|
INPATIENT MS-DRG 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC
|
Facility
|
IP
|
$30,475.62
|
|
|
Service Code
|
MSDRG 641
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,475.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,688.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,475.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,574.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,574.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,574.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,443.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,249.87
|
| Rate for Payer: Multiplan WC |
$15,817.19
|
| Rate for Payer: Prime Health Services WC |
$15,655.79
|
| 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 642: INBORN AND OTHER DISORDERS OF METABOLISM
|
Facility
|
IP
|
$39,510.84
|
|
|
Service Code
|
MSDRG 642
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,510.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,510.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,287.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,361.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,361.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,361.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,735.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,004.21
|
| Rate for Payer: Multiplan WC |
$28,818.84
|
| Rate for Payer: Prime Health Services WC |
$28,524.77
|
| 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 643: ENDOCRINE DISORDERS WITH MCC
|
Facility
|
IP
|
$49,872.85
|
|
|
Service Code
|
MSDRG 643
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,872.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,872.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,404.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,151.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,151.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,151.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,510.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,082.68
|
| Rate for Payer: Multiplan WC |
$33,755.81
|
| Rate for Payer: Prime Health Services WC |
$33,411.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 644: ENDOCRINE DISORDERS WITH CC
|
Facility
|
IP
|
$34,671.38
|
|
|
Service Code
|
MSDRG 644
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,671.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,186.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,671.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,682.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,682.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,682.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,359.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,414.55
|
| Rate for Payer: Multiplan WC |
$20,928.72
|
| Rate for Payer: Prime Health Services WC |
$20,715.16
|
| 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 645: ENDOCRINE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,168.75
|
|
|
Service Code
|
MSDRG 645
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,168.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,067.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,168.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,347.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,347.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,347.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,157.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,945.27
|
| Rate for Payer: Multiplan WC |
$15,250.39
|
| Rate for Payer: Prime Health Services WC |
$15,094.77
|
| 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 650: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC
|
Facility
|
IP
|
$136,346.21
|
|
|
Service Code
|
MSDRG 650
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$136,346.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$136,346.21
|
| Rate for Payer: Blue Distinction Transplant |
$113,455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$86,101.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$63,778.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$63,778.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63,778.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80,361.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,463.51
|
| Rate for Payer: Multiplan WC |
$95,369.35
|
| Rate for Payer: Prime Health Services WC |
$94,396.19
|
| 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 651: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC
|
Facility
|
IP
|
$113,455.00
|
|
|
Service Code
|
MSDRG 651
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$113,455.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,844.85
|
| Rate for Payer: Blue Distinction Transplant |
$113,455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,547.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,257.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$52,257.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,257.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,844.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70,024.59
|
| Rate for Payer: Multiplan WC |
$72,826.46
|
| Rate for Payer: Prime Health Services WC |
$72,083.33
|
| 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 652: KIDNEY TRANSPLANT
|
Facility
|
IP
|
$113,455.00
|
|
|
Service Code
|
MSDRG 652
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$113,455.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$91,081.39
|
| Rate for Payer: Blue Distinction Transplant |
$113,455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,751.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,223.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$105,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$63,280.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,223.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,223.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,501.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,279.09
|
| Rate for Payer: Multiplan WC |
$63,357.08
|
| Rate for Payer: Networks By Design Commercial |
$85,000.00
|
| Rate for Payer: Prime Health Services WC |
$62,710.58
|
| 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 653: MAJOR BLADDER PROCEDURES WITH MCC
|
Facility
|
IP
|
$164,118.70
|
|
|
Service Code
|
MSDRG 653
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$164,118.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$164,118.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$99,814.23
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$73,936.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$73,936.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73,936.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93,159.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,074.87
|
| Rate for Payer: Multiplan WC |
$114,115.04
|
| Rate for Payer: Prime Health Services WC |
$112,950.60
|
| 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 654: MAJOR BLADDER PROCEDURES WITH CC
|
Facility
|
IP
|
$82,990.05
|
|
|
Service Code
|
MSDRG 654
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$82,990.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,990.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,756.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,263.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$44,263.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,263.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,772.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,313.52
|
| Rate for Payer: Multiplan WC |
$58,374.93
|
| Rate for Payer: Prime Health Services WC |
$57,779.27
|
| 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 655: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$63,900.06
|
|
|
Service Code
|
MSDRG 655
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$63,900.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,900.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,330.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,281.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,281.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,281.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,974.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,957.45
|
| Rate for Payer: Multiplan WC |
$44,332.09
|
| Rate for Payer: Prime Health Services WC |
$43,879.73
|
| 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 656: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC
|
Facility
|
IP
|
$95,119.48
|
|
|
Service Code
|
MSDRG 656
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$95,119.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95,119.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,745.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$48,700.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,700.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,700.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61,362.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,258.16
|
| Rate for Payer: Multiplan WC |
$67,879.22
|
| Rate for Payer: Prime Health Services WC |
$67,186.57
|
| 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 657: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC
|
Facility
|
IP
|
$55,908.77
|
|
|
Service Code
|
MSDRG 657
