|
INPATIENT MS-DRG 389: GASTROINTESTINAL OBSTRUCTION WITH CC
|
Facility
|
IP
|
$30,700.15
|
|
|
Service Code
|
MSDRG 389
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,700.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,143.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,700.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,740.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,740.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,740.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,653.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,472.74
|
| Rate for Payer: Multiplan WC |
$16,574.99
|
| Rate for Payer: Prime Health Services WC |
$16,405.86
|
| 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 390: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC
|
Facility
|
IP
|
$27,146.53
|
|
|
Service Code
|
MSDRG 390
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,146.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,946.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,146.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,108.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,108.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,108.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,336.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,945.44
|
| Rate for Payer: Multiplan WC |
$11,613.38
|
| Rate for Payer: Prime Health Services WC |
$11,494.88
|
| 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 391: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC
|
Facility
|
IP
|
$38,674.12
|
|
|
Service Code
|
MSDRG 391
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$38,674.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,674.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,874.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,055.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,055.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,055.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,349.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,594.16
|
| Rate for Payer: Multiplan WC |
$26,368.83
|
| Rate for Payer: Prime Health Services WC |
$26,099.76
|
| 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 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$30,538.48
|
|
|
Service Code
|
MSDRG 392
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,538.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,816.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,538.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,621.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,621.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,621.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,502.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,312.27
|
| Rate for Payer: Multiplan WC |
$16,174.53
|
| Rate for Payer: Prime Health Services WC |
$16,009.48
|
| 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 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$49,099.79
|
|
|
Service Code
|
MSDRG 393
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,099.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,099.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,022.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,868.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,868.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,868.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,154.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,703.80
|
| Rate for Payer: Multiplan WC |
$33,090.43
|
| Rate for Payer: Prime Health Services WC |
$32,752.77
|
| 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 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC
|
Facility
|
IP
|
$32,803.26
|
|
|
Service Code
|
MSDRG 394
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,803.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,403.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,803.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,298.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,298.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,298.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,616.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,560.27
|
| Rate for Payer: Multiplan WC |
$19,365.90
|
| Rate for Payer: Prime Health Services WC |
$19,168.29
|
| 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 395: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$28,471.28
|
|
|
Service Code
|
MSDRG 395
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,471.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,629.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,471.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,089.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,089.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,089.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,573.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,260.39
|
| Rate for Payer: Multiplan WC |
$13,243.97
|
| Rate for Payer: Prime Health Services WC |
$13,108.83
|
| 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 397: APPENDIX PROCEDURES WITH MCC
|
Facility
|
IP
|
$68,107.93
|
|
|
Service Code
|
MSDRG 397
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$68,107.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,107.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,407.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,820.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,820.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,820.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,914.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,019.72
|
| 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 398: APPENDIX PROCEDURES WITH CC
|
Facility
|
IP
|
$45,877.20
|
|
|
Service Code
|
MSDRG 398
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,877.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,877.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,431.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,689.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,689.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,689.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,669.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,124.39
|
| 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 399: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$35,440.77
|
|
|
Service Code
|
MSDRG 399
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,440.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,744.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,440.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,252.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,252.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,252.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,078.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,178.24
|
| 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 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC
|
Facility
|
IP
|
$166,895.64
|
|
|
Service Code
|
MSDRG 405
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$166,895.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$166,895.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$101,185.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$74,952.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$74,952.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74,952.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$94,439.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$100,435.87
|
| Rate for Payer: Multiplan WC |
$113,811.09
|
| Rate for Payer: Prime Health Services WC |
$112,649.76
|
| 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 406: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC
|
Facility
|
IP
|
$87,534.42
|
|
|
Service Code
|
MSDRG 406
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$87,534.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87,534.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,999.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,925.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,925.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,925.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,866.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$61,540.72
|
| Rate for Payer: Multiplan WC |
$60,165.72
|
| Rate for Payer: Prime Health Services WC |
$59,551.78
|
| 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 407: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$65,209.72
|
|
|
Service Code
|
MSDRG 407
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$65,209.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,209.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,976.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,760.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,760.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,760.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,578.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,599.32
