|
INPATIENT MS-DRG 204: RESPIRATORY SIGNS AND SYMPTOMS
|
Facility
|
IP
|
$31,096.82
|
|
|
Service Code
|
MSDRG 204
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,096.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,947.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,096.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,034.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,034.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,034.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,023.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,866.47
|
| Rate for Payer: Multiplan WC |
$16,622.22
|
| Rate for Payer: Prime Health Services WC |
$16,452.61
|
| 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 205: OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$54,881.05
|
|
|
Service Code
|
MSDRG 205
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$54,881.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,881.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,877.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,983.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,983.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,983.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,818.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,537.22
|
| Rate for Payer: Multiplan WC |
$36,575.46
|
| Rate for Payer: Prime Health Services WC |
$36,202.24
|
| 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 206: OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC
|
Facility
|
IP
|
$32,452.99
|
|
|
Service Code
|
MSDRG 206
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,452.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,693.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,452.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,039.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,039.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,039.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,289.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,212.60
|
| Rate for Payer: Multiplan WC |
$18,347.29
|
| Rate for Payer: Prime Health Services WC |
$18,160.07
|
| 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 207: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS
|
Facility
|
IP
|
$209,422.93
|
|
|
Service Code
|
MSDRG 207
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$209,422.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$209,422.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$122,183.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$90,506.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$90,506.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90,506.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$114,038.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$121,278.62
|
| Rate for Payer: Multiplan WC |
$134,840.45
|
| Rate for Payer: Prime Health Services WC |
$133,464.53
|
| 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 208: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS
|
Facility
|
IP
|
$81,968.40
|
|
|
Service Code
|
MSDRG 208
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$81,968.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81,968.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,251.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,890.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,890.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,890.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,301.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,812.80
|
| Rate for Payer: Multiplan WC |
$53,396.89
|
| Rate for Payer: Prime Health Services WC |
$52,852.02
|
| 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 212: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES
|
Facility
|
IP
|
$326,524.54
|
|
|
Service Code
|
MSDRG 212
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$326,524.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$326,524.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$180,003.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$133,336.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$133,336.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$133,336.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168,003.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$178,670.43
|
| 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 215: OTHER HEART ASSIST SYSTEM IMPLANT
|
Facility
|
IP
|
$309,671.88
|
|
|
Service Code
|
MSDRG 215
|
| Min. Negotiated Rate |
$127,172.31 |
| Max. Negotiated Rate |
$309,671.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$309,671.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$171,682.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$127,172.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$127,172.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$127,172.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$160,237.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170,410.90
|
| Rate for Payer: Multiplan WC |
$211,591.42
|
| Rate for Payer: Prime Health Services WC |
$209,432.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$190,538.00
|
| Rate for Payer: United Healthcare All Other HMO |
$197,963.00
|
| Rate for Payer: United Healthcare HMO Rider |
$150,369.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$137,500.00
|
|
|
INPATIENT MS-DRG 216: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$294,225.87
|
|
|
Service Code
|
MSDRG 216
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$294,225.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$294,225.87
|
| 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 |
$164,056.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$121,522.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$121,522.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$121,522.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$153,118.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$162,840.77
|
| Rate for Payer: Multiplan WC |
$200,064.30
|
| Rate for Payer: Prime Health Services WC |
$198,022.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$147,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$150,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$114,207.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$104,433.00
|
|
|
INPATIENT MS-DRG 217: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$192,970.43
|
|
|
Service Code
|
MSDRG 217
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$192,970.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$192,970.43
|
| 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 |
$114,060.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$84,488.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$84,488.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84,488.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$106,456.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$113,215.19
|
| Rate for Payer: Multiplan WC |
$130,381.98
|
| Rate for Payer: Prime Health Services WC |
$129,051.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$120,359.00
|
| Rate for Payer: United Healthcare All Other HMO |
$122,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$93,062.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85,097.00
|
|
|
INPATIENT MS-DRG 218: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$172,701.16
|
|
|
