|
INPATIENT MS-DRG 510: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC
|
Facility
|
IP
|
$82,477.71
|
|
|
Service Code
|
MSDRG 510
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$82,477.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,477.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,503.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,076.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,076.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,076.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,536.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,062.42
|
| Rate for Payer: Multiplan WC |
$59,311.39
|
| Rate for Payer: Prime Health Services WC |
$58,706.18
|
| 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 511: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
|
Facility
|
IP
|
$60,444.04
|
|
|
Service Code
|
MSDRG 511
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$60,444.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,444.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,017.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,017.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,017.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,382.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,263.65
|
| Rate for Payer: Multiplan WC |
$40,641.69
|
| Rate for Payer: Prime Health Services WC |
$40,226.98
|
| 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 512: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$48,923.96
|
|
|
Service Code
|
MSDRG 512
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,923.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,923.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,935.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,804.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,804.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,804.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,073.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,617.63
|
| Rate for Payer: Multiplan WC |
$32,991.85
|
| Rate for Payer: Prime Health Services WC |
$32,655.20
|
| 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 513: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$49,142.24
|
|
|
Service Code
|
MSDRG 513
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,142.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,142.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,043.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,884.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,884.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,884.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,173.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,724.61
|
| Rate for Payer: Multiplan WC |
$32,735.15
|
| Rate for Payer: Prime Health Services WC |
$32,401.11
|
| 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 514: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$34,369.00
|
|
|
Service Code
|
MSDRG 514
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$34,369.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,574.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,369.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,458.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,458.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,458.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,077.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,114.42
|
| Rate for Payer: Multiplan WC |
$21,208.02
|
| Rate for Payer: Prime Health Services WC |
$20,991.61
|
| 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 515: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$95,844.03
|
|
|
Service Code
|
MSDRG 515
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$95,844.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95,844.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,102.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$48,965.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,965.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,965.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61,696.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,613.26
|
| Rate for Payer: Multiplan WC |
$64,028.62
|
| Rate for Payer: Prime Health Services WC |
$63,375.27
|
| 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 516: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$61,868.89
|
|
|
Service Code
|
MSDRG 516
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$61,868.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61,868.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,327.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,538.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,258.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,538.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,538.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,038.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,961.98
|
| Rate for Payer: Multiplan WC |
$41,767.08
|
| Rate for Payer: Prime Health Services WC |
$41,340.89
|
| 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 517: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$45,304.23
|
|
|
Service Code
|
MSDRG 517
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,304.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,304.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,148.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,480.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,258.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,480.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,480.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,405.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,843.58
|
| Rate for Payer: Multiplan WC |
$31,008.02
|
| Rate for Payer: Prime Health Services WC |
$30,691.61
|
| 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 518: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
|
Facility
|
IP
|
$110,707.97
|
|
|
Service Code
|
MSDRG 518
|
| Min. Negotiated Rate |
$14,171.00 |
| Max. Negotiated Rate |
$110,707.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$110,707.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,442.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,401.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,401.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,401.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,546.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,898.13
|
| Rate for Payer: Multiplan WC |
$76,553.83
|
| Rate for Payer: Prime Health Services WC |
$75,772.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,330.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,102.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,498.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,171.00
|
|
|
INPATIENT MS-DRG 519: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
|
Facility
|
IP
|
$59,680.08
|
|
|
Service Code
|
MSDRG 519
|
| Min. Negotiated Rate |
$14,171.00 |
| Max. Negotiated Rate |
$59,680.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,680.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,246.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,738.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,738.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,738.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,030.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,889.24
|
| Rate for Payer: Multiplan WC |
$41,058.58
|
| Rate for Payer: Prime Health Services WC |
$40,639.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,330.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,102.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,498.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,171.00
|
|
|
INPATIENT MS-DRG 520: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$43,397.35
|
|
|
Service Code
|
MSDRG 520
|
| Min. Negotiated Rate |
$10,755.00 |
| Max. Negotiated Rate |
$43,397.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,397.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,206.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,782.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,782.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,782.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,526.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,909.02
|
| Rate for Payer: Multiplan WC |
$30,389.88
|
| Rate for Payer: Prime Health Services WC |
$30,079.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$20,246.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,486.00
|
| Rate for Payer: United Healthcare HMO Rider |
$11,761.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10,755.00
|
|
|
INPATIENT MS-DRG 521: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
|
IP
|
$90,772.17
|
|
|
Service Code
|
MSDRG 521
|
| Min. Negotiated Rate |
$47,110.11 |
| Max. Negotiated Rate |
$90,772.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,772.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,598.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,110.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,110.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,110.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,358.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,127.55
|
| Rate for Payer: Multiplan WC |
$62,003.73
|
| Rate for Payer: Prime Health Services WC |
$61,371.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,948.00
|
| Rate for Payer: United Healthcare All Other HMO |
$54,808.00
|
| Rate for Payer: United Healthcare HMO Rider |
$51,849.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,943.00
