate for Payer: Multiplan WC |
$29,520.43
|
| Rate for Payer: Prime Health Services WC |
$29,219.20
|
| 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: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$50,276.05
|
|
|
Service Code
|
MSDRG 418
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$50,276.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,276.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,407.53
|
| Rate for Payer: EPIC Health Plan Senior |
$35,857.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,857.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,857.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,048.96
|
| Rate for Payer: Multiplan WC |
$30,981.32
|
| Rate for Payer: Prime Health Services WC |
$30,665.18
|
| 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: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$72,045.97
|
|
|
Service Code
|
MSDRG 417
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$72,045.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,045.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,604.35
|
| Rate for Payer: EPIC Health Plan Senior |
$43,410.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,410.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,410.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,170.24
|
| Rate for Payer: Multiplan WC |
$44,396.48
|
| Rate for Payer: Prime Health Services WC |
$43,943.45
|
| 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: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$43,568.28
|
|
|
Service Code
|
MSDRG 419
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,568.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,944.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,568.28
|
| Rate for Payer: EPIC Health Plan Senior |
$32,272.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,272.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,272.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,245.55
|
| Rate for Payer: Multiplan WC |
$24,614.68
|
| Rate for Payer: Prime Health Services WC |
$24,363.51
|
| 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: LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$115,879.88
|
|
|
Service Code
|
MSDRG 956
|
| Min. Negotiated Rate |
$25,608.00 |
| Max. Negotiated Rate |
$115,879.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$115,879.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$79,135.72
|
| Rate for Payer: EPIC Health Plan Senior |
$58,619.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58,619.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,619.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,549.53
|
| Rate for Payer: Multiplan WC |
$71,407.99
|
| Rate for Payer: Prime Health Services WC |
$70,679.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$91,491.00
|
| Rate for Payer: United Healthcare All Other HMO |
$59,139.00
|
| Rate for Payer: United Healthcare HMO Rider |
$44,920.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41,155.00
|
|
|
MS-DRG 42.00: LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT
|
Facility
|
IP
|
$322,847.21
|
|
|
Service Code
|
MSDRG 005
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$322,847.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$243,955.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$322,847.21
|
| Rate for Payer: Blue Distinction Transplant |
$211,721.00
|
| Rate for Payer: Blue Shield of California Transplant |
$160,000.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$176,077.18
|
| Rate for Payer: EPIC Health Plan Senior |
$130,427.54
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$135,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$129,950.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130,427.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$130,427.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$174,772.90
|
| Rate for Payer: Multiplan WC |
$198,946.27
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$226,196.00
|
| Rate for Payer: Prime Health Services WC |
$196,916.21
|
| 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: LIVER TRANSPLANT WITHOUT MCC
|
Facility
|
IP
|
$243,955.00
|
|
|
Service Code
|
MSDRG 006
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$243,955.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$147,008.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243,955.00
|
| Rate for Payer: Blue Distinction Transplant |
$211,721.00
|
| Rate for Payer: Blue Shield of California Transplant |
$160,000.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$93,715.99
|
| Rate for Payer: EPIC Health Plan Senior |
$69,419.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$135,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$129,950.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$69,419.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69,419.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93,021.79
|
| Rate for Payer: Multiplan WC |
$90,590.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$226,196.00
|
| Rate for Payer: Prime Health Services WC |
$89,665.71
|
| 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: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC
|
Facility
|
IP
|
$59,813.47
|
|
|
Service Code
|
MSDRG 496
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$59,813.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,813.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,874.78
|
| Rate for Payer: EPIC Health Plan Senior |
$39,166.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,166.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,166.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,483.11
|
| Rate for Payer: Multiplan WC |
$36,858.51
|
| Rate for Payer: Prime Health Services WC |
$36,482.40
|
| 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: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC
|
Facility
|
IP
|
$106,730.51
|
|
|
Service Code
|
MSDRG 495
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$106,730.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$106,730.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,850.25
|
| Rate for Payer: EPIC Health Plan Senior |
$55,444.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,444.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,444.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,295.80
|
| Rate for Payer: Multiplan WC |
$65,769.93
|
| Rate for Payer: Prime Health Services WC |
$65,098.80
|
| 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: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$43,923.25
|
|
|
Service Code
|
MSDRG 497
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,923.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,702.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,923.25
|
| Rate for Payer: EPIC Health Plan Senior |
$32,535.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,535.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,535.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,597.89
|
| Rate for Payer: Multiplan WC |
$25,081.72
|
| Rate for Payer: Prime Health Services WC |
$24,825.78
|
| 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: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC
|
Facility
|
IP
|
$76,544.87
|
|
|
Service Code
|
MSDRG 498
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$76,544.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$76,544.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,711.59
|
| Rate for Payer: EPIC Health Plan Senior |
$44,971.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,971.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,971.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,261.88
|
| Rate for Payer: Multiplan WC |
$47,168.80
|
| Rate for Payer: Prime Health Services WC |
$46,687.49
|
| 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: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$41,341.77
|
|
|
Service Code
|
MSDRG 499
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$41,341.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,190.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,341.77
|
| Rate for Payer: EPIC Health Plan Senior |
$30,623.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,623.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,623.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,035.53
|
| Rate for Payer: Multiplan WC |
$21,685.43
|
| Rate for Payer: Prime Health Services WC |
$21,464.15
|
| 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: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC
|
Facility
|
IP
|
$72,788.72
|
|
