|
INPATIENT MS-DRG 041: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR
|
Facility
|
IP
|
$67,625.90
|
|
|
Service Code
|
MSDRG 041
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$67,625.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67,625.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,169.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,644.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,644.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,644.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,691.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,783.50
|
| Rate for Payer: Multiplan WC |
$48,016.33
|
| Rate for Payer: Prime Health Services WC |
$47,526.37
|
| 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 042: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$52,743.78
|
|
|
Service Code
|
MSDRG 042
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,743.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,743.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,821.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,201.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,201.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,201.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,833.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,489.73
|
| Rate for Payer: Multiplan WC |
$37,986.32
|
| Rate for Payer: Prime Health Services WC |
$37,598.70
|
| 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 052: SPINAL DISORDERS AND INJURIES WITH CC/MCC
|
Facility
|
IP
|
$58,949.46
|
|
|
Service Code
|
MSDRG 052
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$58,949.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,949.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,885.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,471.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,471.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,471.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,693.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,531.14
|
| Rate for Payer: Multiplan WC |
$36,561.09
|
| Rate for Payer: Prime Health Services WC |
$36,188.01
|
| 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 053: SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$33,505.30
|
|
|
Service Code
|
MSDRG 053
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,505.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,824.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,505.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,818.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,818.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,818.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,271.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,257.11
|
| Rate for Payer: Multiplan WC |
$21,004.71
|
| Rate for Payer: Prime Health Services WC |
$20,790.38
|
| 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 054: NERVOUS SYSTEM NEOPLASMS WITH MCC
|
Facility
|
IP
|
$44,670.63
|
|
|
Service Code
|
MSDRG 054
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$44,670.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,670.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,835.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,248.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,248.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,248.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,113.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,533.03
|
| Rate for Payer: Multiplan WC |
$28,484.09
|
| Rate for Payer: Prime Health Services WC |
$28,193.44
|
| 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 055: NERVOUS SYSTEM NEOPLASMS WITHOUT MCC
|
Facility
|
IP
|
$34,843.51
|
|
|
Service Code
|
MSDRG 055
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,843.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,535.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,843.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,810.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,810.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,810.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,520.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,585.41
|
| Rate for Payer: Multiplan WC |
$20,706.93
|
| Rate for Payer: Prime Health Services WC |
$20,495.63
|
| 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 056: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC
|
Facility
|
IP
|
$72,576.50
|
|
|
Service Code
|
MSDRG 056
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$72,576.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,576.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,614.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,455.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,455.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,455.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,973.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,209.81
|
| Rate for Payer: Multiplan WC |
$45,812.78
|
| Rate for Payer: Prime Health Services WC |
$45,345.30
|
| 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 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$41,326.77
|
|
|
Service Code
|
MSDRG 057
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$41,326.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,326.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,184.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,025.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,025.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,025.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,572.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,894.22
|
| Rate for Payer: Multiplan WC |
$26,728.23
|
| Rate for Payer: Prime Health Services WC |
$26,455.49
|
| 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 058: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC
|
Facility
|
IP
|
$52,383.02
|
|
|
Service Code
|
MSDRG 058
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$52,383.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,383.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,643.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,069.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,069.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,069.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,667.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,312.93
|
| Rate for Payer: Multiplan WC |
$35,431.59
|
| Rate for Payer: Prime Health Services WC |
$35,070.04
|
| 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 059: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC
|
Facility
|
IP
|
$36,549.95
|
|
|
Service Code
|
MSDRG 059
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,549.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,991.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,549.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,074.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,074.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,074.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,113.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,279.21
|
| Rate for Payer: Multiplan WC |
$23,483.46
|
| Rate for Payer: Prime Health Services WC |
$23,243.83
|
| 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 060: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC
|
Facility
|
IP
|
$32,212.00
|
|
|
Service Code
|
MSDRG 060
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,212.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,205.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,212.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,860.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,860.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,860.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,064.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,973.39
|
| Rate for Payer: Multiplan WC |
$18,612.21
|
| Rate for Payer: Prime Health Services WC |
$18,422.29
|
| 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 061: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC
|
Facility
|
IP
|
$84,969.68
|
|
|
Service Code
|
MSDRG 061
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$84,969.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$84,969.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,733.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,987.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,987.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,987.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,684.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,283.75
|
| Rate for Payer: Multiplan WC |
$60,225.27
|
| Rate for Payer: Prime Health Services WC |
$59,610.73
|
| 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 062: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC
|
Facility
|
IP
|
$56,742.46
|
|
|
Service Code
|
MSDRG 062
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$56,742.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,742.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,796.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,663.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,663.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,663.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,676.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,449.51