|
|
|
INPATIENT MS-DRG 522: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
|
IP
|
$71,343.00
|
|
|
Service Code
|
MSDRG 522
|
| Min. Negotiated Rate |
$31,230.00 |
| Max. Negotiated Rate |
$71,343.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,033.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,396.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,330.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,330.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,330.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,036.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,022.82
|
| Rate for Payer: Multiplan WC |
$44,623.71
|
| Rate for Payer: Prime Health Services WC |
$44,168.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$71,343.00
|
| Rate for Payer: United Healthcare All Other HMO |
$44,961.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,152.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,230.00
|
|
|
INPATIENT MS-DRG 533: FRACTURES OF FEMUR WITH MCC
|
Facility
|
IP
|
$49,457.52
|
|
|
Service Code
|
MSDRG 533
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,457.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,457.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,199.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,999.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,999.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,999.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,319.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,879.12
|
| Rate for Payer: Multiplan WC |
$29,291.18
|
| Rate for Payer: Prime Health Services WC |
$28,992.29
|
| 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 534: FRACTURES OF FEMUR WITHOUT MCC
|
Facility
|
IP
|
$30,903.73
|
|
|
Service Code
|
MSDRG 534
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,903.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,555.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,903.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,891.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,891.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,891.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,843.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,674.81
|
| Rate for Payer: Multiplan WC |
$16,344.98
|
| Rate for Payer: Prime Health Services WC |
$16,178.19
|
| 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 535: FRACTURES OF HIP AND PELVIS WITH MCC
|
Facility
|
IP
|
$39,310.76
|
|
|
Service Code
|
MSDRG 535
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,310.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,310.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,189.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,288.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,288.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,288.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,643.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,906.17
|
| Rate for Payer: Multiplan WC |
$26,481.79
|
| Rate for Payer: Prime Health Services WC |
$26,211.56
|
| 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 536: FRACTURES OF HIP AND PELVIS WITHOUT MCC
|
Facility
|
IP
|
$30,560.95
|
|
|
Service Code
|
MSDRG 536
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,560.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,861.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,560.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,637.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,637.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,637.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,523.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,334.57
|
| Rate for Payer: Multiplan WC |
$15,958.90
|
| Rate for Payer: Prime Health Services WC |
$15,796.05
|
| 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 537: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC
|
Facility
|
IP
|
$33,253.82
|
|
|
Service Code
|
MSDRG 537
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,253.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,315.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,253.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,632.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,632.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,632.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,036.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,007.50
|
| Rate for Payer: Multiplan WC |
$20,400.93
|
| Rate for Payer: Prime Health Services WC |
$20,192.76
|
| 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 538: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC
|
Facility
|
IP
|
$29,393.35
|
|
|
Service Code
|
MSDRG 538
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,393.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,497.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,393.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,772.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,772.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,772.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,433.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,175.62
|
| Rate for Payer: Multiplan WC |
$14,297.49
|
| Rate for Payer: Prime Health Services WC |
$14,151.60
|
| 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 539: OSTEOMYELITIS WITH MCC
|
Facility
|
IP
|
$60,159.07
|
|
|
Service Code
|
MSDRG 539
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$60,159.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,159.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,483.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,913.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,913.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,913.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,250.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,124.00
|
| Rate for Payer: Multiplan WC |
$40,988.75
|
| Rate for Payer: Prime Health Services WC |
$40,570.50
|
| 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 540: OSTEOMYELITIS WITH CC
|
Facility
|
IP
|
$39,356.23
|
|
|
Service Code
|
MSDRG 540
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,356.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,356.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,211.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,304.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,304.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,304.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,664.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,928.45
|
| Rate for Payer: Multiplan WC |
$27,654.41
|
| Rate for Payer: Prime Health Services WC |
$27,372.23
|
| 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 541: OSTEOMYELITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$31,620.73
|
|
|
Service Code
|
MSDRG 541
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,620.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,008.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,620.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,422.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,422.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,422.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,512.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,386.50
|
| Rate for Payer: Multiplan WC |
$16,798.84
|
| Rate for Payer: Prime Health Services WC |
$16,627.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 542: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
|
Facility
|
IP
|
$55,287.29
|
|
|
Service Code
|
MSDRG 542
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,287.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,287.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,077.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,131.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,131.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,131.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,005.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,736.29
|
| Rate for Payer: Multiplan WC |
$37,540.67
|
| Rate for Payer: Prime Health Services WC |
$37,157.61
|
| 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 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
|
Facility
|
IP
|
$35,105.47
|
|
|
Service Code
|
MSDRG 543
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,105.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,065.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,105.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,004.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,004.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,004.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,765.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,845.43
|
| Rate for Payer: Multiplan WC |
$22,364.23
|
| Rate for Payer: Prime Health Services WC |
$22,136.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 544: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$30,267.55
|
|
|
Service Code
|
MSDRG 544
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,267.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,267.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,267.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,420.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,420.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,420.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,249.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,043.35
|
| Rate for Payer: Multiplan WC |
$15,979.43
|
| Rate for Payer: Prime Health Services WC |
$15,816.37
|
| 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
|
|
