|
INPATIENT MS-DRG 457: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC
|
Facility
|
IP
|
$184,178.79
|
|
|
Service Code
|
MSDRG 457
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$184,178.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$184,178.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$109,719.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$81,273.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$81,273.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,273.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102,404.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108,906.38
|
| Rate for Payer: Multiplan WC |
$123,974.60
|
| Rate for Payer: Prime Health Services WC |
$122,709.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$85,975.00
|
| Rate for Payer: United Healthcare All Other HMO |
$78,109.00
|
| Rate for Payer: United Healthcare HMO Rider |
$59,327.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54,251.00
|
|
|
INPATIENT MS-DRG 458: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$137,361.80
|
|
|
Service Code
|
MSDRG 458
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$137,361.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$137,361.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$86,602.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$64,150.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64,150.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64,150.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80,829.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,961.24
|
| Rate for Payer: Multiplan WC |
$98,844.11
|
| Rate for Payer: Prime Health Services WC |
$97,835.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$77,772.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$51,399.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53,693.00
|
|
|
INPATIENT MS-DRG 459: SPINAL FUSION EXCEPT CERVICAL WITH MCC
|
Facility
|
IP
|
$201,064.81
|
|
|
Service Code
|
MSDRG 459
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$201,064.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$201,064.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$118,056.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$87,449.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$87,449.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$87,449.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$110,186.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$117,182.28
|
| Rate for Payer: Multiplan WC |
$136,218.45
|
| Rate for Payer: Prime Health Services WC |
$134,828.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$72,883.00
|
| Rate for Payer: United Healthcare All Other HMO |
$65,316.00
|
| Rate for Payer: United Healthcare HMO Rider |
$49,615.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45,367.00
|
|
|
INPATIENT MS-DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$110,892.90
|
|
|
Service Code
|
MSDRG 460
|
| Min. Negotiated Rate |
$28,489.00 |
| Max. Negotiated Rate |
$110,892.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$110,892.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,533.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,469.24
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,469.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,469.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,631.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,988.78
|
| Rate for Payer: Multiplan WC |
$77,340.37
|
| Rate for Payer: Prime Health Services WC |
$76,551.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$77,654.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41,017.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,155.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,489.00
|
|
|
INPATIENT MS-DRG 461: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
|
IP
|
$206,709.65
|
|
|
Service Code
|
MSDRG 461
|
| Min. Negotiated Rate |
$43,041.00 |
| Max. Negotiated Rate |
$206,709.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$206,709.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$120,843.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$89,514.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$89,514.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$89,514.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$112,787.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119,948.81
|
| Rate for Payer: Multiplan WC |
$131,745.60
|
| Rate for Payer: Prime Health Services WC |
$130,401.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$61,219.00
|
| Rate for Payer: United Healthcare All Other HMO |
$61,965.00
|
| Rate for Payer: United Healthcare HMO Rider |
$47,070.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43,041.00
|
|
|
INPATIENT MS-DRG 462: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$86,288.43
|
|
|
Service Code
|
MSDRG 462
|
| Min. Negotiated Rate |
$34,787.00 |
| Max. Negotiated Rate |
$86,288.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$86,288.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,384.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,470.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,470.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,470.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,292.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,930.05
|
| Rate for Payer: Multiplan WC |
$61,313.70
|
| Rate for Payer: Prime Health Services WC |
$60,688.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$49,480.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,083.00
|
| Rate for Payer: United Healthcare HMO Rider |
$38,042.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,787.00
|
|
|
INPATIENT MS-DRG 463: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$171,700.73
|
|
|
Service Code
|
MSDRG 463
|
| Min. Negotiated Rate |
$44,466.00 |
| Max. Negotiated Rate |
$171,700.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$171,700.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$103,557.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76,709.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$76,709.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76,709.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96,654.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102,790.85
|
| Rate for Payer: Multiplan WC |
$107,643.99
|
| Rate for Payer: Prime Health Services WC |
$106,545.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
| Rate for Payer: United Healthcare All Other HMO |
$64,022.00
|
| Rate for Payer: United Healthcare HMO Rider |
$48,627.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44,466.00
|
|
|
INPATIENT MS-DRG 464: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$106,647.00
|
|
|
Service Code
|
MSDRG 464
|
| Min. Negotiated Rate |
$32,351.00 |
| Max. Negotiated Rate |
$106,647.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,990.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,706.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,189.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,189.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,189.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,459.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,234.52
|
| Rate for Payer: Multiplan WC |
$61,346.56
|
| Rate for Payer: Prime Health Services WC |
$60,720.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
| Rate for Payer: United Healthcare All Other HMO |
