|
MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$45,293.30
|
|
|
Service Code
|
MSDRG 581
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$45,293.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,630.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,293.30
|
| Rate for Payer: EPIC Health Plan Senior |
$33,550.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,550.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,550.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,957.79
|
| Rate for Payer: Multiplan WC |
$26,886.35
|
| Rate for Payer: Prime Health Services WC |
$26,612.00
|
| 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 VASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$77,396.75
|
|
|
Service Code
|
MSDRG 253
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$77,396.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77,396.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,108.94
|
| Rate for Payer: EPIC Health Plan Senior |
$45,265.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,265.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,265.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,656.28
|
| Rate for Payer: Multiplan WC |
$47,693.75
|
| Rate for Payer: Prime Health Services WC |
$47,207.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,936.00
|
| Rate for Payer: United Healthcare All Other HMO |
$38,236.00
|
| Rate for Payer: United Healthcare HMO Rider |
$29,046.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26,610.00
|
|
|
MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$103,996.01
|
|
|
Service Code
|
MSDRG 252
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$103,996.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$103,996.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,567.78
|
| Rate for Payer: EPIC Health Plan Senior |
$54,494.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,494.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,494.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,022.83
|
| Rate for Payer: Multiplan WC |
$64,084.86
|
| Rate for Payer: Prime Health Services WC |
$63,430.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$42,180.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41,854.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,795.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29,128.00
|
|
|
MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$56,697.00
|
|
|
Service Code
|
MSDRG 254
|
| Min. Negotiated Rate |
$19,823.00 |
| Max. Negotiated Rate |
$56,697.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,034.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,698.05
|
| Rate for Payer: EPIC Health Plan Senior |
$36,813.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,813.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,813.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,329.92
|
| Rate for Payer: Multiplan WC |
$32,681.33
|
| Rate for Payer: Prime Health Services WC |
$32,347.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,697.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,481.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,636.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,823.00
|
|
|
MS-DRG 42.00: OTITIS MEDIA AND URI WITH MCC
|
Facility
|
IP
|
$40,970.91
|
|
|
Service Code
|
MSDRG 152
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$40,970.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,402.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,970.91
|
| Rate for Payer: EPIC Health Plan Senior |
$30,348.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,348.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,348.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,667.42
|
| Rate for Payer: Multiplan WC |
$21,199.71
|
| Rate for Payer: Prime Health Services WC |
$20,983.39
|
| 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: OTITIS MEDIA AND URI WITHOUT MCC
|
Facility
|
IP
|
$34,963.00
|
|
|
Service Code
|
MSDRG 153
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,963.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,575.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,963.00
|
| Rate for Payer: EPIC Health Plan Senior |
$25,898.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,898.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,898.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,704.02
|
| Rate for Payer: Multiplan WC |
$13,295.59
|
| Rate for Payer: Prime Health Services WC |
$13,159.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$85,139.45
|
|
|
Service Code
|
MSDRG 406
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$85,139.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,139.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$64,735.55
|
| Rate for Payer: EPIC Health Plan Senior |
$47,952.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,952.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,952.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,256.03
|
| Rate for Payer: Multiplan WC |
$52,465.00
|
| Rate for Payer: Prime Health Services WC |
$51,929.64
|
| 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: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$164,576.47
|
|
|
Service Code
|
MSDRG 405
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$164,576.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$164,576.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101,943.06
|
| Rate for Payer: EPIC Health Plan Senior |
$75,513.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75,513.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75,513.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101,187.93
|
| Rate for Payer: Multiplan WC |
$101,416.01
|
| Rate for Payer: Prime Health Services WC |
$100,381.15
|
| 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: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$64,748.91
|
|
|
Service Code
|
MSDRG 407
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$64,748.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,748.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,184.83
|
| Rate for Payer: EPIC Health Plan Senior |
$40,877.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,877.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,877.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,776.05
|
| Rate for Payer: Multiplan WC |
$39,899.85
|
| Rate for Payer: Prime Health Services WC |
$39,492.71
|
| 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: PANCREAS TRANSPLANT
|
Facility
|
IP
|
$241,709.47
|
|
|
Service Code
|
MSDRG 010
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$241,709.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$129,300.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$241,709.47
|
| Rate for Payer: Blue Distinction Transplant |
$115,254.00
|
| Rate for Payer: Blue Shield of California Transplant |
$95,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$138,071.40
|
| Rate for Payer: EPIC Health Plan Senior |
$102,275.11
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$70,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$77,857.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$102,275.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$102,275.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$137,048.65
|
| Rate for Payer: Multiplan WC |
$148,947.23
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$131,771.00
|
| Rate for Payer: Prime Health Services WC |
$147,427.36
|
| 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: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
|
Facility
|
IP
|
$39,921.55
|
|
|
Service Code
|
MSDRG 543
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,921.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,162.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,921.55
|
| Rate for Payer: EPIC Health Plan Senior |
$29,571.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,571.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,571.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,625.84
|
| Rate for Payer: Multiplan WC |
$19,819.16
|
| Rate for Payer: Prime Health Services WC |
$19,616.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
|
Facility
|
IP
|
$56,542.37
|
|
|
Service Code
|
MSDRG 542
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$56,542.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,542.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,340.95
|
| Rate for Payer: EPIC Health Plan Senior |
$38,030.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,030.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,030.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,960.64
|
| Rate for Payer: Multiplan WC |
$34,842.78
|
| Rate for Payer: Prime Health Services WC |
$34,487.24
|
| 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: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$35,587.80
|
|
|
Service Code
|
MSDRG 544
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,587.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,909.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,587.80
|
| Rate for Payer: EPIC Health Plan Senior |
