|
INPATIENT MS-DRG 016: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC
|
Facility
|
IP
|
$187,261.93
|
|
|
Service Code
|
MSDRG 016
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$187,261.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$187,261.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$111,241.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$82,401.07
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$90,244.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,401.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,401.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$103,825.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$110,417.43
|
| Rate for Payer: Multiplan WC |
$124,952.14
|
| Rate for Payer: Networks By Design Commercial |
$140,000.00
|
| Rate for Payer: Prime Health Services WC |
$123,677.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 017: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$187,261.93
|
|
|
Service Code
|
MSDRG 017
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$187,261.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$187,261.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$111,241.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$82,401.07
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$90,244.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,401.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,401.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$103,825.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$110,417.43
|
| Rate for Payer: Multiplan WC |
$89,746.46
|
| Rate for Payer: Networks By Design Commercial |
$140,000.00
|
| Rate for Payer: Prime Health Services WC |
$88,830.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 018: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$1,116,923.29
|
|
|
Service Code
|
MSDRG 018
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$1,116,923.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,116,923.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$570,271.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$422,423.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$422,423.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$422,423.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$532,253.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$566,047.01
|
| Rate for Payer: Multiplan WC |
$742,295.04
|
| Rate for Payer: Prime Health Services WC |
$734,720.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 019: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS
|
Facility
|
IP
|
$242,330.95
|
|
|
Service Code
|
MSDRG 019
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$242,330.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$242,330.95
|
| Rate for Payer: Blue Distinction Transplant |
$135,605.00
|
| Rate for Payer: Blue Shield of California Transplant |
$102,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$138,432.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$102,542.47
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$90,300.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$102,542.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$102,542.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$129,203.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$137,406.91
|
| Rate for Payer: Multiplan WC |
$146,519.55
|
| Rate for Payer: Prime Health Services WC |
$145,024.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 020: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC
|
Facility
|
IP
|
$256,242.96
|
|
|
Service Code
|
MSDRG 020
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$256,242.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$256,242.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$145,301.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$107,630.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$107,630.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$107,630.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$135,614.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$144,225.23
|
| Rate for Payer: Multiplan WC |
$191,057.00
|
| Rate for Payer: Prime Health Services WC |
$189,107.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 021: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC
|
Facility
|
IP
|
$186,182.68
|
|
|
Service Code
|
MSDRG 021
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$186,182.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$186,182.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$110,708.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$82,006.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,006.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,006.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$103,327.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,888.50
|
| Rate for Payer: Multiplan WC |
$139,426.25
|
| Rate for Payer: Prime Health Services WC |
$138,003.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 022: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC
|
Facility
|
IP
|
$105,399.64
|
|
|
Service Code
|
MSDRG 022
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$105,399.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$105,399.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,497.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,405.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$57,405.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,405.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72,330.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,923.16
|
| Rate for Payer: Multiplan WC |
$89,508.23
|
| Rate for Payer: Prime Health Services WC |
$88,594.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 023: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$171,855.34
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$171,855.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$171,855.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$103,634.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76,766.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$76,766.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76,766.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96,725.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102,866.63
|
| Rate for Payer: Multiplan WC |
$117,702.76
|
| Rate for Payer: Prime Health Services WC |
$116,501.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 024: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$114,861.26
|
|
|
Service Code
|
MSDRG 024
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$114,861.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$114,861.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$75,492.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$55,920.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,920.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,920.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$70,460.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,933.67
|
| Rate for Payer: Multiplan WC |
$81,094.44
|
| Rate for Payer: Prime Health Services WC |
$80,266.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 025: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$133,875.46
|
|
|
Service Code
|
MSDRG 025
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$133,875.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$133,875.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$84,881.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62,875.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62,875.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62,875.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79,222.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84,252.58
|
| Rate for Payer: Multiplan WC |
$93,245.87
|
| Rate for Payer: Prime Health Services WC |
$92,294.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 026: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$89,526.18
|
|
|
Service Code
|
MSDRG 026
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$89,526.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,526.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,983.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,654.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$46,654.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,654.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,784.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,516.88
|
| Rate for Payer: Multiplan WC |
$62,092.04
|
| Rate for Payer: Prime Health Services WC |
$61,458.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 027: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$73,755.80
|
|
|
Service Code
|
MSDRG 027
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$73,755.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$73,755.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,196.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,886.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,886.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,886.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,516.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,787.78
|
| Rate for Payer: Multiplan WC |
$51,246.72
|
| Rate for Payer: Prime Health Services WC |
$50,723.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 028: SPINAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$182,687.25
|
|
|
Service Code
|
MSDRG 028
|
| Min. Negotiated Rate |
$25,608.00 |
| Max. Negotiated Rate |
$182,687.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$182,687.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$108,982.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$80,727.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,608.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$80,727.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$80,727.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101,717.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108,175.39