$46,576.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,378.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,351.00
|
|
|
INPATIENT MS-DRG 465: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$106,647.00
|
|
|
Service Code
|
MSDRG 465
|
| Min. Negotiated Rate |
$26,283.00 |
| Max. Negotiated Rate |
$106,647.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,715.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,782.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,653.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,653.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,653.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,663.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,436.12
|
| Rate for Payer: Multiplan WC |
$40,923.04
|
| Rate for Payer: Prime Health Services WC |
$40,505.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
| Rate for Payer: United Healthcare All Other HMO |
$37,843.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,743.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26,283.00
|
|
|
INPATIENT MS-DRG 466: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$157,236.97
|
|
|
Service Code
|
MSDRG 466
|
| Min. Negotiated Rate |
$37,472.00 |
| Max. Negotiated Rate |
$157,236.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$157,236.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$96,416.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$71,419.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$71,419.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71,419.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$89,988.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95,702.12
|
| Rate for Payer: Multiplan WC |
$107,715.87
|
| Rate for Payer: Prime Health Services WC |
$106,616.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$37,472.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41,372.00
|
| Rate for Payer: United Healthcare HMO Rider |
$43,467.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39,746.00
|
|
|
INPATIENT MS-DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH CC
|
Facility
|
IP
|
$105,690.67
|
|
|
Service Code
|
MSDRG 467
|
| Min. Negotiated Rate |
$30,893.00 |
| Max. Negotiated Rate |
$105,690.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$105,690.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,964.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,566.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,566.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,566.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,233.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70,439.15
|
| Rate for Payer: Multiplan WC |
$74,463.21
|
| Rate for Payer: Prime Health Services WC |
$73,703.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$34,616.00
|
| Rate for Payer: United Healthcare All Other HMO |
$32,162.00
|
| Rate for Payer: United Healthcare HMO Rider |
$33,785.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,893.00
|
|
|
INPATIENT MS-DRG 468: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$80,931.59
|
|
|
Service Code
|
MSDRG 468
|
| Min. Negotiated Rate |
$27,553.00 |
| Max. Negotiated Rate |
$80,931.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$80,931.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,739.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,510.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,510.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,510.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,823.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,304.65
|
| Rate for Payer: Multiplan WC |
$57,282.39
|
| Rate for Payer: Prime Health Services WC |
$56,697.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$37,472.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,682.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,132.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,553.00
|
|
|
INPATIENT MS-DRG 469: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$100,946.22
|
|
|
Service Code
|
MSDRG 469
|
| Min. Negotiated Rate |
$23,506.00 |
| Max. Negotiated Rate |
$100,946.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$100,946.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,622.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,831.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,506.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,831.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,831.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,047.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,113.88
|
| Rate for Payer: Multiplan WC |
$66,361.57
|
| Rate for Payer: Prime Health Services WC |
$65,684.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$39,776.00
|
| Rate for Payer: United Healthcare All Other HMO |
$36,955.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,727.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29,927.00
|
|
|
INPATIENT MS-DRG 470: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$57,045.62
|
|
|
Service Code
|
MSDRG 470
|
| Min. Negotiated Rate |
$22,307.00 |
| Max. Negotiated Rate |
$57,045.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,045.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,945.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,774.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,506.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,774.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,774.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,816.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,598.06
|
| Rate for Payer: Multiplan WC |
$39,263.69
|
| Rate for Payer: Prime Health Services WC |
$38,863.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$50,959.00
|
| Rate for Payer: United Healthcare All Other HMO |
$32,115.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,395.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,307.00
|
|
|
INPATIENT MS-DRG 471: CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$149,124.40
|
|
|
Service Code
|
MSDRG 471
|
| Min. Negotiated Rate |
$24,564.00 |
| Max. Negotiated Rate |
$149,124.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$149,124.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$92,410.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$68,452.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$68,452.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68,452.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86,249.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91,726.15
|
| Rate for Payer: Multiplan WC |
$103,442.23
|
| Rate for Payer: Prime Health Services WC |
$102,386.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$39,970.00
|
| Rate for Payer: United Healthcare All Other HMO |
$37,136.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,944.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,125.00
|
|
|
INPATIENT MS-DRG 472: CERVICAL SPINAL FUSION WITH CC
|
Facility
|
IP
|
$89,595.91
|
|
|
Service Code
|
MSDRG 472
|
| Min. Negotiated Rate |
$21,530.00 |
| Max. Negotiated Rate |
$89,595.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,595.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,017.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,679.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$46,679.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,679.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,816.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,551.05
|
| Rate for Payer: Multiplan WC |
$63,067.52