|
Service Code
|
MSDRG 493
|
| Min. Negotiated Rate |
$17,710.00 |
| Max. Negotiated Rate |
$72,788.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,788.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,952.25
|
| Rate for Payer: EPIC Health Plan Senior |
$43,668.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,668.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,668.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,515.56
|
| Rate for Payer: Multiplan WC |
$44,854.17
|
| Rate for Payer: Prime Health Services WC |
$44,396.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$36,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,455.00
|
| Rate for Payer: United Healthcare HMO Rider |
$19,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,710.00
|
|
|
MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC
|
Facility
|
IP
|
$107,658.18
|
|
|
Service Code
|
MSDRG 492
|
| Min. Negotiated Rate |
$21,433.00 |
| Max. Negotiated Rate |
$107,658.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107,658.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$75,284.75
|
| Rate for Payer: EPIC Health Plan Senior |
$55,766.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,766.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,766.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,727.08
|
| Rate for Payer: Multiplan WC |
$66,341.58
|
| Rate for Payer: Prime Health Services WC |
$65,664.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$37,370.00
|
| Rate for Payer: United Healthcare All Other HMO |
$38,031.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,889.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26,467.00
|
|
|
MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$57,157.79
|
|
|
Service Code
|
MSDRG 494
|
| Min. Negotiated Rate |
$15,056.00 |
| Max. Negotiated Rate |
$57,157.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,157.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,630.87
|
| Rate for Payer: EPIC Health Plan Senior |
$38,245.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,245.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,245.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,248.42
|
| Rate for Payer: Multiplan WC |
$35,222.01
|
| Rate for Payer: Prime Health Services WC |
$34,862.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,464.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,638.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,434.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,056.00
|
|
|
MS-DRG 42.00: LUNG TRANSPLANT
|
Facility
|
IP
|
$396,193.74
|
|
|
Service Code
|
MSDRG 007
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$396,193.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$396,193.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$210,431.98
|
| Rate for Payer: EPIC Health Plan Senior |
$155,875.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$155,875.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155,875.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$208,873.22
|
| Rate for Payer: Multiplan WC |
$244,144.19
|
| Rate for Payer: Prime Health Services WC |
$241,652.92
|
| 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: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$67,677.44
|
|
|
Service Code
|
MSDRG 821
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$67,677.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67,677.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,558.18
|
| Rate for Payer: EPIC Health Plan Senior |
$41,894.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,894.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,894.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,139.23
|
| Rate for Payer: Multiplan WC |
$41,704.48
|
| Rate for Payer: Prime Health Services WC |
$41,278.92
|
| 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: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$176,508.85
|
|
|
Service Code
|
MSDRG 820
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$176,508.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$176,508.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$107,533.74
|
| Rate for Payer: EPIC Health Plan Senior |
$79,654.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$79,654.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79,654.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$106,737.19
|
| Rate for Payer: Multiplan WC |
$108,769.02
|
| Rate for Payer: Prime Health Services WC |
$107,659.14
|
| 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: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$41,098.94
|
|
|
Service Code
|
MSDRG 822
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$41,098.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,672.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,098.94
|
| Rate for Payer: EPIC Health Plan Senior |
$30,443.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,443.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,443.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,794.50
|
| Rate for Payer: Multiplan WC |
$21,365.98
|
| Rate for Payer: Prime Health Services WC |
$21,147.96
|
| 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: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC
|
Facility
|
IP
|
$47,535.49
|
|
|
Service Code
|
MSDRG 841
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$47,535.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,535.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,123.87
|
| Rate for Payer: EPIC Health Plan Senior |
$34,906.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,906.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,906.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,774.80
|
| Rate for Payer: Multiplan WC |
$29,292.52
|
| Rate for Payer: Prime Health Services WC |
$28,993.62
|
| 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: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC
|
Facility
|
IP
|
$96,677.72
|
|
|
Service Code
|
MSDRG 840
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$96,677.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96,677.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,141.61
|
| Rate for Payer: EPIC Health Plan Senior |
$51,956.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,956.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,956.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,622.04
|
| Rate for Payer: Multiplan WC |
$59,575.16
|
| Rate for Payer: Prime Health Services WC |
$58,967.25
|
| 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: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC
|
Facility
|
IP
|
$66,677.01
|
|
|
Service Code
|
MSDRG 824
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$66,677.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66,677.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,089.57
|
| Rate for Payer: EPIC Health Plan Senior |
$41,547.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,547.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,547.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,674.09
|
| Rate for Payer: Multiplan WC |
$41,087.99
|
| Rate for Payer: Prime Health Services WC |
$40,668.72
|
| 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: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC
|
Facility
|
IP
|
$141,863.72
|
|
|
Service Code
|
MSDRG 823
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$141,863.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$141,863.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$91,306.29
|
| Rate for Payer: EPIC Health Plan Senior |
$67,634.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67,634.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,634.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,629.95
|
| Rate for Payer: Multiplan WC |
$87,419.86
|
| Rate for Payer: Prime Health Services WC |
$86,527.82
|
| 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: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$42,335.74
|
|
|
Service Code
|
MSDRG 825
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$42,335.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,312.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,335.74
|
| Rate for Payer: EPIC Health Plan Senior |
$31,359.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,359.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,359.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,022.15
|
| Rate for Payer: Multiplan WC |
$22,993.13
|
| Rate for Payer: Prime Health Services WC |
$22,758.51
|
| 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
|
|
