|
INPATIENT MS-DRG 243: PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC
|
Facility
|
IP
|
$69,047.72
|
|
|
Service Code
|
MSDRG 243
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$69,047.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,047.72
|
| 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 |
$52,871.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,164.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,164.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,164.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,347.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,480.32
|
| Rate for Payer: Multiplan WC |
$48,137.50
|
| Rate for Payer: Prime Health Services WC |
$47,646.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,403.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,388.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,412.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,408.00
|
|
|
INPATIENT MS-DRG 244: PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC
|
Facility
|
IP
|
$55,463.12
|
|
|
Service Code
|
MSDRG 244
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$55,463.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,463.12
|
| 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 |
$46,164.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,195.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,195.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,195.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,086.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,822.49
|
| Rate for Payer: Multiplan WC |
$39,041.90
|
| Rate for Payer: Prime Health Services WC |
$38,643.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$23,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$22,125.00
|
| Rate for Payer: United Healthcare HMO Rider |
$19,630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,951.00
|
|
|
INPATIENT MS-DRG 245: AICD GENERATOR PROCEDURES
|
Facility
|
IP
|
$137,373.92
|
|
|
Service Code
|
MSDRG 245
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$137,373.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$137,373.92
|
| 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 |
$86,608.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$64,154.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,547.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64,154.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64,154.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80,834.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,967.18
|
| Rate for Payer: Multiplan WC |
$100,135.86
|
| Rate for Payer: Prime Health Services WC |
$99,114.07
|
| 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 250: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$71,266.85
|
|
|
Service Code
|
MSDRG 250
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$71,266.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71,266.85
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,967.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,976.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,976.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,976.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,369.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,567.93
|
| Rate for Payer: Multiplan WC |
$49,692.12
|
| Rate for Payer: Prime Health Services WC |
$49,185.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$30,903.00
|
| Rate for Payer: United Healthcare All Other HMO |
$33,938.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25,777.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23,570.00
|
|
|
INPATIENT MS-DRG 251: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$48,108.46
|
|
|
Service Code
|
MSDRG 251
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$48,108.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,108.46
|
| 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 |
$42,533.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,505.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,505.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,505.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,697.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,217.96
|
| Rate for Payer: Multiplan WC |
$33,377.94
|
| Rate for Payer: Prime Health Services WC |
$33,037.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$39,303.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,244.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,458.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,621.00
|
|
|
INPATIENT MS-DRG 252: OTHER VASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$101,673.80
|
|
|
Service Code
|
MSDRG 252
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$101,673.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101,673.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,981.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,097.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,097.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,097.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,382.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,470.46
|
| Rate for Payer: Multiplan WC |
$68,659.60
|
| Rate for Payer: Prime Health Services WC |
$67,959.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$40,038.00
|
| Rate for Payer: United Healthcare All Other HMO |
$39,861.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,281.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,688.00
|
|
|
INPATIENT MS-DRG 253: OTHER VASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$77,339.15
|
|
|
Service Code
|
MSDRG 253
|
| Min. Negotiated Rate |
$25,295.00 |
| Max. Negotiated Rate |
$77,339.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77,339.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,965.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,197.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,197.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,197.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,168.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,543.98
|
| Rate for Payer: Multiplan WC |
$54,914.54
|
| Rate for Payer: Prime Health Services WC |
$54,354.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,705.00
|
| Rate for Payer: United Healthcare All Other HMO |
$36,415.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,663.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,295.00
|
|
|
INPATIENT MS-DRG 254: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$53,818.00
|
|
|
Service Code
|
MSDRG 254
|
| Min. Negotiated Rate |
$18,843.00 |
| Max. Negotiated Rate |
$53,818.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,601.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,751.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,149.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,149.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,149.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,767.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,419.90
|
| Rate for Payer: Multiplan WC |
$37,550.94
|
| Rate for Payer: Prime Health Services WC |
$37,167.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$53,818.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,125.00
|
| Rate for Payer: United Healthcare HMO Rider |
$20,606.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18,843.00
