|
MS-DRG 42.00: SKIN ULCERS WITH CC
|
Facility
|
IP
|
$42,219.08
|
|
|
Service Code
|
MSDRG 593
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,219.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,067.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,219.08
|
| Rate for Payer: EPIC Health Plan Senior |
$31,273.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,273.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,273.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,906.34
|
| Rate for Payer: Multiplan WC |
$22,841.81
|
| Rate for Payer: Prime Health Services WC |
$22,608.73
|
| 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: SKIN ULCERS WITH MCC
|
Facility
|
IP
|
$62,338.79
|
|
|
Service Code
|
MSDRG 592
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$62,338.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,338.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,055.94
|
| Rate for Payer: EPIC Health Plan Senior |
$40,041.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,041.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,041.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,655.53
|
| Rate for Payer: Multiplan WC |
$38,414.68
|
| Rate for Payer: Prime Health Services WC |
$38,022.69
|
| 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
|
|
|
MS-DRG 42.00: SKIN ULCERS WITHOUT CC/MCC
|
Facility
|
IP
|
$36,908.37
|
|
|
Service Code
|
MSDRG 594
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,908.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,729.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,908.37
|
| Rate for Payer: EPIC Health Plan Senior |
$27,339.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,339.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,339.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,634.97
|
| Rate for Payer: Multiplan WC |
$15,854.95
|
| Rate for Payer: Prime Health Services WC |
$15,693.16
|
| 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: SOFT TISSUE PROCEDURES WITH CC
|
Facility
|
IP
|
$54,104.97
|
|
|
Service Code
|
MSDRG 501
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$54,104.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,104.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,199.29
|
| Rate for Payer: EPIC Health Plan Senior |
$37,184.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,184.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,184.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,827.44
|
| Rate for Payer: Multiplan WC |
$33,340.79
|
| Rate for Payer: Prime Health Services WC |
$33,000.57
|
| 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: SOFT TISSUE PROCEDURES WITH MCC
|
Facility
|
IP
|
$96,062.31
|
|
|
Service Code
|
MSDRG 500
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$96,062.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96,062.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,851.70
|
| Rate for Payer: EPIC Health Plan Senior |
$51,742.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,742.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,742.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,334.28
|
| Rate for Payer: Multiplan WC |
$59,195.92
|
| Rate for Payer: Prime Health Services WC |
$58,591.88
|
| 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: SOFT TISSUE PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$44,696.92
|
|
|
Service Code
|
MSDRG 502
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$44,696.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,357.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,696.92
|
| Rate for Payer: EPIC Health Plan Senior |
$33,108.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,108.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,108.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,365.83
|
| Rate for Payer: Multiplan WC |
$26,101.73
|
| Rate for Payer: Prime Health Services WC |
$25,835.39
|
| 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: SPINAL DISORDERS AND INJURIES WITH CC/MCC
|
Facility
|
IP
|
$61,010.95
|
|
|
Service Code
|
MSDRG 052
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$61,010.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61,010.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,433.99
|
| Rate for Payer: EPIC Health Plan Senior |
$39,580.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,580.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,580.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,038.18
|
| Rate for Payer: Multiplan WC |
$37,596.43
|
| Rate for Payer: Prime Health Services WC |
$37,212.79
|
| 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: SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$37,940.70
|
|
|
Service Code
|
MSDRG 053
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,940.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,933.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,940.70
|
| Rate for Payer: EPIC Health Plan Senior |
$28,104.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,104.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,104.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,659.65
|
| Rate for Payer: Multiplan WC |
$17,213.09
|
| Rate for Payer: Prime Health Services WC |
$17,037.45
|
| 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: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC
|
Facility
|
IP
|
$173,995.65
|
|
|
Service Code
|
MSDRG 457
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$173,995.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$173,995.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$106,354.93
|
| Rate for Payer: EPIC Health Plan Senior |
$78,781.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$78,781.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78,781.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$105,567.12
|
| Rate for Payer: Multiplan WC |
$107,220.34
|
| Rate for Payer: Prime Health Services WC |
$106,126.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$90,575.00