|
| Rate for Payer: Multiplan WC |
$45,708.03
|
| Rate for Payer: Prime Health Services WC |
$45,241.62
|
| 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 408: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$112,842.22
|
|
|
Service Code
|
MSDRG 408
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$112,842.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$112,842.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,495.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$55,182.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,182.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,182.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69,529.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,944.13
|
| Rate for Payer: Multiplan WC |
$75,358.60
|
| Rate for Payer: Prime Health Services WC |
$74,589.63
|
| 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 409: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$59,337.51
|
|
|
Service Code
|
MSDRG 409
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$59,337.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,337.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,077.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,612.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,612.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,612.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,872.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,721.34
|
| Rate for Payer: Multiplan WC |
$43,771.45
|
| Rate for Payer: Prime Health Services WC |
$43,324.80
|
| 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 410: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$47,450.60
|
|
|
Service Code
|
MSDRG 410
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$47,450.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,450.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,208.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,265.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,265.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,265.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,394.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,895.54
|
| Rate for Payer: Multiplan WC |
$34,864.77
|
| Rate for Payer: Prime Health Services WC |
$34,509.01
|
| 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 411: CHOLECYSTECTOMY WITH C.D.E. WITH MCC
|
Facility
|
IP
|
$87,325.24
|
|
|
Service Code
|
MSDRG 411
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$87,325.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87,325.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$64,290.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,622.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,622.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,622.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60,004.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,813.99
|
| Rate for Payer: Multiplan WC |
$69,376.33
|
| Rate for Payer: Prime Health Services WC |
$68,668.40
|
| 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 412: CHOLECYSTECTOMY WITH C.D.E. WITH CC
|
Facility
|
IP
|
$62,011.38
|
|
|
Service Code
|
MSDRG 412
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$62,011.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,011.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,706.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,819.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,819.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,819.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,392.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,337.89
|
| Rate for Payer: Multiplan WC |
$47,145.59
|
| Rate for Payer: Prime Health Services WC |
$46,664.51
|
| 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 413: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$45,765.03
|
|
|
Service Code
|
MSDRG 413
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,765.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,765.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,375.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,648.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,648.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,648.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,617.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,069.43
|
| Rate for Payer: Multiplan WC |
$33,277.30
|
| Rate for Payer: Prime Health Services WC |
$32,937.74
|
| 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 414: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$106,869.96
|
|
|
Service Code
|
MSDRG 414
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$106,869.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$106,869.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$71,547.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,997.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,997.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,997.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,777.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,017.11
|
| Rate for Payer: Multiplan WC |
$72,590.29
|
| Rate for Payer: Prime Health Services WC |
$71,849.57
|
| 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 415: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$59,898.35
|
|
|
Service Code
|
MSDRG 415
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$59,898.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,898.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,354.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,818.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,818.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,818.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,130.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,996.21
|
| Rate for Payer: Multiplan WC |
$41,072.96
|
| Rate for Payer: Prime Health Services WC |
$40,653.84
|
| 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 416: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$40,599.19
|
|
|
Service Code
|
MSDRG 416
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,599.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,599.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,825.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,759.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,759.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,759.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,236.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,537.62
|
| Rate for Payer: Multiplan WC |
$28,266.40
|
| Rate for Payer: Prime Health Services WC |
$27,977.97
|
| 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 417: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$70,266.42
|
|
|
Service Code
|
MSDRG 417
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$70,266.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70,266.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,473.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,610.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,610.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,610.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,908.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,077.61
|
| Rate for Payer: Multiplan WC |
$48,829.58
|
| Rate for Payer: Prime Health Services WC |
$48,331.32
|
| 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 418: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$49,557.57
|
|
|
Service Code
|
MSDRG 418
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,557.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,557.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,248.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,035.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,035.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,035.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,365.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,928.16
|
| Rate for Payer: Multiplan WC |
$34,111.09
|
| Rate for Payer: Prime Health Services WC |
$33,763.01
|
| 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 419: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$39,810.97
|
|
|
Service Code
|
MSDRG 419
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$39,810.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,810.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,436.03
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,471.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,471.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,471.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,873.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,151.31
|
| Rate for Payer: Multiplan WC |
$26,800.10
|
| Rate for Payer: Prime Health Services WC |
$26,526.63
|
| 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
|
|
