|
INPATIENT MS-DRG 482: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
|
IP
|
$57,674.00
|
|
|
Service Code
|
MSDRG 482
|
| Min. Negotiated Rate |
$17,559.00 |
| Max. Negotiated Rate |
$57,674.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,153.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,555.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,522.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,522.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,522.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,718.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,240.22
|
| Rate for Payer: Multiplan WC |
$33,805.09
|
| Rate for Payer: Prime Health Services WC |
$33,460.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,674.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$19,203.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,559.00
|
|
|
INPATIENT MS-DRG 483: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$75,311.01
|
|
|
Service Code
|
MSDRG 483
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$75,311.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$75,311.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,964.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,455.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,506.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,455.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,455.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52,233.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,549.97
|
| Rate for Payer: Multiplan WC |
$48,416.79
|
| Rate for Payer: Prime Health Services WC |
$47,922.74
|
| 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 485: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC
|
Facility
|
IP
|
$99,860.90
|
|
|
Service Code
|
MSDRG 485
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$99,860.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$99,860.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,086.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,434.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,434.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,434.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,547.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,581.95
|
| Rate for Payer: Multiplan WC |
$66,764.09
|
| Rate for Payer: Prime Health Services WC |
$66,082.82
|
| 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 486: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC
|
Facility
|
IP
|
$60,883.62
|
|
|
Service Code
|
MSDRG 486
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$60,883.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,883.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,840.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,178.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,178.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,178.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,584.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,479.08
|
| Rate for Payer: Multiplan WC |
$42,839.09
|
| Rate for Payer: Prime Health Services WC |
$42,401.96
|
| 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 487: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$46,835.19
|
|
|
Service Code
|
MSDRG 487
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$46,835.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,835.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,904.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,040.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,040.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,040.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,110.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,593.91
|
| Rate for Payer: Multiplan WC |
$32,940.50
|
| Rate for Payer: Prime Health Services WC |
$32,604.38
|
| 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 488: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC
|
Facility
|
IP
|
$63,863.69
|
|
|
Service Code
|
MSDRG 488
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$63,863.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,863.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,312.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,268.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,268.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,268.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,958.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,939.62
|
| Rate for Payer: Multiplan WC |
$46,601.37
|
| Rate for Payer: Prime Health Services WC |
$46,125.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 489: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$37,522.11
|
|
|
Service Code
|
MSDRG 489
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$37,522.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,522.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,305.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,633.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,633.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,633.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,818.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,029.55
|
| Rate for Payer: Multiplan WC |
$27,303.24
|
| Rate for Payer: Prime Health Services WC |
$27,024.64
|
| 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 492: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC
|
Facility
|
IP
|
$104,957.02
|
|
|
Service Code
|
MSDRG 492
|
| Min. Negotiated Rate |
$21,433.00 |
| Max. Negotiated Rate |
$104,957.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,957.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,602.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,298.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,433.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,298.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,298.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,895.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70,079.59
|
| Rate for Payer: Multiplan WC |
$71,588.10
|
| Rate for Payer: Prime Health Services WC |
$70,857.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$35,472.00
|
| Rate for Payer: United Healthcare All Other HMO |
$36,220.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,513.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,159.00
|
|
|
INPATIENT MS-DRG 493: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC
|
Facility
|
IP
|
$72,809.94
|
|
|
Service Code
|
MSDRG 493
|
| Min. Negotiated Rate |
$16,835.00 |
| Max. Negotiated Rate |
$72,809.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,809.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,729.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,540.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,433.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,540.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,540.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,080.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,324.20
|
| Rate for Payer: Multiplan WC |
$48,790.56
|
| Rate for Payer: Prime Health Services WC |
$48,292.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$34,314.00
|
| Rate for Payer: United Healthcare All Other HMO |
$24,243.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,411.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,835.00
|
|
|
INPATIENT MS-DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$56,666.67
|
|
|
Service Code
|
MSDRG 494
|
| Min. Negotiated Rate |
$14,312.00 |
| Max. Negotiated Rate |
$56,666.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,666.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,758.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,636.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,433.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,636.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,636.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,641.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,412.33
|
| Rate for Payer: Multiplan WC |
$38,789.29
|
| Rate for Payer: Prime Health Services WC |
$38,393.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,968.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,651.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,312.00
|
|
|
INPATIENT MS-DRG 495: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC
|
Facility
|
IP
|
$108,567.66
|
|
|
Service Code
|
MSDRG 495
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$108,567.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$108,567.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,385.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$53,618.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$53,618.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,618.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67,559.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,849.17
|
| Rate for Payer: Multiplan WC |
$76,280.69
|
| Rate for Payer: Prime Health Services WC |
$75,502.32
|
| 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 496: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC
|
Facility
|
IP
|
$60,253.05
|
|
|
Service Code
|
MSDRG 496
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$60,253.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,253.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,529.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,947.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,947.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,947.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,294.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,170.04