|
| Rate for Payer: Prime Health Services WC |
$62,423.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,568.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40,108.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,544.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,530.00
|
|
|
INPATIENT MS-DRG 473: CERVICAL SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$74,595.55
|
|
|
Service Code
|
MSDRG 473
|
| Min. Negotiated Rate |
$21,828.00 |
| Max. Negotiated Rate |
$74,595.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$74,595.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,611.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,193.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,193.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,193.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,903.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,199.34
|
| Rate for Payer: Multiplan WC |
$52,062.02
|
| Rate for Payer: Prime Health Services WC |
$51,530.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$40,144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31,425.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,871.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,828.00
|
|
|
INPATIENT MS-DRG 474: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$130,443.68
|
|
|
Service Code
|
MSDRG 474
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$130,443.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$130,443.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$83,186.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$61,619.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$61,619.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61,619.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77,641.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82,570.67
|
| Rate for Payer: Multiplan WC |
$84,135.89
|
| Rate for Payer: Prime Health Services WC |
$83,277.36
|
| 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 475: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$65,018.73
|
|
|
Service Code
|
MSDRG 475
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$65,018.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,018.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,882.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,690.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,690.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,690.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,490.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,505.70
|
| Rate for Payer: Multiplan WC |
$45,615.62
|
| Rate for Payer: Prime Health Services WC |
$45,150.15
|
| 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 476: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$36,395.78
|
|
|
Service Code
|
MSDRG 476
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$36,395.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,678.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,395.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,959.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,959.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,959.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,969.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,126.19
|
| Rate for Payer: Multiplan WC |
$25,208.52
|
| Rate for Payer: Prime Health Services WC |
$24,951.29
|
| 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 477: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$102,134.60
|
|
|
Service Code
|
MSDRG 477
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$102,134.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,134.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,208.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,265.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,265.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,265.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,595.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,696.31
|
| Rate for Payer: Multiplan WC |
$69,881.52
|
| Rate for Payer: Prime Health Services WC |
$69,168.44
|
| 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 478: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$72,264.25
|
|
|
Service Code
|
MSDRG 478
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$72,264.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,264.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,460.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,340.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,340.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,340.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,829.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,056.78
|
| Rate for Payer: Multiplan WC |
$48,238.13
|
| Rate for Payer: Prime Health Services WC |
$47,745.90
|
| 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 479: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$56,509.02
|
|
|
Service Code
|
MSDRG 479
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$56,509.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,509.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,680.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,578.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,578.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,578.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,568.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,335.08
|
| Rate for Payer: Multiplan WC |
$36,316.70
|
| Rate for Payer: Prime Health Services WC |
$35,946.12
|
| 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 480: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
|
IP
|
$89,398.85
|
|
|
Service Code
|
MSDRG 480
|
| Min. Negotiated Rate |
$24,564.00 |
| Max. Negotiated Rate |
$89,398.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,398.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,920.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,607.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$46,607.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,607.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,725.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,454.47
|
| Rate for Payer: Multiplan WC |
$60,911.18
|
| Rate for Payer: Prime Health Services WC |
$60,289.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$53,801.00
|
| Rate for Payer: United Healthcare All Other HMO |
$38,830.00
|
| Rate for Payer: United Healthcare HMO Rider |
$29,495.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26,969.00
|
|
|
INPATIENT MS-DRG 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$70,749.00
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$20,751.00 |
| Max. Negotiated Rate |
$70,749.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,902.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,837.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,916.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,916.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,916.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,515.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,468.63
|
| Rate for Payer: Multiplan WC |
$43,381.25
|
| Rate for Payer: Prime Health Services WC |
$42,938.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$70,749.00
|
| Rate for Payer: United Healthcare All Other HMO |
$29,870.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,693.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,751.00
|
|
