|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$36,138.74
|
|
|
Service Code
|
MSDRG 948
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,138.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,086.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,138.74
|
| Rate for Payer: EPIC Health Plan Senior |
$26,769.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,769.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,769.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,871.05
|
| Rate for Payer: Multiplan WC |
$14,842.41
|
| Rate for Payer: Prime Health Services WC |
$14,690.96
|
| 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: SIMPLE PNEUMONIA AND PLEURISY WITH CC
|
Facility
|
IP
|
$36,500.84
|
|
|
Service Code
|
MSDRG 194
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,500.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,859.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,500.84
|
| Rate for Payer: EPIC Health Plan Senior |
$27,037.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,037.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,037.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,230.46
|
| Rate for Payer: Multiplan WC |
$15,318.79
|
| Rate for Payer: Prime Health Services WC |
$15,162.48
|
| 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: SIMPLE PNEUMONIA AND PLEURISY WITH MCC
|
Facility
|
IP
|
$43,568.04
|
|
|
Service Code
|
MSDRG 193
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$43,568.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,947.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,568.04
|
| Rate for Payer: EPIC Health Plan Senior |
$32,272.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,272.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,272.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,245.31
|
| Rate for Payer: Multiplan WC |
$24,616.55
|
| Rate for Payer: Prime Health Services WC |
$24,365.36
|
| 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: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC
|
Facility
|
IP
|
$33,699.23
|
|
|
Service Code
|
MSDRG 195
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$33,699.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,877.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,699.23
|
| Rate for Payer: EPIC Health Plan Senior |
$24,962.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,962.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,962.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,449.60
|
| Rate for Payer: Multiplan WC |
$11,632.94
|
| Rate for Payer: Prime Health Services WC |
$11,514.24
|
| 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: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT
|
Facility
|
IP
|
$171,250.00
|
|
|
Service Code
|
MSDRG 008
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$171,250.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$164,952.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$171,250.00
|
| Rate for Payer: Blue Distinction Transplant |
$138,317.00
|
| Rate for Payer: Blue Shield of California Transplant |
$102,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$102,119.13
|
| Rate for Payer: EPIC Health Plan Senior |
$75,643.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$90,300.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$96,050.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75,643.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75,643.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101,362.69
|
| Rate for Payer: Multiplan WC |
$101,647.66
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$153,846.00
|
| Rate for Payer: Prime Health Services WC |
$100,610.44
|
| 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: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS
|
Facility
|
IP
|
$240,324.03
|
|
|
Service Code
|
MSDRG 019
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$240,324.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$171,250.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$240,324.03
|
| Rate for Payer: Blue Distinction Transplant |
$138,317.00
|
| Rate for Payer: Blue Shield of California Transplant |
$102,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$137,422.47
|
| Rate for Payer: EPIC Health Plan Senior |
$101,794.42
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$90,300.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$96,050.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$101,794.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$101,794.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$136,404.52
|
| Rate for Payer: Multiplan WC |
$148,093.49
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$153,846.00
|
| Rate for Payer: Prime Health Services WC |
$146,582.34
|
| 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: SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL
|
Facility
|
IP
|
$118,602.26
|
|
|
Service Code
|
MSDRG 402
|
| Min. Negotiated Rate |
$59,562.37 |
| Max. Negotiated Rate |
$118,602.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,602.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,409.20
|
| Rate for Payer: EPIC Health Plan Senior |
$59,562.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,562.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,562.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,813.58
|
| Rate for Payer: Multiplan WC |
$73,085.59
|
| Rate for Payer: Prime Health Services WC |
$72,339.82
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$156,130.43
|
|
|
Service Code
|
MSDRG 450
|
| Min. Negotiated Rate |
$72,582.99 |
| Max. Negotiated Rate |
$156,130.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$156,130.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$97,987.04
|
| Rate for Payer: EPIC Health Plan Senior |
$72,582.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$72,582.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72,582.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$97,261.21
|
| Rate for Payer: Multiplan WC |
$96,211.35
|
| Rate for Payer: Prime Health Services WC |
$95,229.60
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$93,555.18
|
|
|
Service Code
|
MSDRG 451
|
| Min. Negotiated Rate |
$50,872.14 |
| Max. Negotiated Rate |
$93,555.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$93,555.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,677.39
|
| Rate for Payer: EPIC Health Plan Senior |
$50,872.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,872.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,872.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,168.67
|
| Rate for Payer: Multiplan WC |
$57,650.97
|
| Rate for Payer: Prime Health Services WC |
$57,062.69
|
|
|
MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$73,094.91
|
|
|
Service Code
|
MSDRG 135
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$73,094.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$73,094.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,094.00
|
| Rate for Payer: EPIC Health Plan Senior |
$43,773.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,773.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,773.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,656.26
|
| Rate for Payer: Multiplan WC |
$45,042.86
|
| Rate for Payer: Prime Health Services WC |
$44,583.24
|
| 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: SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$38,747.21
|
|
|
Service Code
|
MSDRG 136
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$38,747.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,655.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,747.21
|
| Rate for Payer: EPIC Health Plan Senior |
$28,701.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,701.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,701.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,460.20
|
| Rate for Payer: Multiplan WC |
$18,274.20
|
| Rate for Payer: Prime Health Services WC |
$18,087.73
|
| 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: SKIN DEBRIDEMENT WITH CC
|
Facility
|
IP
|
$50,758.08
|
|
|
Service Code
|
MSDRG 571
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$50,758.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,758.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,631.64
|
| Rate for Payer: EPIC Health Plan Senior |
$36,023.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,023.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,023.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,271.41
|
| Rate for Payer: Multiplan WC |
$31,278.36
|
| Rate for Payer: Prime Health Services WC |
$30,959.19
|
| 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: SKIN DEBRIDEMENT WITH MCC
