|
INPATIENT MS-DRG 179: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,204.67
|
|
|
Service Code
|
MSDRG 179
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,204.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,140.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,204.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,373.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,373.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,373.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,191.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,980.93
|
| Rate for Payer: Multiplan WC |
$16,129.35
|
| Rate for Payer: Prime Health Services WC |
$15,964.76
|
| 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 180: RESPIRATORY NEOPLASMS WITH MCC
|
Facility
|
IP
|
$52,695.27
|
|
|
Service Code
|
MSDRG 180
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$52,695.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,695.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,797.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,183.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,183.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,183.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,811.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,465.94
|
| Rate for Payer: Multiplan WC |
$34,786.74
|
| Rate for Payer: Prime Health Services WC |
$34,431.77
|
| 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 181: RESPIRATORY NEOPLASMS WITH CC
|
Facility
|
IP
|
$35,261.15
|
|
|
Service Code
|
MSDRG 181
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,261.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,380.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,261.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,119.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,119.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,119.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,910.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,999.96
|
| Rate for Payer: Multiplan WC |
$23,282.20
|
| Rate for Payer: Prime Health Services WC |
$23,044.63
|
| 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 182: RESPIRATORY NEOPLASMS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,736.07
|
|
|
Service Code
|
MSDRG 182
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,736.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,009.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,736.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,767.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,767.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,767.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,687.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,508.40
|
| Rate for Payer: Multiplan WC |
$18,226.12
|
| Rate for Payer: Prime Health Services WC |
$18,040.14
|
| 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 183: MAJOR CHEST TRAUMA WITH MCC
|
Facility
|
IP
|
$47,732.54
|
|
|
Service Code
|
MSDRG 183
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,732.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,732.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,347.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,368.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,368.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,368.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,524.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,033.70
|
| Rate for Payer: Multiplan WC |
$30,849.89
|
| Rate for Payer: Prime Health Services WC |
$30,535.10
|
| 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 184: MAJOR CHEST TRAUMA WITH CC
|
Facility
|
IP
|
$34,524.67
|
|
|
Service Code
|
MSDRG 184
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,524.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,889.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,524.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,573.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,573.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,573.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,223.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,268.93
|
| Rate for Payer: Multiplan WC |
$21,464.72
|
| Rate for Payer: Prime Health Services WC |
$21,245.70
|
| 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 185: MAJOR CHEST TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$30,090.89
|
|
|
Service Code
|
MSDRG 185
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,090.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,909.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,090.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,289.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,289.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,289.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,084.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,868.00
|
| Rate for Payer: Multiplan WC |
$15,505.04
|
| Rate for Payer: Prime Health Services WC |
$15,346.83
|
| 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 186: PLEURAL EFFUSION WITH MCC
|
Facility
|
IP
|
$47,053.46
|
|
|
Service Code
|
MSDRG 186
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,053.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,053.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,012.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,120.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,120.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,120.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,211.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,700.89
|
| Rate for Payer: Multiplan WC |
$31,355.09
|
| Rate for Payer: Prime Health Services WC |
$31,035.14
|
| 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 187: PLEURAL EFFUSION WITH CC
|
Facility
|
IP
|
$33,692.41
|
|
|
Service Code
|
MSDRG 187
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,692.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,203.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,692.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,957.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,957.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,957.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,446.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,442.84
|
| Rate for Payer: Multiplan WC |
$21,479.10
|
| Rate for Payer: Prime Health Services WC |
$21,259.93
|
| 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 188: PLEURAL EFFUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$29,953.18
|
|
|
Service Code
|
MSDRG 188
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,953.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,630.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,953.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,187.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,187.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,187.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,956.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,731.30
|
| Rate for Payer: Multiplan WC |
$14,868.41
|
| Rate for Payer: Prime Health Services WC |
$14,716.69
|
| 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 189: PULMONARY EDEMA AND RESPIRATORY FAILURE
|
Facility
|
IP
|
$37,349.31
|
|
|
Service Code
|
MSDRG 189
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$37,349.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,349.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,220.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,570.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,570.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,570.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,739.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,944.86
|
| Rate for Payer: Multiplan WC |
$24,787.52
|
| Rate for Payer: Prime Health Services WC |
$24,534.59
|
| 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 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC
|
Facility
|
IP
|
$35,274.62
|
|
|
Service Code
|
MSDRG 190
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,274.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,408.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,274.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,129.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,129.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,129.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,922.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,013.33
|
| Rate for Payer: Multiplan WC |
$22,292.34
|
| Rate for Payer: Prime Health Services WC |
$22,064.87
|
| 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 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC
|
Facility
|
IP
|
$31,487.49
|
|
|
Service Code
|
MSDRG 191