$26,361.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,361.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,361.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,324.18
|
| Rate for Payer: Multiplan WC |
$14,117.58
|
| Rate for Payer: Prime Health Services WC |
$13,973.52
|
| 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: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC
|
Facility
|
IP
|
$63,748.48
|
|
|
Service Code
|
MSDRG 734
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$63,748.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,748.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,716.24
|
| Rate for Payer: EPIC Health Plan Senior |
$40,530.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,530.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,530.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,310.94
|
| Rate for Payer: Multiplan WC |
$39,283.36
|
| Rate for Payer: Prime Health Services WC |
$38,882.51
|
| 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: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$42,094.11
|
|
|
Service Code
|
MSDRG 735
|
| Min. Negotiated Rate |
$22,398.00 |
| Max. Negotiated Rate |
$42,094.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,800.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,094.11
|
| Rate for Payer: EPIC Health Plan Senior |
$31,180.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,180.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,180.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,782.30
|
| Rate for Payer: Multiplan WC |
$22,677.42
|
| Rate for Payer: Prime Health Services WC |
$22,446.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$24,996.00
|
| Rate for Payer: United Healthcare All Other HMO |
$24,494.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,398.00
|
|
|
MS-DRG 42.00: PENIS PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$68,123.08
|
|
|
Service Code
|
MSDRG 709
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$68,123.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,123.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,765.26
|
| Rate for Payer: EPIC Health Plan Senior |
$42,048.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,048.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,048.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,344.78
|
| Rate for Payer: Multiplan WC |
$41,979.09
|
| Rate for Payer: Prime Health Services WC |
$41,550.74
|
| 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: PENIS PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$46,176.52
|
|
|
Service Code
|
MSDRG 710
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$46,176.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,516.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,176.52
|
| Rate for Payer: EPIC Health Plan Senior |
$34,204.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,204.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,204.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,834.47
|
| Rate for Payer: Multiplan WC |
$28,048.33
|
| Rate for Payer: Prime Health Services WC |
$27,762.13
|
| 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: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC
|
Facility
|
IP
|
$118,544.65
|
|
|
Service Code
|
MSDRG 273
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$118,544.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,544.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,382.23
|
| Rate for Payer: EPIC Health Plan Senior |
$59,542.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,542.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,542.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,786.80
|
| Rate for Payer: Multiplan WC |
$73,050.09
|
| Rate for Payer: Prime Health Services WC |
$72,304.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$62,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$52,172.00
|
| Rate for Payer: United Healthcare HMO Rider |
$36,699.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33,623.00
|
|
|
MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$94,616.24
|
|
|
Service Code
|
MSDRG 274
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$94,616.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$94,616.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,174.39
|
| Rate for Payer: EPIC Health Plan Senior |
$51,240.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,240.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,240.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,661.99
|
| Rate for Payer: Multiplan WC |
$58,304.82
|
| Rate for Payer: Prime Health Services WC |
$57,709.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$42,353.00
|
| Rate for Payer: United Healthcare All Other HMO |
$35,562.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25,015.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,918.00
|
|
|
MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES
|
Facility
|
IP
|
$86,303.59
|
|
|
Service Code
|
MSDRG 321
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$86,303.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$86,303.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,280.82
|
| Rate for Payer: EPIC Health Plan Senior |
$48,356.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,356.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,356.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,797.25
|
| Rate for Payer: Multiplan WC |
$53,182.37
|
| Rate for Payer: Prime Health Services WC |
$52,639.69
|
| 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: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$54,847.71
|
|
|
Service Code
|
MSDRG 322
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$54,847.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,847.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,547.20
|
| Rate for Payer: EPIC Health Plan Senior |
$37,442.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,442.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,442.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,172.78
|
| Rate for Payer: Multiplan WC |
$33,798.49
|
| Rate for Payer: Prime Health Services WC |
$33,453.60
|
| 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: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$70,108.78
|
|
|
Service Code
|
MSDRG 250
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$70,108.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70,108.78
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,695.33
|
| Rate for Payer: EPIC Health Plan Senior |
$42,737.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,737.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,737.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,267.96
|
| Rate for Payer: Multiplan WC |
$43,202.73
|
| Rate for Payer: Prime Health Services WC |
$42,761.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$32,556.00
|
| Rate for Payer: United Healthcare All Other HMO |
$35,635.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24,796.00
|
|
|
MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$47,371.78
|
|
|
Service Code
|
MSDRG 251
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$47,371.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,371.78
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,045.56
|
| Rate for Payer: EPIC Health Plan Senior |
$34,848.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,848.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,848.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,697.07
|
| Rate for Payer: Multiplan WC |
$29,191.64
|
| Rate for Payer: Prime Health Services WC |
$28,893.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,406.00
|
| Rate for Payer: United Healthcare All Other HMO |
$29,656.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,531.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,641.00
|
|
|
MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR
|
Facility
|
IP
|
$68,459.59
|
|
|
Service Code
|
MSDRG 041
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$68,459.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,459.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,922.89
|
| Rate for Payer: EPIC Health Plan Senior |
$42,165.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,165.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,165.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,501.23
|
| Rate for Payer: Multiplan WC |
$42,186.46
|
| Rate for Payer: Prime Health Services WC |
$41,755.99
|
| 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
|
|
|
MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC
|
Facility
|
IP
|
$114,354.98
|
|
|
Service Code
|
MSDRG 040
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$114,354.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$114,354.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$78,419.81
|
| Rate for Payer: EPIC Health Plan Senior |
$58,088.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58,088.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,088.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77,838.93
|
| Rate for Payer: Multiplan WC |
$70,468.31
|
| Rate for Payer: Prime Health Services WC |
$69,749.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
