|
MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$43,566.62
|
|
|
Service Code
|
MSDRG 419
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,566.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,944.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,566.62
|
| Rate for Payer: EPIC Health Plan Senior |
$32,271.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,271.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,271.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,243.90
|
| 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 |
$79,134.06
|
| Rate for Payer: EPIC Health Plan Senior |
$58,617.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58,617.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,617.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,547.88
|
| 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 |
$176,075.52
|
| Rate for Payer: EPIC Health Plan Senior |
$130,426.31
|
| 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 |
$130,426.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$130,426.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$174,771.26
|
| 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 |
$93,714.33
|
| Rate for Payer: EPIC Health Plan Senior |
$69,418.02
|
| 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 |
$69,418.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69,418.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93,020.15
|
| 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 |
$52,873.11
|
| Rate for Payer: EPIC Health Plan Senior |
$39,165.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,165.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,165.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,481.46
|
| 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 |
$74,848.59
|
| Rate for Payer: EPIC Health Plan Senior |
$55,443.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,443.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,443.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,294.16
|
| 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
|
$43,921.59
|
|
|
Service Code
|
MSDRG 497
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,921.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,702.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,921.59
|
| Rate for Payer: EPIC Health Plan Senior |
$32,534.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,534.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,534.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,596.24
|
| 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 |
$60,709.93
|
| Rate for Payer: EPIC Health Plan Senior |
$44,970.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,970.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,970.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,260.23
|
| 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
|
$41,340.11
|
|
|
Service Code
|
MSDRG 499
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$41,340.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,190.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,340.11
|
| Rate for Payer: EPIC Health Plan Senior |
$30,622.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,622.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,622.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,033.88
|
| 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 |
$58,950.58
|
| Rate for Payer: EPIC Health Plan Senior |
$43,667.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,667.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,667.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,513.91
|
| 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 |
$75,283.09
|
| Rate for Payer: EPIC Health Plan Senior |
$55,765.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,765.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,765.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,725.43
|
| 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 |
$51,629.21
|
| Rate for Payer: EPIC Health Plan Senior |
$38,243.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,243.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,243.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,246.77
|
| 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 |
$210,430.32
|
| Rate for Payer: EPIC Health Plan Senior |
$155,874.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$155,874.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155,874.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$208,871.58
|
| 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 |
$56,556.52
|
| Rate for Payer: EPIC Health Plan Senior |
$41,893.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,893.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,893.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,137.58
|
| 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 |
$107,532.08
|
| Rate for Payer: EPIC Health Plan Senior |
$79,653.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$79,653.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79,653.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$106,735.54
|
| 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
|
$41,097.28
|
|
|
Service Code
|
MSDRG 822
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$41,097.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,672.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,097.28
|
| Rate for Payer: EPIC Health Plan Senior |
$30,442.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,442.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,442.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,792.86
|
| 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 |
$47,122.21
|
| Rate for Payer: EPIC Health Plan Senior |
$34,905.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,905.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,905.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,773.16
|
| 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 |
$70,139.95
|
| Rate for Payer: EPIC Health Plan Senior |
$51,955.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,955.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,955.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,620.40
|
| 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 |
$56,087.91
|
| Rate for Payer: EPIC Health Plan Senior |
$41,546.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,546.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,546.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,672.44
|
| 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 |
$91,304.63
|
| Rate for Payer: EPIC Health Plan Senior |
$67,633.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67,633.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,633.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,628.30
|
| 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
|
$42,334.08
|
|
|
Service Code
|
MSDRG 825
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$42,334.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,312.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,334.08
|
| Rate for Payer: EPIC Health Plan Senior |
$31,358.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,358.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,358.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,020.50
|
| 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
|
|
|
MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC
|
Facility
|
IP
|
$39,793.75
|
|
|
Service Code
|
MSDRG 842
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,793.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,889.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,793.75
|
| Rate for Payer: EPIC Health Plan Senior |
$29,476.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,476.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,476.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,498.98
|
| Rate for Payer: Multiplan WC |
$19,651.02
|
| Rate for Payer: Prime Health Services WC |
$19,450.50
|
| 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: MAJOR BLADDER PROCEDURES WITH CC
|
Facility
|
IP
|
$85,554.78
|
|
|
Service Code
|
MSDRG 654
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$85,554.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,554.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$64,930.09
|
| Rate for Payer: EPIC Health Plan Senior |
$48,096.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,096.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,096.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,449.12
|
| Rate for Payer: Multiplan WC |
$52,720.93
|
| Rate for Payer: Prime Health Services WC |
$52,182.96
|
| 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: MAJOR BLADDER PROCEDURES WITH MCC
|
Facility
|
IP
|
$168,999.57
|
|
|
Service Code
|
MSDRG 653
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$168,999.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$168,999.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$104,014.81
|
| Rate for Payer: EPIC Health Plan Senior |
$77,048.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$77,048.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77,048.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$103,244.33
|
| Rate for Payer: Multiplan WC |
$104,141.63
|
| Rate for Payer: Prime Health Services WC |
$103,078.96
|
| 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: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$62,975.43
|
|
|
Service Code
|
MSDRG 655
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$62,975.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,975.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,354.15
|
| Rate for Payer: EPIC Health Plan Senior |
$40,262.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,262.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,262.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,951.52
|
| Rate for Payer: Multiplan WC |
$38,806.98
|
| Rate for Payer: Prime Health Services WC |
$38,410.99
|
| 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
|
|