|
| Rate for Payer: Multiplan WC |
$39,372.53
|
| Rate for Payer: Prime Health Services WC |
$38,970.77
|
| 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 063: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC
|
Facility
|
IP
|
$45,073.83
|
|
|
Service Code
|
MSDRG 063
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,073.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,073.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,034.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,396.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,396.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,396.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,298.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,730.67
|
| Rate for Payer: Multiplan WC |
$32,468.16
|
| Rate for Payer: Prime Health Services WC |
$32,136.86
|
| 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 064: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC
|
Facility
|
IP
|
$60,722.95
|
|
|
Service Code
|
MSDRG 064
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$60,722.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,722.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,761.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,119.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,119.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,119.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,510.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,400.33
|
| Rate for Payer: Multiplan WC |
$40,497.93
|
| Rate for Payer: Prime Health Services WC |
$40,084.69
|
| 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 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS
|
Facility
|
IP
|
$33,993.28
|
|
|
Service Code
|
MSDRG 065
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,993.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,813.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,993.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,180.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,180.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,180.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,727.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,741.48
|
| Rate for Payer: Multiplan WC |
$20,873.27
|
| Rate for Payer: Prime Health Services WC |
$20,660.28
|
| 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 066: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC
|
Facility
|
IP
|
$29,070.04
|
|
|
Service Code
|
MSDRG 066
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,070.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,842.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,070.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,533.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,533.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,533.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,132.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,854.70
|
| Rate for Payer: Multiplan WC |
$14,344.73
|
| Rate for Payer: Prime Health Services WC |
$14,198.36
|
| 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 067: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC
|
Facility
|
IP
|
$42,954.74
|
|
|
Service Code
|
MSDRG 067
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,954.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,954.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,988.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,620.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,620.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,620.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,322.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,692.10
|
| Rate for Payer: Multiplan WC |
$29,040.63
|
| Rate for Payer: Prime Health Services WC |
$28,744.30
|
| 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 068: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC
|
Facility
|
IP
|
$31,816.83
|
|
|
Service Code
|
MSDRG 068
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,816.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,405.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,816.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,568.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,568.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,568.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,695.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,581.15
|
| Rate for Payer: Multiplan WC |
$18,558.81
|
| Rate for Payer: Prime Health Services WC |
$18,369.43
|
| 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 069: TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC
|
Facility
|
IP
|
$30,734.57
|
|
|
Service Code
|
MSDRG 069
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,734.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,213.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,734.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,766.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,766.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,766.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,685.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,506.91
|
| Rate for Payer: Multiplan WC |
$16,386.05
|
| Rate for Payer: Prime Health Services WC |
$16,218.85
|
| 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 070: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$54,250.48
|
|
|
Service Code
|
MSDRG 070
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$54,250.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,250.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,565.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,752.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,752.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,752.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,527.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,228.18
|
| Rate for Payer: Multiplan WC |
$35,408.99
|
| Rate for Payer: Prime Health Services WC |
$35,047.67
|
| 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 071: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC
|
Facility
|
IP
|
$34,672.87
|
|
|
Service Code
|
MSDRG 071
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,672.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,189.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,672.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,683.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,683.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,683.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,361.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,416.04
|
| Rate for Payer: Multiplan WC |
$21,953.49
|
| Rate for Payer: Prime Health Services WC |
$21,729.47
|
| 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 072: NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,499.55
|
|
|
Service Code
|
MSDRG 072
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,499.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,737.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,499.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,592.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,592.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,592.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,466.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,273.63
|
| Rate for Payer: Multiplan WC |
$15,854.16
|
| Rate for Payer: Prime Health Services WC |
$15,692.38
|
| 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 073: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC
|
Facility
|
IP
|
$45,868.11
|
|
|
Service Code
|
MSDRG 073
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,868.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,868.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,426.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,686.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,686.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,686.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,665.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,119.94
|
| Rate for Payer: Multiplan WC |
$30,790.34
|
| Rate for Payer: Prime Health Services WC |
$30,476.15
|
| 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 074: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$34,139.97
|
|
|
Service Code
|
MSDRG 074
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,139.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,110.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,139.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,288.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,288.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,288.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,863.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,887.09
|
| Rate for Payer: Multiplan WC |
$21,021.14
|
| Rate for Payer: Prime Health Services WC |
$20,806.64
|
| 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
|
|
