|
MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC
|
Facility
|
IP
|
$151,680.04
|
|
|
Service Code
|
MSDRG 278
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$151,680.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$151,680.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$95,902.50
|
| Rate for Payer: EPIC Health Plan Senior |
$71,038.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$71,038.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71,038.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95,192.11
|
| Rate for Payer: Multiplan WC |
$93,468.92
|
| Rate for Payer: Prime Health Services WC |
$92,515.16
|
| 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: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC
|
Facility
|
IP
|
$97,144.59
|
|
|
Service Code
|
MSDRG 279
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$97,144.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97,144.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,358.62
|
| Rate for Payer: EPIC Health Plan Senior |
$52,117.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,117.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,117.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,837.45
|
| Rate for Payer: Multiplan WC |
$59,862.85
|
| Rate for Payer: Prime Health Services WC |
$59,252.00
|
| 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: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM
|
Facility
|
IP
|
$93,027.68
|
|
|
Service Code
|
MSDRG 173
|
| Min. Negotiated Rate |
$50,689.13 |
| Max. Negotiated Rate |
$93,027.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$93,027.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,430.33
|
| Rate for Payer: EPIC Health Plan Senior |
$50,689.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,689.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,689.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,923.43
|
| Rate for Payer: Multiplan WC |
$57,325.91
|
| Rate for Payer: Prime Health Services WC |
$56,740.96
|
|
|
MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$42,808.34
|
|
|
Service Code
|
MSDRG 383
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,808.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,325.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,808.34
|
| Rate for Payer: EPIC Health Plan Senior |
$31,709.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,709.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,709.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,491.24
|
| Rate for Payer: Multiplan WC |
$23,617.10
|
| Rate for Payer: Prime Health Services WC |
$23,376.11
|
| 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: UNCOMPLICATED PEPTIC ULCER WITHOUT MCC
|
Facility
|
IP
|
$37,205.14
|
|
|
Service Code
|
MSDRG 384
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,205.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,362.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,205.14
|
| Rate for Payer: EPIC Health Plan Senior |
$27,559.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,559.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,559.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,929.54
|
| Rate for Payer: Multiplan WC |
$16,245.39
|
| Rate for Payer: Prime Health Services WC |
$16,079.62
|
| 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: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC
|
Facility
|
IP
|
$51,346.21
|
|
|
Service Code
|
MSDRG 256
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$51,346.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,346.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,907.12
|
| Rate for Payer: EPIC Health Plan Senior |
$36,227.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,227.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,227.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,544.85
|
| Rate for Payer: Multiplan WC |
$31,640.78
|
| Rate for Payer: Prime Health Services WC |
$31,317.91
|
| 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: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC
|
Facility
|
IP
|
$79,321.81
|
|
|
Service Code
|
MSDRG 255
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$79,321.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$79,321.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,010.63
|
| Rate for Payer: EPIC Health Plan Senior |
$45,933.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,933.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,933.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$61,551.29
|
| Rate for Payer: Multiplan WC |
$48,880.03
|
| Rate for Payer: Prime Health Services WC |
$48,381.25
|
| 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
|
|
|
MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$37,521.79
|
|
|
Service Code
|
MSDRG 257
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$37,521.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,038.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,521.79
|
| Rate for Payer: EPIC Health Plan Senior |
$27,793.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,793.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,793.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,243.85
|
| Rate for Payer: Multiplan WC |
$16,661.99
|
| Rate for Payer: Prime Health Services WC |
$16,491.97
|
| 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: URETHRAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$52,255.69
|
|
|
Service Code
|
MSDRG 671
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$52,255.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,255.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,333.12
|
| Rate for Payer: EPIC Health Plan Senior |
$36,543.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,543.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,543.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,967.69
|
| Rate for Payer: Multiplan WC |
$32,201.22
|
| Rate for Payer: Prime Health Services WC |
$31,872.64
|
| 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: URETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,397.24
|
|
|
Service Code
|
MSDRG 672
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$40,397.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,177.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,397.24
|
| Rate for Payer: EPIC Health Plan Senior |
$29,923.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,923.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,923.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,098.00
|
| Rate for Payer: Multiplan WC |
$20,444.99
|
| Rate for Payer: Prime Health Services WC |
$20,236.36
|
| 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: URETHRAL STRICTURE
|
Facility
|
IP
|
$39,082.34
|
|
|
Service Code
|
MSDRG 697
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,082.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,370.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,082.34
|
| Rate for Payer: EPIC Health Plan Senior |
$28,949.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,949.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,949.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,792.84
|
| Rate for Payer: Multiplan WC |
$18,715.08
|
| Rate for Payer: Prime Health Services WC |
$18,524.11
|
| 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: URINARY STONES WITH MCC
|
Facility
|
IP
|
$45,736.33
|
|
|
Service Code
|
MSDRG 693
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$45,736.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,576.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,736.33
|
| Rate for Payer: EPIC Health Plan Senior |
$33,878.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,878.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,878.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,397.54
|
| Rate for Payer: Multiplan WC |
$27,469.21
|
| Rate for Payer: Prime Health Services WC |
$27,188.92
|
| 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: URINARY STONES WITHOUT MCC
|
Facility
|
IP
|
$35,952.71
|
|
|
Service Code
|
MSDRG 694
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,952.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,688.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,952.71
|
| Rate for Payer: EPIC Health Plan Senior |
