|
INPATIENT MS-DRG 573: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$188,507.92
|
|
|
Service Code
|
MSDRG 573
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$188,507.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188,507.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$111,856.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$82,856.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82,856.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,856.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104,399.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111,028.10
|
| Rate for Payer: Multiplan WC |
$120,559.38
|
| Rate for Payer: Prime Health Services WC |
$119,329.19
|
| 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 574: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$103,250.23
|
|
|
Service Code
|
MSDRG 574
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$103,250.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$103,250.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,759.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,673.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,673.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,673.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,109.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,243.08
|
| Rate for Payer: Multiplan WC |
$74,025.78
|
| Rate for Payer: Prime Health Services WC |
$73,270.41
|
| 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 575: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$62,026.54
|
|
|
Service Code
|
MSDRG 575
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$62,026.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,026.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,405.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,596.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,596.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,596.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,111.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,039.23
|
| Rate for Payer: Multiplan WC |
$42,091.56
|
| Rate for Payer: Prime Health Services WC |
$41,662.05
|
| 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 576: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$172,288.86
|
|
|
Service Code
|
MSDRG 576
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$172,288.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$172,288.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$103,848.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76,924.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$76,924.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76,924.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96,925.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$103,079.08
|
| Rate for Payer: Multiplan WC |
$116,010.56
|
| Rate for Payer: Prime Health Services WC |
$114,826.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 577: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$80,310.12
|
|
|
Service Code
|
MSDRG 577
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$80,310.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$80,310.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,432.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,283.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,283.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,283.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,537.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,000.06
|
| Rate for Payer: Multiplan WC |
$53,778.87
|
| Rate for Payer: Prime Health Services WC |
$53,230.11
|
| 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 578: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$48,823.92
|
|
|
Service Code
|
MSDRG 578
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,823.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,823.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,886.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,767.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,767.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,767.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,027.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,568.58
|
| Rate for Payer: Multiplan WC |
$35,168.71
|
| Rate for Payer: Prime Health Services WC |
$34,809.85
|
| 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 579: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC
|
Facility
|
IP
|
$101,322.14
|
|
|
Service Code
|
MSDRG 579
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$101,322.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101,322.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,807.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,968.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,968.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,968.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,220.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,298.11
|
| Rate for Payer: Multiplan WC |
$64,724.82
|
| Rate for Payer: Prime Health Services WC |
$64,064.36
|
| 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 580: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
|
Facility
|
IP
|
$52,949.93
|
|
|
Service Code
|
MSDRG 580
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,949.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,949.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,923.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,276.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,276.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,276.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,928.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,590.76
|
| Rate for Payer: Multiplan WC |
$35,655.43
|
| Rate for Payer: Prime Health Services WC |
$35,291.60
|
| 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 581: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,826.56
|
|
|
Service Code
|
MSDRG 581
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,826.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,826.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,937.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,842.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,842.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,341.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,649.07
|
| Rate for Payer: Multiplan WC |
$28,987.23
|
| Rate for Payer: Prime Health Services WC |
$28,691.45
|
| 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 582: MASTECTOMY FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$50,539.80
|
|
|
Service Code
|
MSDRG 582
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$50,539.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,539.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,844.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,217.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,217.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,217.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,854.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,512.00
|
| Rate for Payer: Multiplan WC |
$39,733.97
|
| Rate for Payer: Prime Health Services WC |
$39,328.52
|
| 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 583: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$46,137.92
|
|
|
Service Code
|
MSDRG 583
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$46,137.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,137.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,560.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,785.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,785.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,785.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,789.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,252.17
|
| Rate for Payer: Multiplan WC |
$31,026.51
|
| Rate for Payer: Prime Health Services WC |
$30,709.91
|
| 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 584: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$59,376.92
|
|
|
Service Code
|
MSDRG 584
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$59,376.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,376.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,096.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,627.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,627.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,627.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,890.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,740.65
|
| Rate for Payer: Multiplan WC |
$43,861.80
|
| Rate for Payer: Prime Health Services WC |
$43,414.23
|
| 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 585: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$51,052.14
|
|
|
Service Code
|
MSDRG 585