Service Code
|
MSDRG 218
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$172,701.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$172,701.16
|
| 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 |
$104,051.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$77,075.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$77,075.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77,075.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$97,115.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$103,281.17
|
| Rate for Payer: Multiplan WC |
$121,959.97
|
| Rate for Payer: Prime Health Services WC |
$120,715.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$156,273.00
|
| Rate for Payer: United Healthcare All Other HMO |
$110,848.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,200.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76,993.00
|
|
|
INPATIENT MS-DRG 219: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$233,772.74
|
|
|
Service Code
|
MSDRG 219
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$233,772.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$233,772.74
|
| 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 |
$134,206.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$99,412.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$99,412.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$99,412.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$125,259.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$133,212.51
|
| Rate for Payer: Multiplan WC |
$166,926.64
|
| Rate for Payer: Prime Health Services WC |
$165,223.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$140,190.00
|
| Rate for Payer: United Healthcare All Other HMO |
$139,384.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105,875.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96,814.00
|
|
|
INPATIENT MS-DRG 220: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$158,995.29
|
|
|
Service Code
|
MSDRG 220
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$158,995.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$158,995.29
|
| 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 |
$97,284.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$72,062.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$72,062.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72,062.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90,798.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96,563.88
|
| Rate for Payer: Multiplan WC |
$111,617.81
|
| Rate for Payer: Prime Health Services WC |
$110,478.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$111,411.00
|
| Rate for Payer: United Healthcare All Other HMO |
$139,384.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105,875.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96,814.00
|
|
|
INPATIENT MS-DRG 221: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$162,555.00
|
|
|
Service Code
|
MSDRG 221
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$162,555.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$140,926.96
|
| 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 |
$88,363.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$65,454.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$65,454.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65,454.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82,472.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87,708.53
|
| Rate for Payer: Multiplan WC |
$97,170.39
|
| Rate for Payer: Prime Health Services WC |
$96,178.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$162,555.00
|
| Rate for Payer: United Healthcare All Other HMO |
$139,384.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105,875.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96,814.00
|
|
|
INPATIENT MS-DRG 228: OTHER CARDIOTHORACIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$152,753.23
|
|
|
Service Code
|
MSDRG 228
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$152,753.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$152,753.23
|
| 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 |
$94,202.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$69,779.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$69,779.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69,779.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87,922.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93,504.64
|
| Rate for Payer: Multiplan WC |
$101,209.91
|
| Rate for Payer: Prime Health Services WC |
$100,177.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$114,283.00
|
| Rate for Payer: United Healthcare All Other HMO |
$79,615.00
|
| Rate for Payer: United Healthcare HMO Rider |
$82,735.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$75,655.00
|
|
|
INPATIENT MS-DRG 229: OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$96,392.75
|
|
|
Service Code
|
MSDRG 229
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$96,392.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96,392.75
|
| 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 |
$66,373.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,165.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,165.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,165.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61,948.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,882.23
|
| Rate for Payer: Multiplan WC |
$67,788.85
|
| Rate for Payer: Prime Health Services WC |
$67,097.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$67,625.00
|
| Rate for Payer: United Healthcare All Other HMO |
$62,832.00
|
| Rate for Payer: United Healthcare HMO Rider |
$65,291.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59,704.00
|
|
|
INPATIENT MS-DRG 231: CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
|
IP
|
$246,020.40
|
|
|
Service Code
|
MSDRG 231
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$246,020.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$246,020.40
|
| 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 |
$140,254.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$103,891.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$103,891.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$103,891.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$130,903.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$139,215.12
|
| Rate for Payer: Multiplan WC |
$172,366.75
|
| Rate for Payer: Prime Health Services WC |
$170,607.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$101,973.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,744.00
|
| Rate for Payer: United Healthcare HMO Rider |
$89,600.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81,931.00
|
|
|
INPATIENT MS-DRG 232: CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
|
IP
|
$180,337.76
|
|
|
Service Code
|
MSDRG 232
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$180,337.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$180,337.76
|
| 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 |
$107,822.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$79,868.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$79,868.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79,868.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$100,634.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$107,023.88
|
| Rate for Payer: Multiplan WC |
$120,298.57
|