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,487.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,738.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,487.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,324.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,324.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,324.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,388.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,254.25
|
| Rate for Payer: Multiplan WC |
$17,747.62
|
| Rate for Payer: Prime Health Services WC |
$17,566.53
|
| 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 192: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$28,385.96
|
|
|
Service Code
|
MSDRG 192
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,385.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,456.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,385.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,026.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,026.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,026.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,493.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,175.70
|
| Rate for Payer: Multiplan WC |
$13,391.84
|
| Rate for Payer: Prime Health Services WC |
$13,255.19
|
| 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 193: SIMPLE PNEUMONIA AND PLEURISY WITH MCC
|
Facility
|
IP
|
$40,217.21
|
|
|
Service Code
|
MSDRG 193
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$40,217.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,217.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,636.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,619.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,619.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,619.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,060.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,350.41
|
| Rate for Payer: Multiplan WC |
$26,670.72
|
| Rate for Payer: Prime Health Services WC |
$26,398.57
|
| 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 194: SIMPLE PNEUMONIA AND PLEURISY WITH CC
|
Facility
|
IP
|
$31,086.33
|
|
|
Service Code
|
MSDRG 194
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,086.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,925.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,086.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,026.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,026.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,026.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,013.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,856.06
|
| Rate for Payer: Multiplan WC |
$17,254.75
|
| Rate for Payer: Prime Health Services WC |
$17,078.68
|
| 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 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC
|
Facility
|
IP
|
$28,143.45
|
|
|
Service Code
|
MSDRG 195
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,143.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,965.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,143.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,847.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,847.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,847.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,267.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,934.98
|
| Rate for Payer: Multiplan WC |
$13,180.31
|
| Rate for Payer: Prime Health Services WC |
$13,045.82
|
| 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 196: INTERSTITIAL LUNG DISEASE WITH MCC
|
Facility
|
IP
|
$57,460.95
|
|
|
Service Code
|
MSDRG 196
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$57,460.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,460.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,150.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,926.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,926.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,926.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,007.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,801.62
|
| Rate for Payer: Multiplan WC |
$35,686.24
|
| Rate for Payer: Prime Health Services WC |
$35,322.09
|
| 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 197: INTERSTITIAL LUNG DISEASE WITH CC
|
Facility
|
IP
|
$33,710.35
|
|
|
Service Code
|
MSDRG 197
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,710.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,240.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,710.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,970.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,970.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,970.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,462.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,460.64
|
| Rate for Payer: Multiplan WC |
$20,199.68
|
| Rate for Payer: Prime Health Services WC |
$19,993.56
|
| 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 198: INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$30,427.72
|
|
|
Service Code
|
MSDRG 198
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,427.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,591.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,427.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,539.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,539.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,539.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,399.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,202.33
|
| Rate for Payer: Multiplan WC |
$14,599.38
|
| Rate for Payer: Prime Health Services WC |
$14,450.41
|
| 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 199: PNEUMOTHORAX WITH MCC
|
Facility
|
IP
|
$53,783.62
|
|
|
Service Code
|
MSDRG 199
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$53,783.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,783.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,335.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,581.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,581.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,581.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,312.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,999.36
|
| Rate for Payer: Multiplan WC |
$36,115.45
|
| Rate for Payer: Prime Health Services WC |
$35,746.92
|
| 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 200: PNEUMOTHORAX WITH CC
|
Facility
|
IP
|
$34,900.40
|
|
|
Service Code
|
MSDRG 200
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,900.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,650.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,900.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,852.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,852.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,573.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,641.88
|
| Rate for Payer: Multiplan WC |
$22,015.10
|
| Rate for Payer: Prime Health Services WC |
$21,790.46
|
| 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 201: PNEUMOTHORAX WITHOUT CC/MCC
|
Facility
|
IP
|
$29,348.45
|
|
|
Service Code
|
MSDRG 201
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,348.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,406.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,348.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,739.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,739.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,739.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,391.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,131.05
|
| Rate for Payer: Multiplan WC |
$14,948.50
|
| Rate for Payer: Prime Health Services WC |
$14,795.96
|
| 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 202: BRONCHITIS AND ASTHMA WITH CC/MCC
|
Facility
|
IP
|
$33,111.61
|
|
|
Service Code
|
MSDRG 202
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,111.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,027.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,111.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,527.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,527.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,527.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,904.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,866.34
|
| Rate for Payer: Multiplan WC |
$19,012.67
|
| Rate for Payer: Prime Health Services WC |
$18,818.66
|
| 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 203: BRONCHITIS AND ASTHMA WITHOUT CC/MCC
|
Facility
|
IP
|
$29,180.80
|
|
|
Service Code
|
MSDRG 203
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,180.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,066.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,180.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,615.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,615.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,615.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,235.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,964.65
|
| Rate for Payer: Multiplan WC |
$13,699.88
|
| Rate for Payer: Prime Health Services WC |
$13,560.09
|
| 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
|
|
