|
MS-DRG 42.00: MEDICAL BACK PROBLEMS WITHOUT MCC
|
Facility
|
IP
|
$59,884.00
|
|
|
Service Code
|
MSDRG 552
|
| Min. Negotiated Rate |
$13,778.00 |
| Max. Negotiated Rate |
$59,884.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,218.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,544.42
|
| Rate for Payer: EPIC Health Plan Senior |
$28,551.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,551.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,551.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,258.90
|
| Rate for Payer: Multiplan WC |
$18,005.19
|
| Rate for Payer: Prime Health Services WC |
$17,821.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$59,884.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,038.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,778.00
|
|
|
MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC
|
Facility
|
IP
|
$38,853.96
|
|
|
Service Code
|
MSDRG 760
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,853.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,879.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,853.96
|
| Rate for Payer: EPIC Health Plan Senior |
$28,780.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,780.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,780.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,566.15
|
| Rate for Payer: Multiplan WC |
$18,412.45
|
| Rate for Payer: Prime Health Services WC |
$18,224.56
|
| 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: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$33,859.93
|
|
|
Service Code
|
MSDRG 761
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$33,859.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,217.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,859.93
|
| Rate for Payer: EPIC Health Plan Senior |
$25,081.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,081.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,081.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,609.12
|
| Rate for Payer: Multiplan WC |
$11,842.17
|
| Rate for Payer: Prime Health Services WC |
$11,721.33
|
| 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: MINOR BLADDER PROCEDURES WITH CC
|
Facility
|
IP
|
$46,547.37
|
|
|
Service Code
|
MSDRG 663
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$46,547.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,304.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,547.37
|
| Rate for Payer: EPIC Health Plan Senior |
$34,479.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,479.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,479.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,202.57
|
| Rate for Payer: Multiplan WC |
$28,534.05
|
| Rate for Payer: Prime Health Services WC |
$28,242.89
|
| 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: MINOR BLADDER PROCEDURES WITH MCC
|
Facility
|
IP
|
$94,573.79
|
|
|
Service Code
|
MSDRG 662
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$94,573.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$94,573.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,156.17
|
| Rate for Payer: EPIC Health Plan Senior |
$51,226.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,226.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,226.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,643.90
|
| Rate for Payer: Multiplan WC |
$58,278.66
|
| Rate for Payer: Prime Health Services WC |
$57,683.98
|
| 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: MINOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,191.59
|
|
|
Service Code
|
MSDRG 664
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$40,191.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,735.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,191.59
|
| Rate for Payer: EPIC Health Plan Senior |
$29,771.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,771.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,893.88
|
| Rate for Payer: Multiplan WC |
$20,172.23
|
| Rate for Payer: Prime Health Services WC |
$19,966.39
|
| 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: MINOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$48,817.85
|
|
|
Service Code
|
MSDRG 606
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$48,817.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,817.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,724.53
|
| Rate for Payer: EPIC Health Plan Senior |
$35,351.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,351.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,351.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,371.01
|
| Rate for Payer: Multiplan WC |
$30,082.75
|
| Rate for Payer: Prime Health Services WC |
$29,775.78
|
| 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: MINOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$37,130.10
|
|
|
Service Code
|
MSDRG 607
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,130.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,199.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,130.10
|
| Rate for Payer: EPIC Health Plan Senior |
$27,503.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,503.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,503.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,855.07
|
| Rate for Payer: Multiplan WC |
$16,144.51
|
| Rate for Payer: Prime Health Services WC |
$15,979.77
|
| 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: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$45,997.85
|
|
|
Service Code
|
MSDRG 345
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$45,997.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,131.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,997.85
|
| Rate for Payer: EPIC Health Plan Senior |
$34,072.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,072.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,072.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,657.12
|
| Rate for Payer: Multiplan WC |
$27,811.08
|
| Rate for Payer: Prime Health Services WC |
$27,527.29
|
| 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: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$81,686.46
|
|
|
Service Code
|
MSDRG 344
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$81,686.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81,686.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,119.86
|
| Rate for Payer: EPIC Health Plan Senior |
$46,755.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$46,755.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,755.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,652.30
|
| Rate for Payer: Multiplan WC |
$50,337.18
|
| Rate for Payer: Prime Health Services WC |
$49,823.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$42,541.62
|
|
|
Service Code
|
MSDRG 346
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$42,541.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,752.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,541.62
|
| Rate for Payer: EPIC Health Plan Senior |
$31,512.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,512.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,512.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,226.50
|
| Rate for Payer: Multiplan WC |
$23,264.01
|
| Rate for Payer: Prime Health Services WC |
$23,026.63
|
| 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: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC
|
Facility
|
IP
|
$43,715.97
|
|
|
Service Code
|
MSDRG 640
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$43,715.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,259.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,715.97
|
| Rate for Payer: EPIC Health Plan Senior |
$32,382.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,382.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,382.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,392.15
|
| Rate for Payer: Multiplan WC |
$24,808.97
|
| Rate for Payer: Prime Health Services WC |
$24,555.82
|
| 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: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC
|
Facility
|
IP
|
$35,954.37
|
|
|
Service Code
|
MSDRG 641
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,954.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,688.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,954.37
