|
INPATIENT MS-DRG 670: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$33,187.95
|
|
|
Service Code
|
MSDRG 670
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$33,187.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,182.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,187.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,583.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,583.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,583.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,975.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,942.12
|
| Rate for Payer: Multiplan WC |
$20,279.77
|
| Rate for Payer: Prime Health Services WC |
$20,072.83
|
| 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 671: URETHRAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$51,897.96
|
|
|
Service Code
|
MSDRG 671
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,897.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,897.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,404.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,891.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,891.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,891.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,443.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,075.19
|
| Rate for Payer: Multiplan WC |
$37,612.56
|
| Rate for Payer: Prime Health Services WC |
$37,228.76
|
| 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 672: URETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$32,812.25
|
|
|
Service Code
|
MSDRG 672
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$32,812.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,972.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,812.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,305.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,305.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,305.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,624.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,569.20
|
| Rate for Payer: Multiplan WC |
$21,392.85
|
| Rate for Payer: Prime Health Services WC |
$21,174.56
|
| 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 673: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC
|
Facility
|
IP
|
$112,108.57
|
|
|
Service Code
|
MSDRG 673
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$112,108.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$112,108.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,133.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,913.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,913.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,913.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69,191.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,584.59
|
| Rate for Payer: Multiplan WC |
$71,754.44
|
| Rate for Payer: Prime Health Services WC |
$71,022.26
|
| 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 674: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC
|
Facility
|
IP
|
$72,218.78
|
|
|
Service Code
|
MSDRG 674
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$72,218.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,218.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,437.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,324.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,324.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,324.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,808.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,034.48
|
| Rate for Payer: Multiplan WC |
$48,681.72
|
| Rate for Payer: Prime Health Services WC |
$48,184.96
|
| 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 675: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$48,096.33
|
|
|
Service Code
|
MSDRG 675
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,096.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,096.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,527.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,501.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,501.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,501.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,691.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,212.00
|
| Rate for Payer: Multiplan WC |
$34,632.71
|
| Rate for Payer: Prime Health Services WC |
$34,279.32
|
| 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 682: RENAL FAILURE WITH MCC
|
Facility
|
IP
|
$45,498.25
|
|
|
Service Code
|
MSDRG 682
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,498.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,498.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,244.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,551.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,551.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,551.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,494.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,938.68
|
| Rate for Payer: Multiplan WC |
$30,529.53
|
| Rate for Payer: Prime Health Services WC |
$30,218.00
|
| 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 683: RENAL FAILURE WITH CC
|
Facility
|
IP
|
$32,262.89
|
|
|
Service Code
|
MSDRG 683
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,262.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,308.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,262.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,898.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,898.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,898.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,112.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,023.91
|
| Rate for Payer: Multiplan WC |
$18,378.10
|
| Rate for Payer: Prime Health Services WC |
$18,190.57
|
| 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 684: RENAL FAILURE WITHOUT CC/MCC
|
Facility
|
IP
|
$27,887.49
|
|
|
Service Code
|
MSDRG 684
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,887.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,447.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,887.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,657.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,657.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,657.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,028.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,680.92
|
| Rate for Payer: Multiplan WC |
$12,420.46
|
| Rate for Payer: Prime Health Services WC |
$12,293.72
|
| 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 686: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC
|
Facility
|
IP
|
$55,763.25
|
|
|
Service Code
|
MSDRG 686
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,763.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,763.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,312.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,305.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,305.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,305.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,225.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,969.58
|
| Rate for Payer: Multiplan WC |
$34,866.83
|
| Rate for Payer: Prime Health Services WC |
$34,511.05
|
| 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 687: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC
|
Facility
|
IP
|
$34,425.89
|
|
|
Service Code
|
MSDRG 687
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,425.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,689.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,425.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,500.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,500.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,500.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,130.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,170.88
|
| Rate for Payer: Multiplan WC |
$21,353.83
|
| Rate for Payer: Prime Health Services WC |
$21,135.93
|
| 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 688: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,468.14
|
|
|
Service Code
|
MSDRG 688
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,468.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,673.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,468.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,568.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,568.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,568.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,436.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,242.45
|
| Rate for Payer: Multiplan WC |
$17,792.80
|
| Rate for Payer: Prime Health Services WC |
$17,611.24
|
| 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 689: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC
|
Facility
|
IP
|
$36,358.36
|
|
|
Service Code
|
MSDRG 689
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,358.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,603.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,358.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,932.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,932.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,932.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,934.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,089.04