|
Facility
|
IP
|
$91,257.22
|
|
|
Service Code
|
MSDRG 570
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$91,257.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$91,257.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,601.06
|
| Rate for Payer: EPIC Health Plan Senior |
$50,074.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,074.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,074.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,100.31
|
| Rate for Payer: Multiplan WC |
$56,234.91
|
| Rate for Payer: Prime Health Services WC |
$55,661.08
|
| 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: SKIN DEBRIDEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$41,078.81
|
|
|
Service Code
|
MSDRG 572
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$41,078.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,633.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,078.81
|
| Rate for Payer: EPIC Health Plan Senior |
$30,428.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,428.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,428.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,774.53
|
| Rate for Payer: Multiplan WC |
$21,341.70
|
| Rate for Payer: Prime Health Services WC |
$21,123.92
|
| 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: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$80,725.44
|
|
|
Service Code
|
MSDRG 577
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$80,725.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$80,725.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,668.05
|
| Rate for Payer: EPIC Health Plan Senior |
$46,420.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$46,420.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,420.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,203.85
|
| Rate for Payer: Multiplan WC |
$49,744.98
|
| Rate for Payer: Prime Health Services WC |
$49,237.37
|
| 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: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$163,563.91
|
|
|
Service Code
|
MSDRG 576
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$163,563.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$163,563.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$101,468.79
|
| Rate for Payer: EPIC Health Plan Senior |
$75,162.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75,162.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75,162.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$100,717.17
|
| Rate for Payer: Multiplan WC |
$100,792.05
|
| Rate for Payer: Prime Health Services WC |
$99,763.56
|
| 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: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$51,246.17
|
|
|
Service Code
|
MSDRG 578
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$51,246.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,246.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,860.25
|
| Rate for Payer: EPIC Health Plan Senior |
$36,192.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,192.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,192.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,498.33
|
| Rate for Payer: Multiplan WC |
$31,579.13
|
| Rate for Payer: Prime Health Services WC |
$31,256.89
|
| 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: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$105,041.91
|
|
|
Service Code
|
MSDRG 574
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$105,041.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$105,041.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,057.67
|
| Rate for Payer: EPIC Health Plan Senior |
$54,857.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,857.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,857.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,509.09
|
| Rate for Payer: Multiplan WC |
$64,729.37
|
| Rate for Payer: Prime Health Services WC |
$64,068.87
|
| 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: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$186,691.99
|
|
|
Service Code
|
MSDRG 573
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$186,691.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$186,691.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$112,301.76
|
| Rate for Payer: EPIC Health Plan Senior |
$83,186.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$83,186.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$83,186.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111,469.90
|
| Rate for Payer: Multiplan WC |
$115,044.13
|
| Rate for Payer: Prime Health Services WC |
$113,870.21
|
| 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: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$60,531.96
|
|
|
Service Code
|
MSDRG 575
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$60,531.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,531.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,209.64
|
| Rate for Payer: EPIC Health Plan Senior |
$39,414.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,414.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,414.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,815.50
|
| Rate for Payer: Multiplan WC |
$37,301.26
|
| Rate for Payer: Prime Health Services WC |
$36,920.63
|
| 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: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$57,988.44
|
|
|
Service Code
|
MSDRG 623
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$57,988.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,988.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,018.28
|
| Rate for Payer: EPIC Health Plan Senior |
$38,532.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,532.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,532.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,632.96
|
| Rate for Payer: Multiplan WC |
$35,733.89
|
| Rate for Payer: Prime Health Services WC |
$35,369.26
|
| 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: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$113,442.47
|
|
|
Service Code
|
MSDRG 622
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$113,442.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$113,442.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,992.42
|
| Rate for Payer: EPIC Health Plan Senior |
$57,772.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$57,772.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,772.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77,414.69
|
| Rate for Payer: Multiplan WC |
$69,906.00
|
| Rate for Payer: Prime Health Services WC |
$69,192.67
|
| 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: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$39,100.79
|
|
|
Service Code
|
MSDRG 624
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$39,100.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,409.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,100.79
|
| Rate for Payer: EPIC Health Plan Senior |
$28,963.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,963.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,963.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,811.16
|
| Rate for Payer: Multiplan WC |
$18,739.36
|
| Rate for Payer: Prime Health Services WC |
$18,548.15
|
| 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: SKIN GRAFTS FOR INJURIES WITH CC/MCC
|
Facility
|
IP
|
$117,053.11
|
|
|
Service Code
|
MSDRG 904
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$117,053.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$117,053.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$79,683.60
|
| Rate for Payer: EPIC Health Plan Senior |
$59,024.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,024.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,024.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,093.35
|
| Rate for Payer: Multiplan WC |
$72,130.96
|
| Rate for Payer: Prime Health Services WC |
$71,394.93
|
| 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: SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$49,966.83
|
|
|
Service Code
|
MSDRG 905
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$49,966.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,966.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,261.06
|
| Rate for Payer: EPIC Health Plan Senior |
$35,748.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,748.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,748.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,903.57
|
| Rate for Payer: Multiplan WC |
$30,790.78
|
| Rate for Payer: Prime Health Services WC |
$30,476.59
|
| 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
|
|