$26,631.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,631.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,631.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,686.40
|
| Rate for Payer: Multiplan WC |
$14,597.69
|
| Rate for Payer: Prime Health Services WC |
$14,448.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$55,378.24
|
|
|
Service Code
|
MSDRG 742
|
| Min. Negotiated Rate |
$22,398.00 |
| Max. Negotiated Rate |
$55,378.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,378.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,795.68
|
| Rate for Payer: EPIC Health Plan Senior |
$37,626.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,626.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,626.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,419.42
|
| Rate for Payer: Multiplan WC |
$34,125.41
|
| Rate for Payer: Prime Health Services WC |
$33,777.19
|
| 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: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$41,878.26
|
|
|
Service Code
|
MSDRG 743
|
| Min. Negotiated Rate |
$22,164.96 |
| Max. Negotiated Rate |
$41,878.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,339.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,878.26
|
| Rate for Payer: EPIC Health Plan Senior |
$31,020.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,020.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,020.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,568.05
|
| Rate for Payer: Multiplan WC |
$22,393.46
|
| Rate for Payer: Prime Health Services WC |
$22,164.96
|
| 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: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$55,123.58
|
|
|
Service Code
|
MSDRG 740
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$55,123.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,123.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,676.41
|
| Rate for Payer: EPIC Health Plan Senior |
$37,538.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,538.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,538.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,301.03
|
| Rate for Payer: Multiplan WC |
$33,968.49
|
| Rate for Payer: Prime Health Services WC |
$33,621.87
|
| 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: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$120,684.96
|
|
|
Service Code
|
MSDRG 739
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$120,684.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$120,684.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$81,384.74
|
| Rate for Payer: EPIC Health Plan Senior |
$60,284.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$60,284.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60,284.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80,781.89
|
| Rate for Payer: Multiplan WC |
$74,369.00
|
| Rate for Payer: Prime Health Services WC |
$73,610.13
|
| 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: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$44,361.78
|
|
|
Service Code
|
MSDRG 741
|
| Min. Negotiated Rate |
$22,398.00 |
| Max. Negotiated Rate |
$44,361.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,642.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,361.78
|
| Rate for Payer: EPIC Health Plan Senior |
$32,860.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,860.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,860.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,033.18
|
| Rate for Payer: Multiplan WC |
$25,660.85
|
| Rate for Payer: Prime Health Services WC |
$25,399.00
|
| 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: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$60,583.49
|
|
|
Service Code
|
MSDRG 737
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$60,583.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,583.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,233.77
|
| Rate for Payer: EPIC Health Plan Senior |
$39,432.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,432.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,432.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,839.44
|
| Rate for Payer: Multiplan WC |
$37,333.02
|
| Rate for Payer: Prime Health Services WC |
$36,952.07
|
| 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: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$119,372.28
|
|
|
Service Code
|
MSDRG 736
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$119,372.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$119,372.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,769.87
|
| Rate for Payer: EPIC Health Plan Senior |
$59,829.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,829.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,829.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80,171.57
|
| Rate for Payer: Multiplan WC |
$73,560.09
|
| Rate for Payer: Prime Health Services WC |
$72,809.48
|
| 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: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$46,396.61
|
|
|
Service Code
|
MSDRG 738
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$46,396.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,986.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,396.61
|
| Rate for Payer: EPIC Health Plan Senior |
$34,367.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,367.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,367.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,052.93
|
| Rate for Payer: Multiplan WC |
$28,337.90
|
| Rate for Payer: Prime Health Services WC |
$28,048.73
|
| 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: VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$50,767.17
|
|
|
Service Code
|
MSDRG 746
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$50,767.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,767.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,635.90
|
| Rate for Payer: EPIC Health Plan Senior |
$36,026.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,026.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,026.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,275.63
|
| Rate for Payer: Multiplan WC |
$31,283.96
|
| Rate for Payer: Prime Health Services WC |
$30,964.74
|
| 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: VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$38,420.64
|
|
|
Service Code
|
MSDRG 747
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$38,420.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,957.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,420.64
|
| Rate for Payer: EPIC Health Plan Senior |
$28,459.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,459.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,459.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,136.04
|
| Rate for Payer: Multiplan WC |
$17,844.53
|
| Rate for Payer: Prime Health Services WC |
$17,662.44
|
| 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: VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$40,424.21
|
|
|
Service Code
|
MSDRG 768
|
| Min. Negotiated Rate |
$4,760.00 |
| Max. Negotiated Rate |
$40,424.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,235.43
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,424.21
|
| Rate for Payer: EPIC Health Plan Senior |
$29,943.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,943.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,943.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,124.77
|
| Rate for Payer: Multiplan WC |
$20,480.48
|
| Rate for Payer: Prime Health Services WC |
$20,271.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
|
MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC
|
Facility
|
IP
|
$35,131.98
|
|
|
Service Code
|
MSDRG 806
|
| Min. Negotiated Rate |
$5,236.00 |
| Max. Negotiated Rate |
$35,131.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,936.66
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,131.98
|
| Rate for Payer: EPIC Health Plan Senior |
$26,023.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,023.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,023.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,871.74
|
| Rate for Payer: Multiplan WC |
$13,517.90
|
| Rate for Payer: Prime Health Services WC |
$13,379.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
