|
MS-DRG 42.00: NORMAL NEWBORN
|
Facility
|
IP
|
$27,695.82
|
|
|
Service Code
|
MSDRG 795
|
| Min. Negotiated Rate |
$1,053.00 |
| Max. Negotiated Rate |
$27,695.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,057.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,695.82
|
| Rate for Payer: EPIC Health Plan Senior |
$20,515.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,515.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,515.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,490.66
|
| Rate for Payer: Multiplan WC |
$3,732.56
|
| Rate for Payer: Prime Health Services WC |
$3,694.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,650.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,342.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,053.00
|
|
|
MS-DRG 42.00: ORBITAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$68,411.09
|
|
|
Service Code
|
MSDRG 113
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$68,411.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,411.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,901.81
|
| Rate for Payer: EPIC Health Plan Senior |
$42,149.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,149.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,149.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,480.32
|
| Rate for Payer: Multiplan WC |
$42,156.57
|
| Rate for Payer: Prime Health Services WC |
$41,726.40
|
| 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: ORBITAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$41,644.21
|
|
|
Service Code
|
MSDRG 114
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$41,644.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,836.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,644.21
|
| Rate for Payer: EPIC Health Plan Senior |
$30,847.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,847.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,847.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,335.73
|
| Rate for Payer: Multiplan WC |
$22,083.35
|
| Rate for Payer: Prime Health Services WC |
$21,858.01
|
| 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: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY
|
Facility
|
IP
|
$50,633.78
|
|
|
Service Code
|
MSDRG 884
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$50,633.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,633.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,575.09
|
| Rate for Payer: EPIC Health Plan Senior |
$35,981.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,981.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,981.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,215.28
|
| Rate for Payer: Multiplan WC |
$31,201.76
|
| Rate for Payer: Prime Health Services WC |
$30,883.37
|
| 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: O.R. PROCEDURES FOR OBESITY WITH CC
|
Facility
|
IP
|
$48,414.65
|
|
|
Service Code
|
MSDRG 620
|
| Min. Negotiated Rate |
$12,166.00 |
| Max. Negotiated Rate |
$48,414.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,414.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,535.66
|
| Rate for Payer: EPIC Health Plan Senior |
$35,211.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,211.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,211.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,183.54
|
| Rate for Payer: Multiplan WC |
$29,834.28
|
| Rate for Payer: Prime Health Services WC |
$29,529.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,337.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,283.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,912.00
|
|
|
MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH MCC
|
Facility
|
IP
|
$82,656.57
|
|
|
Service Code
|
MSDRG 619
|
| Min. Negotiated Rate |
$12,166.00 |
| Max. Negotiated Rate |
$82,656.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,656.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,574.24
|
| Rate for Payer: EPIC Health Plan Senior |
$47,092.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,092.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,092.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,103.32
|
| Rate for Payer: Multiplan WC |
$50,934.98
|
| Rate for Payer: Prime Health Services WC |
$50,415.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,337.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,283.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,912.00
|
|
|
MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC
|
Facility
|
IP
|
$45,615.87
|
|
|
Service Code
|
MSDRG 621
|
| Min. Negotiated Rate |
$12,166.00 |
| Max. Negotiated Rate |
$45,615.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,315.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,615.87
|
| Rate for Payer: EPIC Health Plan Senior |
$33,789.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,789.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,789.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,277.97
|
| Rate for Payer: Multiplan WC |
$27,308.55
|
| Rate for Payer: Prime Health Services WC |
$27,029.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,337.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,283.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,912.00
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC
|
Facility
|
IP
|
$64,009.20
|
|
|
Service Code
|
MSDRG 940
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$64,009.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,009.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,840.01
|
| Rate for Payer: EPIC Health Plan Senior |
$40,622.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,622.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,622.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,433.79
|
| Rate for Payer: Multiplan WC |
$39,444.02
|
| Rate for Payer: Prime Health Services WC |
$39,041.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC
|
Facility
|
IP
|
$96,222.98
|
|
|
Service Code
|
MSDRG 939
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$96,222.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96,222.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,928.62
|
| Rate for Payer: EPIC Health Plan Senior |
$51,798.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,798.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,798.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,410.63
|
| Rate for Payer: Multiplan WC |
$59,294.94
|
| Rate for Payer: Prime Health Services WC |
$58,689.89
|
| 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: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC
|
Facility
|
IP
|
$59,246.56
|
|
|
Service Code
|
MSDRG 941
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$59,246.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,246.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,609.23
|
| Rate for Payer: EPIC Health Plan Senior |
$38,969.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,969.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,969.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,219.53
|
| Rate for Payer: Multiplan WC |
$36,509.17
|
| Rate for Payer: Prime Health Services WC |
$36,136.62
|
| 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: O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS
|
Facility
|
IP
|
$119,129.75
|
|
|
Service Code
|
MSDRG 876
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$119,129.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$119,129.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,657.94
|
| Rate for Payer: EPIC Health Plan Senior |
$59,746.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,746.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,746.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80,060.47
|
| Rate for Payer: Multiplan WC |
$73,410.64
|
| Rate for Payer: Prime Health Services WC |
$72,661.56
|
| 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: OSTEOMYELITIS WITH CC
|
Facility
|
IP
|
$43,234.59
|
|
|
Service Code
|
MSDRG 540
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$43,234.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,231.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,234.59
|
| Rate for Payer: EPIC Health Plan Senior |
$32,025.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,025.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,025.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,914.33
|
| Rate for Payer: Multiplan WC |
$24,175.67
|
| Rate for Payer: Prime Health Services WC |
$23,928.98
|
| 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: OSTEOMYELITIS WITH MCC
|
Facility
|
IP
|
$61,311.08
|
|
|
Service Code
|
MSDRG 539
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$61,311.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61,311.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,576.22