| Rate for Payer: Prime Health Services WC |
$119,071.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$89,284.00
|
| Rate for Payer: United Healthcare All Other HMO |
$82,953.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76,039.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69,531.00
|
|
|
INPATIENT MS-DRG 233: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC
|
Facility
|
IP
|
$236,452.67
|
|
|
Service Code
|
MSDRG 233
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$236,452.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$236,452.67
|
| 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 |
$135,529.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$100,392.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$100,392.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$100,392.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126,494.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$134,525.96
|
| Rate for Payer: Multiplan WC |
$159,052.95
|
| Rate for Payer: Prime Health Services WC |
$157,429.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$135,867.00
|
| Rate for Payer: United Healthcare All Other HMO |
$101,161.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76,840.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$70,265.00
|
|
|
INPATIENT MS-DRG 234: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC
|
Facility
|
IP
|
$157,579.54
|
|
|
Service Code
|
MSDRG 234
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$157,579.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$157,579.54
|
| 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 |
$96,585.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$71,544.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$71,544.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71,544.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90,146.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95,870.01
|
| Rate for Payer: Multiplan WC |
$106,508.33
|
| Rate for Payer: Prime Health Services WC |
$105,421.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$97,821.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,922.00
|
| Rate for Payer: United Healthcare HMO Rider |
$70,582.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64,541.00
|
|
|
INPATIENT MS-DRG 235: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$178,276.27
|
|
|
Service Code
|
MSDRG 235
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$178,276.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$178,276.27
|
| 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 |
$106,804.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$79,114.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$79,114.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79,114.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$99,684.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$106,013.55
|
| Rate for Payer: Multiplan WC |
$123,013.49
|
| Rate for Payer: Prime Health Services WC |
$121,758.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$79,536.00
|
| Rate for Payer: United Healthcare All Other HMO |
$70,702.00
|
| Rate for Payer: United Healthcare HMO Rider |
$53,703.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,106.00
|
|
|
INPATIENT MS-DRG 236: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$122,513.02
|
|
|
Service Code
|
MSDRG 236
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$122,513.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122,513.02
|
| 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 |
$79,271.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$58,719.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58,719.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,719.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73,986.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,683.81
|
| Rate for Payer: Multiplan WC |
$83,755.96
|
| Rate for Payer: Prime Health Services WC |
$82,901.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$72,566.00
|
| Rate for Payer: United Healthcare All Other HMO |
$65,316.00
|
| Rate for Payer: United Healthcare HMO Rider |
$49,615.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45,367.00
|
|
|
INPATIENT MS-DRG 239: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC
|
Facility
|
IP
|
$145,722.95
|
|
|
Service Code
|
MSDRG 239
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$145,722.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$145,722.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$90,731.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$67,208.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67,208.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,208.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84,682.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,059.07
|
| Rate for Payer: Multiplan WC |
$95,496.67
|
| Rate for Payer: Prime Health Services WC |
$94,522.21
|
| 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 240: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC
|
Facility
|
IP
|
$85,163.71
|
|
|
Service Code
|
MSDRG 240
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$85,163.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,163.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,829.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,058.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,058.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,058.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,774.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,378.82
|
| Rate for Payer: Multiplan WC |
$55,740.11
|
| Rate for Payer: Prime Health Services WC |
$55,171.33
|
| 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 241: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC
|
Facility
|
IP
|
$42,133.18
|
|
|
Service Code
|
MSDRG 241
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,133.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,133.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,645.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,367.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,367.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,367.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,002.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,351.85
|
| Rate for Payer: Multiplan WC |
$31,808.95
|
| Rate for Payer: Prime Health Services WC |
$31,484.37
|
| 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 242: PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC
|
Facility
|
IP
|
$104,744.81
|
|
|
Service Code
|
MSDRG 242
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$104,744.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,744.81
|
| 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 |
$70,497.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,220.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,220.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,220.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,797.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,975.56
|
| Rate for Payer: Multiplan WC |
$71,333.45
|
| Rate for Payer: Prime Health Services WC |
$70,605.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$36,319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$33,743.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,370.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,428.00
|
|
