|
INPATIENT MS-DRG 420: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$97,035.45
|
|
|
Service Code
|
MSDRG 420
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$97,035.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97,035.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,691.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,400.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,400.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,400.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,245.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,197.19
|
| Rate for Payer: Multiplan WC |
$66,973.55
|
| Rate for Payer: Prime Health Services WC |
$66,290.15
|
| 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 421: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
|
IP
|
$51,828.23
|
|
|
Service Code
|
MSDRG 421
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,828.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,828.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,369.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,866.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,866.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,866.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,411.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,041.03
|
| Rate for Payer: Multiplan WC |
$37,203.88
|
| Rate for Payer: Prime Health Services WC |
$36,824.25
|
| 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 422: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$42,775.88
|
|
|
Service Code
|
MSDRG 422
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,775.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,775.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,900.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,555.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,555.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,555.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,240.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,604.45
|
| Rate for Payer: Multiplan WC |
$28,455.34
|
| Rate for Payer: Prime Health Services WC |
$28,164.98
|
| 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 423: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$118,562.84
|
|
|
Service Code
|
MSDRG 423
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$118,562.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,562.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,320.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,274.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$57,274.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,274.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72,165.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,747.83
|
| Rate for Payer: Multiplan WC |
$80,747.37
|
| Rate for Payer: Prime Health Services WC |
$79,923.42
|
| 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 424: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$63,278.59
|
|
|
Service Code
|
MSDRG 424
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$63,278.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,278.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,688.03
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,546.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,546.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,546.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,308.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,312.56
|
| Rate for Payer: Multiplan WC |
$48,642.70
|
| Rate for Payer: Prime Health Services WC |
$48,146.35
|
| 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 425: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$48,563.20
|
|
|
Service Code
|
MSDRG 425
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,563.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,563.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,757.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,672.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,672.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,672.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,907.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,440.82
|
| Rate for Payer: Multiplan WC |
$29,379.48
|
| Rate for Payer: Prime Health Services WC |
$29,079.69
|
| 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 432: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$58,085.46
|
|
|
Service Code
|
MSDRG 432
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$58,085.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,085.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,459.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,155.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,155.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,155.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,295.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,107.70
|
| Rate for Payer: Multiplan WC |
$38,776.97
|
| Rate for Payer: Prime Health Services WC |
$38,381.29
|
| 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 433: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$34,211.82
|
|
|
Service Code
|
MSDRG 433
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,211.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,255.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,211.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,342.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,342.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,342.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,931.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,958.40
|
| Rate for Payer: Multiplan WC |
$21,353.83
|
| Rate for Payer: Prime Health Services WC |
$21,135.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 434: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$28,800.58
|
|
|
Service Code
|
MSDRG 434
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,800.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,296.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,800.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,333.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,333.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,333.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,880.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,587.24
|
| Rate for Payer: Multiplan WC |
$12,890.74
|
| Rate for Payer: Prime Health Services WC |
$12,759.21
|
| 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 435: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC
|
Facility
|
IP
|
$53,353.13
|
|
|
Service Code
|
MSDRG 435
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$53,353.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,353.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,122.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,424.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,424.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,424.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,114.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,788.36
|
| Rate for Payer: Multiplan WC |
$35,901.87
|
| Rate for Payer: Prime Health Services WC |
$35,535.52
|
| 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 436: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC
|
Facility
|
IP
|
$35,255.16
|
|
|
Service Code
|
MSDRG 436
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,255.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,368.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,255.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,114.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,114.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,114.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,904.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,994.01
|
| Rate for Payer: Multiplan WC |
$22,598.34
|
| Rate for Payer: Prime Health Services WC |
$22,367.74
|
| 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 437: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC
|
Facility
|
IP
|
$31,219.56
|
|
|
Service Code
|
MSDRG 437
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,219.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,195.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,219.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,125.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,125.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,125.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,138.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,988.30
|
| Rate for Payer: Multiplan WC |
$17,371.80
|
| Rate for Payer: Prime Health Services WC |
$17,194.54
|
| 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 438: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC
|
Facility
|
IP
|
$50,591.34
|
|
|
Service Code
|
MSDRG 438
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$50,591.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,591.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,758.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,414.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,414.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,414.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,841.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,434.80
|
| Rate for Payer: Multiplan WC |
$34,037.15
|
| Rate for Payer: Prime Health Services WC |
$33,689.84
|
| 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 439: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC
|
Facility
|
IP
|
$31,580.31
|
