|
INPATIENT MS-DRG 075: VIRAL MENINGITIS WITH CC/MCC
|
Facility
|
IP
|
$58,018.76
|
|
|
Service Code
|
MSDRG 075
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$58,018.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,018.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,426.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,130.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,130.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,130.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,264.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,075.00
|
| Rate for Payer: Multiplan WC |
$37,479.07
|
| Rate for Payer: Prime Health Services WC |
$37,096.63
|
| 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 076: VIRAL MENINGITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$32,587.70
|
|
|
Service Code
|
MSDRG 076
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,587.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,966.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,587.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,139.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,139.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,139.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,415.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,346.31
|
| Rate for Payer: Multiplan WC |
$20,275.66
|
| Rate for Payer: Prime Health Services WC |
$20,068.77
|
| 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 077: HYPERTENSIVE ENCEPHALOPATHY WITH MCC
|
Facility
|
IP
|
$45,804.44
|
|
|
Service Code
|
MSDRG 077
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,804.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,804.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,395.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,663.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,663.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,663.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,635.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,088.73
|
| Rate for Payer: Multiplan WC |
$32,123.16
|
| Rate for Payer: Prime Health Services WC |
$31,795.37
|
| 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 078: HYPERTENSIVE ENCEPHALOPATHY WITH CC
|
Facility
|
IP
|
$34,000.76
|
|
|
Service Code
|
MSDRG 078
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,000.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,828.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,000.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,185.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,185.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,185.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,734.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,748.90
|
| Rate for Payer: Multiplan WC |
$20,388.62
|
| Rate for Payer: Prime Health Services WC |
$20,180.57
|
| 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 079: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC
|
Facility
|
IP
|
$29,867.87
|
|
|
Service Code
|
MSDRG 079
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,867.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,458.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,867.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,124.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,124.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,124.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,876.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,646.63
|
| Rate for Payer: Multiplan WC |
$15,071.72
|
| Rate for Payer: Prime Health Services WC |
$14,917.93
|
| 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 080: NONTRAUMATIC STUPOR AND COMA WITH MCC
|
Facility
|
IP
|
$66,958.95
|
|
|
Service Code
|
MSDRG 080
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$66,958.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66,958.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,840.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,400.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,400.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,400.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,384.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,456.63
|
| Rate for Payer: Multiplan WC |
$41,890.31
|
| Rate for Payer: Prime Health Services WC |
$41,462.85
|
| 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 081: NONTRAUMATIC STUPOR AND COMA WITHOUT MCC
|
Facility
|
IP
|
$32,393.12
|
|
|
Service Code
|
MSDRG 081
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,393.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,572.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,393.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,994.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,994.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,994.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,233.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,153.17
|
| Rate for Payer: Multiplan WC |
$18,452.03
|
| Rate for Payer: Prime Health Services WC |
$18,263.74
|
| 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 082: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC
|
Facility
|
IP
|
$69,068.94
|
|
|
Service Code
|
MSDRG 082
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$69,068.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,068.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,882.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,172.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,172.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,172.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,356.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,490.72
|
| Rate for Payer: Multiplan WC |
$46,521.28
|
| Rate for Payer: Prime Health Services WC |
$46,046.57
|
| 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 083: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC
|
Facility
|
IP
|
$41,120.62
|
|
|
Service Code
|
MSDRG 083
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$41,120.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,120.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,082.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,950.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,950.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,950.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,477.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,793.17
|
| Rate for Payer: Multiplan WC |
$27,687.27
|
| Rate for Payer: Prime Health Services WC |
$27,404.75
|
| 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 084: TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC
|
Facility
|
IP
|
$32,545.79
|
|
|
Service Code
|
MSDRG 084
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,545.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,881.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,545.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,107.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,107.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,107.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,376.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,304.71
|
| Rate for Payer: Multiplan WC |
$18,821.68
|
| Rate for Payer: Prime Health Services WC |
$18,629.63
|
| 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 085: TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC
|
Facility
|
IP
|
$68,902.20
|
|
|
Service Code
|
MSDRG 085
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$68,902.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,902.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,800.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,111.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,111.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,111.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,280.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,409.01
|
| Rate for Payer: Multiplan WC |
$47,967.05
|
| Rate for Payer: Prime Health Services WC |
$47,477.59
|
| 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 086: TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC
|
Facility
|
IP
|
$39,929.20
|
|
|
Service Code
|
MSDRG 086
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,929.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,929.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,494.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,514.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,514.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,514.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,928.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,209.27
|
| Rate for Payer: Multiplan WC |
$26,691.26
|
| Rate for Payer: Prime Health Services WC |
$26,418.90
|
| 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 087: TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC
|
Facility
|
IP
|
$32,044.34
|
|
|
Service Code
|
MSDRG 087
