|
INPATIENT MS-DRG 297: CARDIAC ARREST, UNEXPLAINED WITH CC
|
Facility
|
IP
|
$29,685.24
|
|
|
Service Code
|
MSDRG 297
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,685.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,088.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,685.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,989.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,989.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,989.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,706.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,465.35
|
| Rate for Payer: Multiplan WC |
$13,067.36
|
| Rate for Payer: Prime Health Services WC |
$12,934.02
|
| 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 298: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC
|
Facility
|
IP
|
$25,360.75
|
|
|
Service Code
|
MSDRG 298
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$25,360.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,305.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,360.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,785.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18,785.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,785.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,670.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,172.89
|
| Rate for Payer: Multiplan WC |
$10,032.06
|
| Rate for Payer: Prime Health Services WC |
$9,929.70
|
| 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 299: PERIPHERAL VASCULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$47,784.08
|
|
|
Service Code
|
MSDRG 299
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,784.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,784.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,372.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,387.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,387.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,387.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,547.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,058.96
|
| Rate for Payer: Multiplan WC |
$31,585.10
|
| Rate for Payer: Prime Health Services WC |
$31,262.80
|
| 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 300: PERIPHERAL VASCULAR DISORDERS WITH CC
|
Facility
|
IP
|
$34,750.71
|
|
|
Service Code
|
MSDRG 300
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,750.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,347.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,750.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,741.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,741.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,741.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,434.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,493.30
|
| Rate for Payer: Multiplan WC |
$21,175.16
|
| Rate for Payer: Prime Health Services WC |
$20,959.09
|
| 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 301: PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$29,403.84
|
|
|
Service Code
|
MSDRG 301
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,403.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,518.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,403.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,780.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,780.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,780.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,443.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,186.03
|
| Rate for Payer: Multiplan WC |
$14,708.22
|
| Rate for Payer: Prime Health Services WC |
$14,558.14
|
| 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 302: ATHEROSCLEROSIS WITH MCC
|
Facility
|
IP
|
$35,560.50
|
|
|
Service Code
|
MSDRG 302
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,560.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,987.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,560.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,341.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,341.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,341.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,189.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,297.09
|
| Rate for Payer: Multiplan WC |
$24,762.88
|
| Rate for Payer: Prime Health Services WC |
$24,510.20
|
| 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 303: ATHEROSCLEROSIS WITHOUT MCC
|
Facility
|
IP
|
$28,629.94
|
|
|
Service Code
|
MSDRG 303
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,629.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,950.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,629.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,207.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,207.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,207.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,721.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,417.86
|
| Rate for Payer: Multiplan WC |
$13,884.71
|
| Rate for Payer: Prime Health Services WC |
$13,743.03
|
| 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 304: HYPERTENSION WITH MCC
|
Facility
|
IP
|
$35,978.13
|
|
|
Service Code
|
MSDRG 304
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,978.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,833.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,978.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,650.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,650.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,650.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,579.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,711.63
|
| Rate for Payer: Multiplan WC |
$22,561.37
|
| Rate for Payer: Prime Health Services WC |
$22,331.16
|
| 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 305: HYPERTENSION WITHOUT MCC
|
Facility
|
IP
|
$30,057.98
|
|
|
Service Code
|
MSDRG 305
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,057.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,843.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,057.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,265.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,265.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,265.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,054.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,835.33
|
| Rate for Payer: Multiplan WC |
$15,312.00
|
| Rate for Payer: Prime Health Services WC |
$15,155.76
|
| 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 306: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
|
IP
|
$46,589.63
|
|
|
Service Code
|
MSDRG 306
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$46,589.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,589.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,783.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,950.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,950.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,950.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,997.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,473.56
|
| Rate for Payer: Multiplan WC |
$30,307.73
|
| Rate for Payer: Prime Health Services WC |
$29,998.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 307: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$32,888.59
|
|
|
Service Code
|
MSDRG 307
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,888.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,575.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,888.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,361.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,361.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,361.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,696.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,644.97
|
| Rate for Payer: Multiplan WC |
$18,716.94
|
| Rate for Payer: Prime Health Services WC |
$18,525.95
|
| 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 308: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC
|
Facility
|
IP
|
$36,774.49
|
|
|
Service Code
|
MSDRG 308
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,774.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,445.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,774.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,240.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,240.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,240.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,322.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,502.08
|
| Rate for Payer: Multiplan WC |
$24,081.07
|
| Rate for Payer: Prime Health Services WC |
$23,835.34
|
| 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 309: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC
|
Facility
|
IP
|
$29,926.25
|
|
|
Service Code
|
MSDRG 309
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,926.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,576.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,926.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,167.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,167.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,167.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,931.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,704.57