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,052.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,052.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,986.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,582.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,582.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,582.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,054.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,660.66
|
| Rate for Payer: Multiplan WC |
$37,809.70
|
| Rate for Payer: Prime Health Services WC |
$37,423.89
|
| 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 592: SKIN ULCERS WITH MCC
|
Facility
|
IP
|
$63,363.47
|
|
|
Service Code
|
MSDRG 592
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$63,363.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,363.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,065.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,085.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,085.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,085.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,727.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,694.48
|
| Rate for Payer: Multiplan WC |
$36,637.07
|
| Rate for Payer: Prime Health Services WC |
$36,263.23
|
| 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 593: SKIN ULCERS WITH CC
|
Facility
|
IP
|
$36,889.76
|
|
|
Service Code
|
MSDRG 593
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,889.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,679.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,889.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,325.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,325.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,325.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,430.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,616.50
|
| Rate for Payer: Multiplan WC |
$23,655.97
|
| Rate for Payer: Prime Health Services WC |
$23,414.58
|
| 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 594: SKIN ULCERS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,565.43
|
|
|
Service Code
|
MSDRG 594
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,565.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,870.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,565.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,641.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,641.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,641.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,527.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,339.02
|
| Rate for Payer: Multiplan WC |
$15,893.18
|
| Rate for Payer: Prime Health Services WC |
$15,731.00
|
| 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 595: MAJOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$65,937.30
|
|
|
Service Code
|
MSDRG 595
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$65,937.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,937.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,336.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,026.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,026.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,026.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,913.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,955.90
|
| Rate for Payer: Multiplan WC |
$43,976.81
|
| Rate for Payer: Prime Health Services WC |
$43,528.07
|
| 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 596: MAJOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$33,882.53
|
|
|
Service Code
|
MSDRG 596
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,882.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,588.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,882.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,098.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,098.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,098.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,623.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,631.55
|
| Rate for Payer: Multiplan WC |
$22,421.72
|
| Rate for Payer: Prime Health Services WC |
$22,192.93
|
| 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 597: MALIGNANT BREAST DISORDERS WITH MCC
|
Facility
|
IP
|
$48,520.76
|
|
|
Service Code
|
MSDRG 597
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$48,520.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,520.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,736.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,656.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,656.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,656.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,887.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,420.03
|
| Rate for Payer: Multiplan WC |
$34,583.43
|
| Rate for Payer: Prime Health Services WC |
$34,230.53
|
| 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 598: MALIGNANT BREAST DISORDERS WITH CC
|
Facility
|
IP
|
$36,723.60
|
|
|
Service Code
|
MSDRG 598
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,723.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,342.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,723.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,202.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,202.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,202.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,275.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,451.58
|
| Rate for Payer: Multiplan WC |
$21,935.01
|
| Rate for Payer: Prime Health Services WC |
$21,711.18
|
| 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 599: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$28,849.99
|
|
|
Service Code
|
MSDRG 599
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,849.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,838.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,849.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,370.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,370.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,370.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,926.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,636.28
|
| Rate for Payer: Multiplan WC |
$15,353.07
|
| Rate for Payer: Prime Health Services WC |
$15,196.41
|
| 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 600: NON-MALIGNANT BREAST DISORDERS WITH CC/MCC
|
Facility
|
IP
|
$34,129.50
|
|
|
Service Code
|
MSDRG 600
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,129.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,089.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,129.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,281.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,281.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,281.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,854.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,876.69
|
| Rate for Payer: Multiplan WC |
$21,380.52
|
| Rate for Payer: Prime Health Services WC |
$21,162.35
|
| 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 601: NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$28,261.72
|
|
|
Service Code
|
MSDRG 601
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,261.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,874.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,261.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,934.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,934.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,934.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,377.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,052.38
|
| Rate for Payer: Multiplan WC |
$14,455.63
|
| Rate for Payer: Prime Health Services WC |
$14,308.12
|
| 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 602: CELLULITIS WITH MCC
|
Facility
|
IP
|
$45,095.05
|
|
|
Service Code
|
MSDRG 602
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,095.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,095.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,045.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,403.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,403.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,403.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,308.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,741.07
|
| Rate for Payer: Multiplan WC |
$29,597.17
|
| Rate for Payer: Prime Health Services WC |
$29,295.15
|
| 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 603: CELLULITIS WITHOUT MCC
|
Facility
|
IP
|
$32,021.89
|
|
|
Service Code
|
MSDRG 603
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,021.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,820.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,021.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,719.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,719.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,719.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,887.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,784.69
|
| Rate for Payer: Multiplan WC |
$18,109.07
|
| Rate for Payer: Prime Health Services WC |
$17,924.28
|
| 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
|
|