|
| Rate for Payer: EPIC Health Plan Senior |
$39,686.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,686.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,686.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,179.36
|
| Rate for Payer: Multiplan WC |
$37,781.37
|
| Rate for Payer: Prime Health Services WC |
$37,395.85
|
| 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: OSTEOMYELITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$37,282.06
|
|
|
Service Code
|
MSDRG 541
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,282.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,523.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,282.06
|
| Rate for Payer: EPIC Health Plan Senior |
$27,616.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,616.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,616.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,005.90
|
| Rate for Payer: Multiplan WC |
$16,344.40
|
| Rate for Payer: Prime Health Services WC |
$16,177.62
|
| 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: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$43,147.94
|
|
|
Service Code
|
MSDRG 818
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,147.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,047.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,147.94
|
| Rate for Payer: EPIC Health Plan Senior |
$31,961.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,961.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,961.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,828.33
|
| Rate for Payer: Multiplan WC |
$24,061.71
|
| Rate for Payer: Prime Health Services WC |
$23,816.19
|
| 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: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$76,854.09
|
|
|
Service Code
|
MSDRG 817
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$76,854.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$76,854.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,856.43
|
| Rate for Payer: EPIC Health Plan Senior |
$45,078.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,078.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,078.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,405.65
|
| Rate for Payer: Multiplan WC |
$47,359.35
|
| Rate for Payer: Prime Health Services WC |
$46,876.09
|
| 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: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$36,452.79
|
|
|
Service Code
|
MSDRG 819
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$36,452.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,753.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,452.79
|
| Rate for Payer: EPIC Health Plan Senior |
$27,002.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,002.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,002.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,182.77
|
| Rate for Payer: Multiplan WC |
$15,253.41
|
| Rate for Payer: Prime Health Services WC |
$15,097.76
|
| 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: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$35,471.59
|
|
|
Service Code
|
MSDRG 832
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,471.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,658.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,471.59
|
| Rate for Payer: EPIC Health Plan Senior |
$26,275.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,275.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,275.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,208.83
|
| Rate for Payer: Multiplan WC |
$13,962.52
|
| Rate for Payer: Prime Health Services WC |
$13,820.05
|
| 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: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$41,202.59
|
|
|
Service Code
|
MSDRG 831
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$41,202.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,893.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,202.59
|
| Rate for Payer: EPIC Health Plan Senior |
$30,520.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,520.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,520.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,897.39
|
| Rate for Payer: Multiplan WC |
$21,502.36
|
| Rate for Payer: Prime Health Services WC |
$21,282.94
|
| 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: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$32,239.74
|
|
|
Service Code
|
MSDRG 833
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$32,239.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,758.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,239.74
|
| Rate for Payer: EPIC Health Plan Senior |
$23,881.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,881.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,881.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,000.93
|
| Rate for Payer: Multiplan WC |
$9,710.62
|
| Rate for Payer: Prime Health Services WC |
$9,611.54
|
| 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: OTHER CARDIOTHORACIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$151,073.72
|
|
|
Service Code
|
MSDRG 228
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$151,073.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$151,073.72
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$95,620.18
|
| Rate for Payer: EPIC Health Plan Senior |
$70,829.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$70,829.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$70,829.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$94,911.88
|
| Rate for Payer: Multiplan WC |
$93,095.29
|
| Rate for Payer: Prime Health Services WC |
$92,145.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$120,397.00
|
| Rate for Payer: United Healthcare All Other HMO |
$83,596.00
|
| Rate for Payer: United Healthcare HMO Rider |
$86,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$79,589.00
|
|
|
MS-DRG 42.00: OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$94,170.59
|
|
|
Service Code
|
MSDRG 229
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$94,170.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$94,170.59
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,967.30
|
| Rate for Payer: EPIC Health Plan Senior |
$51,086.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,086.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,086.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,456.43
|
| Rate for Payer: Multiplan WC |
$58,030.20
|
| Rate for Payer: Prime Health Services WC |
$57,438.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$71,243.00
|
| Rate for Payer: United Healthcare All Other HMO |
$65,974.00
|
| Rate for Payer: United Healthcare HMO Rider |
$68,556.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62,809.00
|
|
|
MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC
|
Facility
|
IP
|
$38,523.13
|
|
|
Service Code
|
MSDRG 315
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,523.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,173.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,523.13
|
| Rate for Payer: EPIC Health Plan Senior |
$28,535.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,535.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,535.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,237.77
|
| Rate for Payer: Multiplan WC |
$17,977.16
|
| Rate for Payer: Prime Health Services WC |
$17,793.72
|
| 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: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$65,285.51
|
|
|
Service Code
|
MSDRG 314
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$65,285.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,285.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,437.82
|
| Rate for Payer: EPIC Health Plan Senior |
$41,065.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,065.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,065.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,027.17
|
| Rate for Payer: Multiplan WC |
$40,230.51
|
| Rate for Payer: Prime Health Services WC |
$39,819.99
|
| 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: OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$34,552.89
|
|
|
Service Code
|
MSDRG 316
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,552.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,696.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,552.89
|
| Rate for Payer: EPIC Health Plan Senior |
$25,594.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,594.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,594.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,296.94
|
| Rate for Payer: Multiplan WC |
$12,753.83
|
| Rate for Payer: Prime Health Services WC |
$12,623.69
|
| 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
|
|