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,044.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,866.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,044.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,736.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,736.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,736.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,908.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,806.98
|
| Rate for Payer: Multiplan WC |
$17,916.02
|
| Rate for Payer: Prime Health Services WC |
$17,733.20
|
| 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 088: CONCUSSION WITH MCC
|
Facility
|
IP
|
$46,498.68
|
|
|
Service Code
|
MSDRG 088
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$46,498.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,498.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,738.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,917.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,917.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,917.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,955.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,428.97
|
| Rate for Payer: Multiplan WC |
$32,371.64
|
| Rate for Payer: Prime Health Services WC |
$32,041.32
|
| 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 089: CONCUSSION WITH CC
|
Facility
|
IP
|
$35,991.61
|
|
|
Service Code
|
MSDRG 089
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,991.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,860.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,991.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,660.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,660.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,660.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,592.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,725.00
|
| Rate for Payer: Multiplan WC |
$23,980.44
|
| Rate for Payer: Prime Health Services WC |
$23,735.74
|
| 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 090: CONCUSSION WITHOUT CC/MCC
|
Facility
|
IP
|
$32,771.82
|
|
|
Service Code
|
MSDRG 090
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,771.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,339.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,771.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,275.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,275.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,275.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,587.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,529.06
|
| Rate for Payer: Multiplan WC |
$16,903.57
|
| Rate for Payer: Prime Health Services WC |
$16,731.08
|
| 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 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC
|
Facility
|
IP
|
$54,241.39
|
|
|
Service Code
|
MSDRG 091
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$54,241.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,241.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,561.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,749.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,749.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,749.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,523.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,223.73
|
| Rate for Payer: Multiplan WC |
$35,474.71
|
| Rate for Payer: Prime Health Services WC |
$35,112.72
|
| 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 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH CC
|
Facility
|
IP
|
$34,138.49
|
|
|
Service Code
|
MSDRG 092
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,138.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,107.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,138.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,287.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,287.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,287.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,862.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,885.61
|
| Rate for Payer: Multiplan WC |
$20,419.42
|
| Rate for Payer: Prime Health Services WC |
$20,211.06
|
| 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 093: OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$30,370.82
|
|
|
Service Code
|
MSDRG 093
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,370.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,476.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,370.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,496.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,496.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,496.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,346.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,145.85
|
| Rate for Payer: Multiplan WC |
$15,706.29
|
| Rate for Payer: Prime Health Services WC |
$15,546.03
|
| 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 094: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC
|
Facility
|
IP
|
$109,825.77
|
|
|
Service Code
|
MSDRG 094
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$109,825.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$109,825.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,006.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,078.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,078.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,078.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,139.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,465.78
|
| Rate for Payer: Multiplan WC |
$73,387.09
|
| Rate for Payer: Prime Health Services WC |
$72,638.25
|
| 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 095: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC
|
Facility
|
IP
|
$72,279.41
|
|
|
Service Code
|
MSDRG 095
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$72,279.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,279.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,467.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,346.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,346.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,346.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,836.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,064.19
|
| Rate for Payer: Multiplan WC |
$52,507.66
|
| Rate for Payer: Prime Health Services WC |
$51,971.87
|
| 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 096: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$66,079.79
|
|
|
Service Code
|
MSDRG 096
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$66,079.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66,079.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,406.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,078.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,078.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,078.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,979.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,025.74
|
| Rate for Payer: Multiplan WC |
$46,911.47
|
| Rate for Payer: Prime Health Services WC |
$46,432.78
|
| 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 097: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC
|
Facility
|
IP
|
$110,256.26
|
|
|
Service Code
|
MSDRG 097
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$110,256.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$110,256.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,219.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,236.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,236.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,236.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,337.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,676.75
|
| Rate for Payer: Multiplan WC |
$79,849.93
|
| Rate for Payer: Prime Health Services WC |
$79,035.13
|
| 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 098: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC
|
Facility
|
IP
|
$65,315.82
|
|
|
Service Code
|
MSDRG 098
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$65,315.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,315.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,029.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,799.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,799.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,799.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,627.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,651.33
|
| Rate for Payer: Multiplan WC |
$42,802.13
|
| Rate for Payer: Prime Health Services WC |
$42,365.37
|
| 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 099: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$40,023.18
|
|
|
Service Code
|
MSDRG 099
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$40,023.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,023.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,540.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,548.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,548.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,548.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,971.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,255.32
|
| Rate for Payer: Multiplan WC |
$28,720.26
|
| Rate for Payer: Prime Health Services WC |
$28,427.20
|
| 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
|
|