|
| Rate for Payer: Multiplan WC |
$43,120.44
|
| Rate for Payer: Prime Health Services WC |
$42,680.44
|
| 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 497: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$43,273.06
|
|
|
Service Code
|
MSDRG 497
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$43,273.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,273.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,145.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,737.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,083.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,737.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,737.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,469.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,848.10
|
| Rate for Payer: Multiplan WC |
$31,250.36
|
| Rate for Payer: Prime Health Services WC |
$30,931.48
|
| 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 498: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC
|
Facility
|
IP
|
$79,155.08
|
|
|
Service Code
|
MSDRG 498
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$79,155.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$79,155.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,862.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,861.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,861.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,861.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,005.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,433.97
|
| Rate for Payer: Multiplan WC |
$52,637.04
|
| Rate for Payer: Prime Health Services WC |
$52,099.93
|
| 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 499: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC
|
Facility
|
IP
|
$39,101.58
|
|
|
Service Code
|
MSDRG 499
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$39,101.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,101.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,085.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,211.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,211.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,211.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,546.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,803.65
|
| Rate for Payer: Multiplan WC |
$27,081.45
|
| Rate for Payer: Prime Health Services WC |
$26,805.11
|
| 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 500: SOFT TISSUE PROCEDURES WITH MCC
|
Facility
|
IP
|
$98,308.72
|
|
|
Service Code
|
MSDRG 500
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$98,308.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98,308.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,319.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,866.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,866.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,866.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,831.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,821.23
|
| Rate for Payer: Multiplan WC |
$65,809.14
|
| Rate for Payer: Prime Health Services WC |
$65,137.61
|
| 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 501: SOFT TISSUE PROCEDURES WITH CC
|
Facility
|
IP
|
$52,619.48
|
|
|
Service Code
|
MSDRG 501
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,619.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,619.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,760.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,155.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,155.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,155.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,776.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,428.81
|
| Rate for Payer: Multiplan WC |
$36,099.02
|
| Rate for Payer: Prime Health Services WC |
$35,730.66
|
| 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 502: SOFT TISSUE PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$41,917.93
|
|
|
Service Code
|
MSDRG 502
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$41,917.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,917.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,476.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,241.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,241.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,241.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,844.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,183.96
|
| Rate for Payer: Multiplan WC |
$28,227.39
|
| Rate for Payer: Prime Health Services WC |
$27,939.36
|
| 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 503: FOOT PROCEDURES WITH MCC
|
Facility
|
IP
|
$81,304.48
|
|
|
Service Code
|
MSDRG 503
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$81,304.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81,304.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,923.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,647.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,647.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,647.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,995.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,487.41
|
| Rate for Payer: Multiplan WC |
$52,025.05
|
| Rate for Payer: Prime Health Services WC |
$51,494.19
|
| 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 504: FOOT PROCEDURES WITH CC
|
Facility
|
IP
|
$52,358.76
|
|
|
Service Code
|
MSDRG 504
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,358.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,358.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,631.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,060.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,060.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,060.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,656.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,301.03
|
| Rate for Payer: Multiplan WC |
$36,448.14
|
| Rate for Payer: Prime Health Services WC |
$36,076.22
|
| 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 505: FOOT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$51,710.00
|
|
|
Service Code
|
MSDRG 505
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,710.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,710.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,311.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,823.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,823.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,823.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,357.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,983.07
|
| Rate for Payer: Multiplan WC |
$36,283.84
|
| Rate for Payer: Prime Health Services WC |
$35,913.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 506: MAJOR THUMB OR JOINT PROCEDURES
|
Facility
|
IP
|
$44,340.18
|
|
|
Service Code
|
MSDRG 506
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,340.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,340.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,672.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,127.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,127.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,127.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,960.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,371.10
|
| Rate for Payer: Multiplan WC |
$28,952.33
|
| Rate for Payer: Prime Health Services WC |
$28,656.89
|
| 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 507: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$64,624.62
|
|
|
Service Code
|
MSDRG 507
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$64,624.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,624.62
|
| 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 |
$38,091.05
|
| Rate for Payer: Prime Health Services WC |
$37,702.37
|
| 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 508: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$43,473.14
|
|
|
Service Code
|
MSDRG 508
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$43,473.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,473.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,244.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,810.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,810.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,810.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,561.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,946.16
|
| Rate for Payer: Multiplan WC |
$29,740.92
|
| Rate for Payer: Prime Health Services WC |
$29,437.44
|
| 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 509: ARTHROSCOPY
|
Facility
|
IP
|
$40,205.08
|
|
|
Service Code
|
MSDRG 509
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,205.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,205.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,227.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,057.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,057.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,057.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,612.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,937.30
|
| Rate for Payer: Multiplan WC |
$31,172.32
|
| Rate for Payer: Prime Health Services WC |
$30,854.24
|
| 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
|
|