|
|
|
INPATIENT MS-DRG 255: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC
|
Facility
|
IP
|
$83,290.18
|
|
|
Service Code
|
MSDRG 255
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$83,290.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$83,290.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,904.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,373.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,373.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,373.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,910.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,460.61
|
| Rate for Payer: Multiplan WC |
$52,688.39
|
| Rate for Payer: Prime Health Services WC |
$52,150.75
|
| 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 256: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC
|
Facility
|
IP
|
$49,709.15
|
|
|
Service Code
|
MSDRG 256
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,709.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,709.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,323.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,091.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,091.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,091.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,435.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,002.45
|
| Rate for Payer: Multiplan WC |
$33,519.64
|
| Rate for Payer: Prime Health Services WC |
$33,177.60
|
| 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 257: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$33,613.06
|
|
|
Service Code
|
MSDRG 257
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$33,613.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,043.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,613.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,898.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,898.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,898.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,372.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,364.07
|
| Rate for Payer: Multiplan WC |
$21,536.61
|
| Rate for Payer: Prime Health Services WC |
$21,316.85
|
| 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 258: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$82,113.92
|
|
|
Service Code
|
MSDRG 258
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$82,113.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,113.92
|
| 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 |
$59,323.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,943.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,943.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,943.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,368.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,884.12
|
| Rate for Payer: Multiplan WC |
$58,555.66
|
| Rate for Payer: Prime Health Services WC |
$57,958.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$36,575.00
|
| Rate for Payer: United Healthcare All Other HMO |
$30,425.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,636.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,698.00
|
|
|
INPATIENT MS-DRG 259: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
|
IP
|
$56,587.85
|
|
|
Service Code
|
MSDRG 259
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$56,587.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,587.85
|
| 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 |
$46,719.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,607.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,607.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,607.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,605.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,373.73
|
| Rate for Payer: Multiplan WC |
$40,951.79
|
| Rate for Payer: Prime Health Services WC |
$40,533.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$36,575.00
|
| Rate for Payer: United Healthcare All Other HMO |
$29,086.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,636.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,698.00
|
|
|
INPATIENT MS-DRG 260: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$100,503.60
|
|
|
Service Code
|
MSDRG 260
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$100,503.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$100,503.60
|
| 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 |
$68,403.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,669.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,669.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,669.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,843.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,896.96
|
| Rate for Payer: Multiplan WC |
$71,848.92
|
| Rate for Payer: Prime Health Services WC |
$71,115.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$48,768.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,253.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,600.00
|
|
|
INPATIENT MS-DRG 261: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
|
IP
|
$57,048.65
|
|
|
Service Code
|
MSDRG 261
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$57,048.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,048.65
|
| 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 |
$46,947.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,775.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,775.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,775.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,817.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,599.56
|
| Rate for Payer: Multiplan WC |
$39,241.10
|
| Rate for Payer: Prime Health Services WC |
$38,840.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$48,768.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40,571.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,600.00
|
|
|
INPATIENT MS-DRG 262: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$49,878.91
|
|
|
Service Code
|
MSDRG 262
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$49,878.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,878.91
|
| 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 |
$43,407.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,153.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,153.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,153.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,513.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,085.65
|
| Rate for Payer: Multiplan WC |
$34,435.56
|
| Rate for Payer: Prime Health Services WC |
$34,084.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$48,768.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40,571.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,600.00
|
|
|
INPATIENT MS-DRG 263: VEIN LIGATION AND STRIPPING
|
Facility
|
IP
|
$85,648.76
|
|
|
Service Code
|
MSDRG 263
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$85,648.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,648.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,068.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,236.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,236.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,236.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,997.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,616.53
|
| Rate for Payer: Multiplan WC |