|
| Rate for Payer: Multiplan WC |
$15,147.70
|
| Rate for Payer: Prime Health Services WC |
$14,993.13
|
| 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 310: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$27,056.73
|
|
|
Service Code
|
MSDRG 310
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,056.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,764.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,056.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,042.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,042.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,042.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,252.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,856.31
|
| Rate for Payer: Multiplan WC |
$11,319.71
|
| Rate for Payer: Prime Health Services WC |
$11,204.20
|
| 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 311: ANGINA PECTORIS
|
Facility
|
IP
|
$29,228.70
|
|
|
Service Code
|
MSDRG 311
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,228.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,163.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,228.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,650.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,650.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,650.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,280.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,012.19
|
| Rate for Payer: Multiplan WC |
$13,720.42
|
| Rate for Payer: Prime Health Services WC |
$13,580.42
|
| 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 312: SYNCOPE AND COLLAPSE
|
Facility
|
IP
|
$31,704.55
|
|
|
Service Code
|
MSDRG 312
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,704.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,177.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,704.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,484.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,484.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,484.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,590.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,469.70
|
| Rate for Payer: Multiplan WC |
$17,511.45
|
| Rate for Payer: Prime Health Services WC |
$17,332.77
|
| 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 313: CHEST PAIN
|
Facility
|
IP
|
$29,610.40
|
|
|
Service Code
|
MSDRG 313
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,610.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,936.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,610.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,933.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,933.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,933.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,636.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,391.06
|
| Rate for Payer: Multiplan WC |
$14,856.08
|
| Rate for Payer: Prime Health Services WC |
$14,704.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 314: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$63,466.55
|
|
|
Service Code
|
MSDRG 314
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$63,466.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,466.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,116.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,123.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,123.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,123.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,775.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,744.98
|
| Rate for Payer: Multiplan WC |
$42,769.27
|
| Rate for Payer: Prime Health Services WC |
$42,332.85
|
| 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 315: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC
|
Facility
|
IP
|
$33,258.30
|
|
|
Service Code
|
MSDRG 315
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,258.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,324.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,258.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,635.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,635.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,635.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,041.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,011.95
|
| Rate for Payer: Multiplan WC |
$19,889.58
|
| Rate for Payer: Prime Health Services WC |
$19,686.63
|
| 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 316: OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$29,147.86
|
|
|
Service Code
|
MSDRG 316
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,147.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,999.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,147.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,591.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,591.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,591.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,204.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,931.95
|
| Rate for Payer: Multiplan WC |
$14,005.88
|
| Rate for Payer: Prime Health Services WC |
$13,862.96
|
| 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 319: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC
|
Facility
|
IP
|
$132,235.36
|
|
|
Service Code
|
MSDRG 319
|
| Min. Negotiated Rate |
$53,798.00 |
| Max. Negotiated Rate |
$132,235.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$132,235.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$84,071.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62,275.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62,275.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62,275.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78,466.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83,448.77
|
| Rate for Payer: Multiplan WC |
$88,442.39
|
| Rate for Payer: Prime Health Services WC |
$87,539.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$81,709.00
|
| Rate for Payer: United Healthcare All Other HMO |
$73,964.00
|
| Rate for Payer: United Healthcare HMO Rider |
$58,833.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53,798.00
|
|
|
INPATIENT MS-DRG 320: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$67,483.42
|
|
|
Service Code
|
MSDRG 320
|
| Min. Negotiated Rate |
$30,800.00 |
| Max. Negotiated Rate |
$67,483.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67,483.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,099.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,592.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,592.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,592.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,626.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,713.66
|
| Rate for Payer: Multiplan WC |
$50,753.85
|
| Rate for Payer: Prime Health Services WC |
$50,235.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$46,777.00
|
| Rate for Payer: United Healthcare All Other HMO |
$42,347.00
|
| Rate for Payer: United Healthcare HMO Rider |
$33,682.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,800.00
|
|
|
INPATIENT MS-DRG 321: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES
|
Facility
|
IP
|
$87,149.41
|
|
|
Service Code
|
MSDRG 321
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$87,149.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87,149.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,809.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,785.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,785.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,785.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,689.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$61,352.03
|
| 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 322: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$55,278.19
|
|
|
Service Code
|
MSDRG 322
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$55,278.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,278.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,073.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,128.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,128.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,128.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,001.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,731.86
|
| 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 323: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$125,508.24
|
|
|
Service Code
|
MSDRG 323
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$125,508.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$125,508.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,749.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59,814.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,814.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,814.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75,366.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80,151.79
|
| 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
|
|