|
| Rate for Payer: Multiplan WC |
$23,557.39
|
| Rate for Payer: Prime Health Services WC |
$23,317.01
|
| 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 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC
|
Facility
|
IP
|
$30,857.31
|
|
|
Service Code
|
MSDRG 690
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,857.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,461.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,857.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,857.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,857.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,857.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,800.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,628.74
|
| Rate for Payer: Multiplan WC |
$16,338.82
|
| Rate for Payer: Prime Health Services WC |
$16,172.10
|
| 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 693: URINARY STONES WITH MCC
|
Facility
|
IP
|
$42,936.55
|
|
|
Service Code
|
MSDRG 693
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,936.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,936.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,979.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,614.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,614.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,614.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,314.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,683.18
|
| Rate for Payer: Multiplan WC |
$29,383.59
|
| Rate for Payer: Prime Health Services WC |
$29,083.76
|
| 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 694: URINARY STONES WITHOUT MCC
|
Facility
|
IP
|
$30,495.07
|
|
|
Service Code
|
MSDRG 694
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,495.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,728.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,495.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,588.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,588.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,588.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,462.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,269.18
|
| Rate for Payer: Multiplan WC |
$16,369.63
|
| Rate for Payer: Prime Health Services WC |
$16,202.59
|
| 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 695: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$36,681.69
|
|
|
Service Code
|
MSDRG 695
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,681.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,257.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,681.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,171.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,171.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,171.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,236.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,409.97
|
| Rate for Payer: Multiplan WC |
$23,582.03
|
| Rate for Payer: Prime Health Services WC |
$23,341.40
|
| 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 696: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$29,138.89
|
|
|
Service Code
|
MSDRG 696
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,138.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,981.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,138.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,584.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,584.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,584.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,196.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,923.04
|
| Rate for Payer: Multiplan WC |
$14,231.78
|
| Rate for Payer: Prime Health Services WC |
$14,086.55
|
| 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 697: URETHRAL STRICTURE
|
Facility
|
IP
|
$35,440.77
|
|
|
Service Code
|
MSDRG 697
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,440.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,744.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,440.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,252.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,252.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,252.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,078.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,178.24
|
| Rate for Payer: Multiplan WC |
$20,380.40
|
| Rate for Payer: Prime Health Services WC |
$20,172.44
|
| 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 698: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC
|
Facility
|
IP
|
$50,154.79
|
|
|
Service Code
|
MSDRG 698
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$50,154.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,154.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,543.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,254.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,254.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,254.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,640.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,220.84
|
| Rate for Payer: Multiplan WC |
$32,909.70
|
| Rate for Payer: Prime Health Services WC |
$32,573.89
|
| 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 699: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC
|
Facility
|
IP
|
$34,059.14
|
|
|
Service Code
|
MSDRG 699
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,059.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,946.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,059.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,228.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,228.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,228.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,788.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,806.85
|
| Rate for Payer: Multiplan WC |
$20,784.97
|
| Rate for Payer: Prime Health Services WC |
$20,572.88
|
| 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 700: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$29,381.39
|
|
|
Service Code
|
MSDRG 700
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,381.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,472.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,381.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,763.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,763.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,763.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,422.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,163.75
|
| Rate for Payer: Multiplan WC |
$15,213.42
|
| Rate for Payer: Prime Health Services WC |
$15,058.18
|
| 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 707: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$59,476.96
|
|
|
Service Code
|
MSDRG 707
|
| Min. Negotiated Rate |
$21,291.00 |
| Max. Negotiated Rate |
$59,476.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,476.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,146.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,663.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,663.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,663.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,936.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,789.67
|
| Rate for Payer: Multiplan WC |
$40,976.43
|
| Rate for Payer: Prime Health Services WC |
$40,558.30
|
| 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 708: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$44,215.89
|
|
|
Service Code
|
MSDRG 708
|
| Min. Negotiated Rate |
$21,291.00 |
| Max. Negotiated Rate |
$44,215.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,215.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,611.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,082.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,082.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,082.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,903.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,310.17
|
| Rate for Payer: Multiplan WC |
$30,490.50
|
| Rate for Payer: Prime Health Services WC |
$30,179.38
|
| 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 709: PENIS PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$64,269.92
|
|
|
Service Code
|
MSDRG 709
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$64,269.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,269.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,273.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,980.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,980.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,980.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,855.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,893.49
|
| Rate for Payer: Multiplan WC |
$49,533.98
|
| Rate for Payer: Prime Health Services WC |
$49,028.53
|
| 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
|
|