|
| Rate for Payer: United Healthcare All Other HMO |
$82,014.00
|
| Rate for Payer: United Healthcare HMO Rider |
$62,293.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57,072.00
|
|
|
MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC
|
Facility
|
IP
|
$256,752.27
|
|
|
Service Code
|
MSDRG 456
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$256,752.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$256,752.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$145,117.29
|
| Rate for Payer: EPIC Health Plan Senior |
$107,494.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$107,494.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$107,494.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$144,042.35
|
| Rate for Payer: Multiplan WC |
$158,216.97
|
| Rate for Payer: Prime Health Services WC |
$156,602.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$112,148.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99,575.00
|
| Rate for Payer: United Healthcare HMO Rider |
$75,636.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69,294.00
|
|
|
MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$130,904.49
|
|
|
Service Code
|
MSDRG 458
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$130,904.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$130,904.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$86,171.45
|
| Rate for Payer: EPIC Health Plan Senior |
$63,830.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$63,830.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63,830.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,533.14
|
| Rate for Payer: Multiplan WC |
$80,666.51
|
| Rate for Payer: Prime Health Services WC |
$79,843.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$81,933.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,046.00
|
| Rate for Payer: United Healthcare HMO Rider |
$53,969.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,445.00
|
|
|
MS-DRG 42.00: SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS
|
Facility
|
IP
|
$101,761.72
|
|
|
Service Code
|
MSDRG 029
|
| Min. Negotiated Rate |
$25,608.00 |
| Max. Negotiated Rate |
$101,761.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101,761.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,521.24
|
| Rate for Payer: EPIC Health Plan Senior |
$53,719.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$53,719.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,719.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,984.05
|
| Rate for Payer: Multiplan WC |
$62,708.03
|
| Rate for Payer: Prime Health Services WC |
$62,068.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$76,644.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,114.00
|
| Rate for Payer: United Healthcare HMO Rider |
$36,551.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33,485.00
|
|
|
MS-DRG 42.00: SPINAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$184,306.12
|
|
|
Service Code
|
MSDRG 028
|
| Min. Negotiated Rate |
$25,608.00 |
| Max. Negotiated Rate |
$184,306.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$184,306.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$111,184.26
|
| Rate for Payer: EPIC Health Plan Senior |
$82,358.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,358.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,358.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$110,360.67
|
| Rate for Payer: Multiplan WC |
$113,573.90
|
| Rate for Payer: Prime Health Services WC |
$112,414.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$58,958.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,841.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,569.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,994.00
|
|
|
MS-DRG 42.00: SPINAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$67,465.23
|
|
|
Service Code
|
MSDRG 030
|
| Min. Negotiated Rate |
$20,798.00 |
| Max. Negotiated Rate |
$67,465.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67,465.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,457.12
|
| Rate for Payer: EPIC Health Plan Senior |
$41,820.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,820.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,820.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,038.92
|
| Rate for Payer: Multiplan WC |
$41,573.71
|
| Rate for Payer: Prime Health Services WC |
$41,149.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$58,958.00
|
| Rate for Payer: United Healthcare All Other HMO |
$29,890.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,701.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,798.00
|
|
|
MS-DRG 42.00: SPLENIC PROCEDURES WITH CC
|
Facility
|
IP
|
$88,334.76
|
|
|
Service Code
|
MSDRG 800
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$88,334.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$88,334.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,232.19
|
| Rate for Payer: EPIC Health Plan Senior |
$49,060.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,060.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,060.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,741.58
|
| Rate for Payer: Multiplan WC |
$54,434.02
|
| Rate for Payer: Prime Health Services WC |
$53,878.57
|
| 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: SPLENIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$144,146.52
|
|
|
Service Code
|
MSDRG 799
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$144,146.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$144,146.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$92,373.87
|
| Rate for Payer: EPIC Health Plan Senior |
$68,425.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$68,425.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68,425.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91,689.62
|
| Rate for Payer: Multiplan WC |
$88,826.57
|
| Rate for Payer: Prime Health Services WC |
$87,920.18
|
| 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: SPLENIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$49,769.78