|
| Rate for Payer: Multiplan WC |
$120,703.14
|
| Rate for Payer: Prime Health Services WC |
$119,471.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$55,964.00
|
| Rate for Payer: United Healthcare All Other HMO |
$68,420.00
|
| Rate for Payer: United Healthcare HMO Rider |
$51,970.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47,523.00
|
|
|
INPATIENT MS-DRG 029: SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS
|
Facility
|
IP
|
$103,929.31
|
|
|
Service Code
|
MSDRG 029
|
| Min. Negotiated Rate |
$25,608.00 |
| Max. Negotiated Rate |
$103,929.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$103,929.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,095.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,922.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,608.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,922.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,922.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,422.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,575.91
|
| Rate for Payer: Multiplan WC |
$70,185.46
|
| Rate for Payer: Prime Health Services WC |
$69,469.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$72,752.00
|
| Rate for Payer: United Healthcare All Other HMO |
$45,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,810.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,830.00
|
|
|
INPATIENT MS-DRG 030: SPINAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$70,302.80
|
|
|
Service Code
|
MSDRG 030
|
| Min. Negotiated Rate |
$19,770.00 |
| Max. Negotiated Rate |
$70,302.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70,302.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,491.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,623.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,608.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,623.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,623.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,925.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,095.46
|
| Rate for Payer: Multiplan WC |
$48,080.00
|
| Rate for Payer: Prime Health Services WC |
$47,589.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$55,964.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,467.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,620.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,770.00
|
|
|
INPATIENT MS-DRG 031: VENTRICULAR SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$124,798.85
|
|
|
Service Code
|
MSDRG 031
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$124,798.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124,798.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,399.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59,555.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,555.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,555.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75,039.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,804.13
|
| Rate for Payer: Multiplan WC |
$84,630.82
|
| Rate for Payer: Prime Health Services WC |
$83,767.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 032: VENTRICULAR SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$65,294.60
|
|
|
Service Code
|
MSDRG 032
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$65,294.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,294.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,018.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,791.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,791.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,791.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,617.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,640.92
|
| Rate for Payer: Multiplan WC |
$42,192.19
|
| Rate for Payer: Prime Health Services WC |
$41,761.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 033: VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$49,199.84
|
|
|
Service Code
|
MSDRG 033
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,199.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,199.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,071.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,905.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,905.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,905.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,200.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,752.82
|
| Rate for Payer: Multiplan WC |
$34,881.21
|
| Rate for Payer: Prime Health Services WC |
$34,525.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 034: CAROTID ARTERY STENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$118,274.84
|
|
|
Service Code
|
MSDRG 034
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$118,274.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,274.84
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,178.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,169.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$57,169.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,169.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72,033.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,606.67
|
| Rate for Payer: Multiplan WC |
$82,133.58
|
| Rate for Payer: Prime Health Services WC |
$81,295.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 035: CAROTID ARTERY STENT PROCEDURES WITH CC
|
Facility
|
IP
|
$69,711.64
|
|
|
Service Code
|
MSDRG 035
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$69,711.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,711.64
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,199.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,407.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,407.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,407.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,653.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,805.72
|
| Rate for Payer: Multiplan WC |
$46,901.20
|
| Rate for Payer: Prime Health Services WC |
$46,422.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 036: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$54,817.39
|
|
|
Service Code
|
MSDRG 036
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$54,817.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,817.39
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,845.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,959.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,959.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,959.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,789.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,506.01
|
| Rate for Payer: Multiplan WC |
$38,622.95
|
| Rate for Payer: Prime Health Services WC |
$38,228.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 037: EXTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$102,334.69
|
|
|
Service Code
|
MSDRG 037
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$102,334.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,334.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,307.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,339.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,339.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,339.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,687.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,794.37
|
| Rate for Payer: Multiplan WC |
$69,269.54
|
| Rate for Payer: Prime Health Services WC |
$68,562.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 038: EXTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$48,502.57
|
|
|
Service Code
|
MSDRG 038
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,502.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,502.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,727.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,650.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,650.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,650.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,879.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,411.09
|
| Rate for Payer: Multiplan WC |
$33,587.40
|
| Rate for Payer: Prime Health Services WC |
$33,244.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 039: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$35,858.38
|
|
|
Service Code
|
MSDRG 039
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,858.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,590.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,858.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,561.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,561.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,561.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,467.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,592.76
|
| Rate for Payer: Multiplan WC |
$23,672.40
|
| Rate for Payer: Prime Health Services WC |
$23,430.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 040: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC
|
Facility
|
IP
|
$116,731.76
|
|
|
Service Code
|
MSDRG 040
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$116,731.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$116,731.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$76,416.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$56,604.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$56,604.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,604.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,322.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75,850.41
|
| Rate for Payer: Multiplan WC |
$77,800.39
|
| Rate for Payer: Prime Health Services WC |
$77,006.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