$57,214.62
|
| Rate for Payer: Prime Health Services WC |
$56,630.80
|
| 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 264: OTHER CIRCULATORY SYSTEM O.R. PROCEDURES
|
Facility
|
IP
|
$99,012.06
|
|
|
Service Code
|
MSDRG 264
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$99,012.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$99,012.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,667.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,123.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,123.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,123.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,156.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,165.93
|
| Rate for Payer: Multiplan WC |
$67,969.58
|
| Rate for Payer: Prime Health Services WC |
$67,276.01
|
| 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 265: AICD LEAD PROCEDURES
|
Facility
|
IP
|
$107,139.78
|
|
|
Service Code
|
MSDRG 265
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$107,139.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107,139.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$71,680.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$53,096.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,547.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$53,096.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,096.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,901.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,149.34
|
| Rate for Payer: Multiplan WC |
$69,456.41
|
| Rate for Payer: Prime Health Services WC |
$68,747.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 266: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$205,698.00
|
|
|
Service Code
|
MSDRG 266
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$205,698.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$189,356.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$112,275.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$83,167.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$83,167.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$83,167.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104,790.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111,444.12
|
| Rate for Payer: Multiplan WC |
$135,555.12
|
| Rate for Payer: Prime Health Services WC |
$134,171.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$205,698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$194,804.00
|
| Rate for Payer: United Healthcare HMO Rider |
$147,969.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135,306.00
|
|
|
INPATIENT MS-DRG 267: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$154,449.00
|
|
|
Service Code
|
MSDRG 267
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$154,449.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$147,948.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$91,829.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$68,022.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$68,022.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68,022.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85,707.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91,149.64
|
| Rate for Payer: Multiplan WC |
$105,980.54
|
| Rate for Payer: Prime Health Services WC |
$104,899.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$154,449.00
|
| Rate for Payer: United Healthcare All Other HMO |
$146,267.00
|
| Rate for Payer: United Healthcare HMO Rider |
$111,104.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101,596.00
|
|
|
INPATIENT MS-DRG 268: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC
|
Facility
|
IP
|
$207,807.09
|
|
|
Service Code
|
MSDRG 268
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$207,807.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$207,807.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$121,385.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$89,915.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$89,915.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$89,915.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$113,293.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$120,486.66
|
| Rate for Payer: Multiplan WC |
$142,128.84
|
| Rate for Payer: Prime Health Services WC |
$140,678.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$120,710.00
|
| Rate for Payer: United Healthcare All Other HMO |
$106,481.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,883.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,960.00
|
|
|
INPATIENT MS-DRG 269: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
|
Facility
|
IP
|
$126,072.12
|
|
|
Service Code
|
MSDRG 269
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$126,072.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$126,072.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$81,028.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$60,021.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$60,021.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60,021.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75,626.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80,428.14
|
| Rate for Payer: Multiplan WC |
$87,820.13
|
| Rate for Payer: Prime Health Services WC |
$86,924.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$75,032.00
|
| Rate for Payer: United Healthcare All Other HMO |
$66,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$50,278.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45,974.00
|
|
|
INPATIENT MS-DRG 270: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$153,304.98
|
|
|
Service Code
|
MSDRG 270
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$153,304.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$153,304.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$94,474.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$69,981.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$69,981.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69,981.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88,176.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93,775.06
|
| Rate for Payer: Multiplan WC |
$104,994.79
|
| Rate for Payer: Prime Health Services WC |
$103,923.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$91,000.00
|
| Rate for Payer: United Healthcare All Other HMO |
$80,275.00
|
| Rate for Payer: United Healthcare HMO Rider |
$60,976.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55,758.00
|
|
|
INPATIENT MS-DRG 271: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$104,778.16
|
|
|
Service Code
|
MSDRG 271
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$104,778.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,778.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,514.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,232.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,232.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,232.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,813.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,991.94
|
| Rate for Payer: Multiplan WC |
$71,544.98
|
| Rate for Payer: Prime Health Services WC |
$70,814.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,398.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,280.00
|
| Rate for Payer: United Healthcare HMO Rider |
$40,470.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50,192.00
|
|