|
|
Service Code
|
MSDRG 439
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,580.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,926.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,580.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,392.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,392.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,392.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,474.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,346.38
|
| Rate for Payer: Multiplan WC |
$17,862.63
|
| Rate for Payer: Prime Health Services WC |
$17,680.35
|
| 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 440: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$27,993.76
|
|
|
Service Code
|
MSDRG 440
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,993.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,662.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,993.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,736.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,736.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,736.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,127.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,786.40
|
| Rate for Payer: Multiplan WC |
$12,453.32
|
| Rate for Payer: Prime Health Services WC |
$12,326.25
|
| 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 441: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$55,423.71
|
|
|
Service Code
|
MSDRG 441
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,423.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,423.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,144.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,181.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,181.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,181.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,068.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,803.17
|
| Rate for Payer: Multiplan WC |
$38,912.52
|
| Rate for Payer: Prime Health Services WC |
$38,515.45
|
| 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 442: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$33,021.80
|
|
|
Service Code
|
MSDRG 442
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,021.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,845.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,021.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,460.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,460.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,460.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,820.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,777.19
|
| Rate for Payer: Multiplan WC |
$19,427.51
|
| Rate for Payer: Prime Health Services WC |
$19,229.27
|
| 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 443: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$29,477.17
|
|
|
Service Code
|
MSDRG 443
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,477.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,666.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,477.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,834.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,834.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,834.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,512.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,258.82
|
| Rate for Payer: Multiplan WC |
$13,387.73
|
| Rate for Payer: Prime Health Services WC |
$13,251.12
|
| 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 444: DISORDERS OF THE BILIARY TRACT WITH MCC
|
Facility
|
IP
|
$49,512.09
|
|
|
Service Code
|
MSDRG 444
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,512.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,512.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,226.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,019.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,019.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,019.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,344.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,905.88
|
| Rate for Payer: Multiplan WC |
$34,187.07
|
| Rate for Payer: Prime Health Services WC |
$33,838.23
|
| 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 445: DISORDERS OF THE BILIARY TRACT WITH CC
|
Facility
|
IP
|
$35,047.09
|
|
|
Service Code
|
MSDRG 445
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,047.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,947.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,047.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,960.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,960.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,960.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,710.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,787.49
|
| Rate for Payer: Multiplan WC |
$22,581.90
|
| Rate for Payer: Prime Health Services WC |
$22,351.48
|
| 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 446: DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC
|
Facility
|
IP
|
$30,776.48
|
|
|
Service Code
|
MSDRG 446
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,776.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,298.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,776.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,797.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,797.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,797.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,724.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,548.50
|
| Rate for Payer: Multiplan WC |
$16,669.46
|
| Rate for Payer: Prime Health Services WC |
$16,499.36
|
| 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 453: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$268,642.20
|
|
|
Service Code
|
MSDRG 453
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$268,642.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$268,642.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$151,423.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$112,165.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$112,165.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$112,165.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$141,328.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$150,302.15
|
| Rate for Payer: Multiplan WC |
$188,007.34
|
| Rate for Payer: Prime Health Services WC |
$186,088.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$145,048.00
|
| Rate for Payer: United Healthcare All Other HMO |
$121,204.00
|
| Rate for Payer: United Healthcare HMO Rider |
$92,062.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84,184.00
|
|
|
INPATIENT MS-DRG 454: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC
|
Facility
|
IP
|
$185,421.75
|
|
|
Service Code
|
MSDRG 454
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$185,421.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$185,421.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$110,332.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$81,728.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$81,728.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,728.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102,977.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,515.56
|
| Rate for Payer: Multiplan WC |
$125,085.62
|
| Rate for Payer: Prime Health Services WC |
$123,809.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$122,371.00
|
| Rate for Payer: United Healthcare All Other HMO |
$94,605.00
|
| Rate for Payer: United Healthcare HMO Rider |
$71,860.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65,709.00
|
|
|
INPATIENT MS-DRG 455: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$139,623.37
|
|
|
Service Code
|
MSDRG 455
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$139,623.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$139,623.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$87,719.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$64,977.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64,977.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64,977.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$81,871.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87,069.66
|
| Rate for Payer: Multiplan WC |
$98,328.65
|
| Rate for Payer: Prime Health Services WC |
$97,325.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,035.00
|
| Rate for Payer: United Healthcare All Other HMO |
$79,476.00
|
| Rate for Payer: United Healthcare HMO Rider |
$60,371.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55,204.00
|
|
|
INPATIENT MS-DRG 456: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC
|
Facility
|
IP
|
$255,545.69
|
|
|
Service Code
|
MSDRG 456
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$255,545.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$255,545.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$144,957.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$107,375.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$107,375.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$107,375.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$135,293.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$143,883.50
|
| Rate for Payer: Multiplan WC |
$173,516.79
|
| Rate for Payer: Prime Health Services WC |
$171,746.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,453.00
|
| Rate for Payer: United Healthcare All Other HMO |
$94,833.00
|
| Rate for Payer: United Healthcare HMO Rider |
$72,034.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65,869.00
|
|