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$55,908.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,908.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,384.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,358.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,358.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,358.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,292.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,040.89
|
| Rate for Payer: Multiplan WC |
$38,567.50
|
| Rate for Payer: Prime Health Services WC |
$38,173.95
|
| 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 658: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$44,879.81
|
|
|
Service Code
|
MSDRG 658
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,879.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,879.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,938.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,325.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,325.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,325.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,209.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,635.57
|
| Rate for Payer: Multiplan WC |
$32,427.09
|
| Rate for Payer: Prime Health Services WC |
$32,096.20
|
| 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 659: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
|
Facility
|
IP
|
$78,485.09
|
|
|
Service Code
|
MSDRG 659
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$78,485.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78,485.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,531.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,616.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,616.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,616.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,696.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,105.61
|
| Rate for Payer: Multiplan WC |
$52,920.44
|
| Rate for Payer: Prime Health Services WC |
$52,380.44
|
| 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 660: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC
|
Facility
|
IP
|
$40,802.30
|
|
|
Service Code
|
MSDRG 660
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,802.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,802.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,925.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,833.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,833.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,833.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,330.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,637.18
|
| Rate for Payer: Multiplan WC |
$28,981.08
|
| Rate for Payer: Prime Health Services WC |
$28,685.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 661: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$34,472.29
|
|
|
Service Code
|
MSDRG 661
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$34,472.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,783.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,472.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,535.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,535.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,535.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,174.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,216.94
|
| Rate for Payer: Multiplan WC |
$22,136.27
|
| Rate for Payer: Prime Health Services WC |
$21,910.39
|
| 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 662: MINOR BLADDER PROCEDURES WITH MCC
|
Facility
|
IP
|
$90,847.96
|
|
|
Service Code
|
MSDRG 662
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$90,847.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,847.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,636.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,137.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,137.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,137.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,393.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,164.69
|
| Rate for Payer: Multiplan WC |
$62,404.20
|
| Rate for Payer: Prime Health Services WC |
$61,767.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 663: MINOR BLADDER PROCEDURES WITH CC
|
Facility
|
IP
|
$44,231.04
|
|
|
Service Code
|
MSDRG 663
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,231.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,231.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,618.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,087.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,087.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,087.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,910.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,317.63
|
| Rate for Payer: Multiplan WC |
$31,318.12
|
| Rate for Payer: Prime Health Services WC |
$30,998.55
|
| 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 664: MINOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$34,669.88
|
|
|
Service Code
|
MSDRG 664
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$34,669.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,183.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,669.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,681.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,681.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,681.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,358.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,413.06
|
| Rate for Payer: Multiplan WC |
$23,138.45
|
| Rate for Payer: Prime Health Services WC |
$22,902.34
|
| 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 665: PROSTATECTOMY WITH MCC
|
Facility
|
IP
|
$93,649.16
|
|
|
Service Code
|
MSDRG 665
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$93,649.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$93,649.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,019.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$48,162.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,162.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,162.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60,684.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,537.56
|
| Rate for Payer: Multiplan WC |
$62,847.78
|
| Rate for Payer: Prime Health Services WC |
$62,206.48
|
| 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 666: PROSTATECTOMY WITH CC
|
Facility
|
IP
|
$52,064.70
|
|
|
Service Code
|
MSDRG 666
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,064.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,064.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,486.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,952.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,952.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,952.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,520.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,156.90
|
| Rate for Payer: Multiplan WC |
$35,361.76
|
| Rate for Payer: Prime Health Services WC |
$35,000.93
|
| 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 667: PROSTATECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$34,490.25
|
|
|
Service Code
|
MSDRG 667
|
| Min. Negotiated Rate |
$19,999.65 |
| Max. Negotiated Rate |
$34,490.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,819.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,490.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,548.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,548.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,548.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,190.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,234.76
|
| Rate for Payer: Multiplan WC |
$20,205.84
|
| Rate for Payer: Prime Health Services WC |
$19,999.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$23,727.00
|
| Rate for Payer: United Healthcare All Other HMO |
$23,328.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,284.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,291.00
|
|
|
INPATIENT MS-DRG 668: TRANSURETHRAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$85,430.49
|
|
|
Service Code
|
MSDRG 668
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$85,430.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,430.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,961.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,156.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,156.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,156.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,897.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,509.58
|
| Rate for Payer: Multiplan WC |
$57,972.42
|
| Rate for Payer: Prime Health Services WC |
$57,380.86
|
| 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 669: TRANSURETHRAL PROCEDURES WITH CC
|
Facility
|
IP
|
$46,522.93
|
|
|
Service Code
|
MSDRG 669
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$46,522.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,522.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,750.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,926.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,926.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,926.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,966.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,440.88
|
| Rate for Payer: Multiplan WC |
$32,328.52
|
| Rate for Payer: Prime Health Services WC |
$31,998.64
|
| 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
|
|