|
| Rate for Payer: EPIC Health Plan Senior |
$26,632.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,632.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,632.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,688.05
|
| Rate for Payer: Multiplan WC |
$14,597.69
|
| Rate for Payer: Prime Health Services WC |
$14,448.73
|
| 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: MOUTH PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$44,718.45
|
|
|
Service Code
|
MSDRG 137
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$44,718.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,399.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,718.45
|
| Rate for Payer: EPIC Health Plan Senior |
$33,124.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,124.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,124.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,387.21
|
| Rate for Payer: Multiplan WC |
$26,127.88
|
| Rate for Payer: Prime Health Services WC |
$25,861.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: MOUTH PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$36,410.19
|
|
|
Service Code
|
MSDRG 138
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$36,410.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,662.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,410.19
|
| Rate for Payer: EPIC Health Plan Senior |
$26,970.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,970.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,970.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,140.48
|
| Rate for Payer: Multiplan WC |
$15,197.36
|
| Rate for Payer: Prime Health Services WC |
$15,042.28
|
| 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: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC
|
Facility
|
IP
|
$215,325.45
|
|
|
Service Code
|
MSDRG 427
|
| Min. Negotiated Rate |
$93,122.26 |
| Max. Negotiated Rate |
$215,325.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$215,325.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$125,715.05
|
| Rate for Payer: EPIC Health Plan Senior |
$93,122.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$93,122.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$93,122.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$124,783.83
|
| Rate for Payer: Multiplan WC |
$132,688.77
|
| Rate for Payer: Prime Health Services WC |
$131,334.80
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$317,572.23
|
|
|
Service Code
|
MSDRG 426
|
| Min. Negotiated Rate |
$128,597.36 |
| Max. Negotiated Rate |
$317,572.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$317,572.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$173,606.44
|
| Rate for Payer: EPIC Health Plan Senior |
$128,597.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$128,597.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128,597.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$172,320.46
|
| Rate for Payer: Multiplan WC |
$195,695.70
|
| Rate for Payer: Prime Health Services WC |
$193,698.81
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC
|
Facility
|
IP
|
$166,862.30
|
|
|
Service Code
|
MSDRG 428
|
| Min. Negotiated Rate |
$76,307.69 |
| Max. Negotiated Rate |
$166,862.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$166,862.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$103,015.38
|
| Rate for Payer: EPIC Health Plan Senior |
$76,307.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$76,307.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76,307.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102,252.30
|
| Rate for Payer: Multiplan WC |
$102,824.59
|
| Rate for Payer: Prime Health Services WC |
$101,775.36
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$203,259.69
|
|
|
Service Code
|
MSDRG 447
|
| Min. Negotiated Rate |
$88,935.98 |
| Max. Negotiated Rate |
$203,259.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$203,259.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$120,063.57
|
| Rate for Payer: EPIC Health Plan Senior |
$88,935.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$88,935.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$88,935.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119,174.21
|
| Rate for Payer: Multiplan WC |
$125,253.55
|
| Rate for Payer: Prime Health Services WC |
$123,975.45
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$123,795.39
|
|
|
Service Code
|
MSDRG 448
|
| Min. Negotiated Rate |
$61,365.38 |
| Max. Negotiated Rate |
$123,795.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$123,795.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$82,843.26
|
| Rate for Payer: EPIC Health Plan Senior |
$61,365.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$61,365.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61,365.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82,229.61
|
| Rate for Payer: Multiplan WC |
$76,285.72
|
| Rate for Payer: Prime Health Services WC |
$75,507.29
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC
|
Facility
|
IP
|
$42,233.49
|
|
|
Service Code
|
MSDRG 059
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,233.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,094.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,233.49
|
| Rate for Payer: EPIC Health Plan Senior |
$31,284.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,284.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,284.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,920.65
|
| Rate for Payer: Multiplan WC |
$22,858.63
|
| Rate for Payer: Prime Health Services WC |
$22,625.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC
|
Facility
|
IP
|
$55,960.30
|
|
|
Service Code
|
MSDRG 058
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$55,960.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,960.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,069.97
|
| Rate for Payer: EPIC Health Plan Senior |
$37,829.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,829.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,829.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,691.68
|
| Rate for Payer: Multiplan WC |
$34,484.09
|
| Rate for Payer: Prime Health Services WC |
$34,132.21
|
| 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: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC
|
Facility
|
IP
|
$37,530.55
|
|
|
Service Code
|
MSDRG 060
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,530.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,054.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,530.55
|
| Rate for Payer: EPIC Health Plan Senior |
$27,800.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,800.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,800.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,252.55
|
| Rate for Payer: Multiplan WC |
$16,671.33
|
| Rate for Payer: Prime Health Services WC |
$16,501.21
|
| 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: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$71,542.73
|
|
|
Service Code
|
MSDRG 827
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$71,542.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71,542.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,368.65
|
| Rate for Payer: EPIC Health Plan Senior |
$43,236.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,236.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,236.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,936.29
|
| Rate for Payer: Multiplan WC |
$44,086.36
|
| Rate for Payer: Prime Health Services WC |
$43,636.50
|
| 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: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$144,774.06
|
|
|
Service Code
|
MSDRG 826
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$144,774.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$144,774.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$92,669.47
|
| Rate for Payer: EPIC Health Plan Senior |
$68,644.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$68,644.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68,644.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91,983.03
|
| Rate for Payer: Multiplan WC |
$89,213.28
|
| Rate for Payer: Prime Health Services WC |
$88,302.94
|
| 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
|
|