|
|
|
Service Code
|
MSDRG 801
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$49,769.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,769.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,168.73
|
| Rate for Payer: EPIC Health Plan Senior |
$35,680.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,680.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,680.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,811.92
|
| Rate for Payer: Multiplan WC |
$30,669.35
|
| Rate for Payer: Prime Health Services WC |
$30,356.39
|
| 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: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC
|
Facility
|
IP
|
$37,906.61
|
|
|
Service Code
|
MSDRG 537
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,906.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,860.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,906.61
|
| Rate for Payer: EPIC Health Plan Senior |
$28,078.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,078.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,078.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,625.82
|
| Rate for Payer: Multiplan WC |
$17,168.26
|
| Rate for Payer: Prime Health Services WC |
$16,993.07
|
| 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: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC
|
Facility
|
IP
|
$34,392.17
|
|
|
Service Code
|
MSDRG 538
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,392.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,357.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,392.17
|
| Rate for Payer: EPIC Health Plan Senior |
$25,475.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,475.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,475.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,137.41
|
| Rate for Payer: Multiplan WC |
$12,544.60
|
| Rate for Payer: Prime Health Services WC |
$12,416.59
|
| 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: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC
|
Facility
|
IP
|
$73,610.28
|
|
|
Service Code
|
MSDRG 327
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$73,610.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$73,610.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,335.40
|
| Rate for Payer: EPIC Health Plan Senior |
$43,952.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,952.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,952.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,895.88
|
| Rate for Payer: Multiplan WC |
$45,360.44
|
| Rate for Payer: Prime Health Services WC |
$44,897.58
|
| 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: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$153,974.96
|
|
|
Service Code
|
MSDRG 326
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$153,974.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$153,974.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$96,977.44
|
| Rate for Payer: EPIC Health Plan Senior |
$71,835.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$71,835.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71,835.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96,259.09
|
| Rate for Payer: Multiplan WC |
$94,883.10
|
| Rate for Payer: Prime Health Services WC |
$93,914.91
|
| 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: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$48,308.55
|
|
|
Service Code
|
MSDRG 328
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$48,308.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,308.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,484.32
|
| Rate for Payer: EPIC Health Plan Senior |
$35,173.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,173.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,173.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,132.58
|
| Rate for Payer: Multiplan WC |
$29,768.90
|
| Rate for Payer: Prime Health Services WC |
$29,465.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: SYNCOPE AND COLLAPSE
|
Facility
|
IP
|
$37,229.29
|
|
|
Service Code
|
MSDRG 312
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,229.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,414.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,229.29
|
| Rate for Payer: EPIC Health Plan Senior |
$27,577.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,577.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,577.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,953.51
|
| Rate for Payer: Multiplan WC |
$16,277.15
|
| Rate for Payer: Prime Health Services WC |
$16,111.06
|
| 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: TENDONITIS, MYOSITIS AND BURSITIS WITH MCC
|
Facility
|
IP
|
$46,980.71
|
|
|
Service Code
|
MSDRG 557
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$46,980.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,980.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,862.36
|
| Rate for Payer: EPIC Health Plan Senior |
$34,712.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,712.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,712.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,515.23
|
| Rate for Payer: Multiplan WC |
$28,950.65
|
| Rate for Payer: Prime Health Services WC |
$28,655.24
|
| 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: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC
|
Facility
|
IP
|
$37,122.77
|
|
|
Service Code
|
MSDRG 558
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,122.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,186.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,122.77
|
| Rate for Payer: EPIC Health Plan Senior |
$27,498.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,498.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,498.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,847.79
|
| Rate for Payer: Multiplan WC |
$16,137.04
|
| Rate for Payer: Prime Health Services WC |
$15,972.38
|
| 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
|
|
