|
INTERSTITIAL AND ALVEOLAR LUNG DISEASES
|
Facility
|
IP
|
$9,762.90
|
|
|
Service Code
|
APR-DRG 1421
|
| Min. Negotiated Rate |
$7,489.17 |
| Max. Negotiated Rate |
$9,762.90 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7,489.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,762.90
|
|
|
INTERSTITIAL AND ALVEOLAR LUNG DISEASES
|
Facility
|
IP
|
$15,565.66
|
|
|
Service Code
|
APR-DRG 1423
|
| Min. Negotiated Rate |
$11,940.50 |
| Max. Negotiated Rate |
$15,565.66 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11,940.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,565.66
|
|
|
INTESTINAL OBSTRUCTION
|
Facility
|
IP
|
$9,667.12
|
|
|
Service Code
|
APR-DRG 2472
|
| Min. Negotiated Rate |
$7,415.70 |
| Max. Negotiated Rate |
$9,667.12 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7,415.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,667.12
|
|
|
INTESTINAL OBSTRUCTION
|
Facility
|
IP
|
$26,655.10
|
|
|
Service Code
|
APR-DRG 2474
|
| Min. Negotiated Rate |
$20,447.27 |
| Max. Negotiated Rate |
$26,655.10 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20,447.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26,655.10
|
|
|
INTESTINAL OBSTRUCTION
|
Facility
|
IP
|
$14,450.15
|
|
|
Service Code
|
APR-DRG 2473
|
| Min. Negotiated Rate |
$11,084.78 |
| Max. Negotiated Rate |
$14,450.15 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11,084.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,450.15
|
|
|
INTESTINAL OBSTRUCTION
|
Facility
|
IP
|
$7,460.94
|
|
|
Service Code
|
APR-DRG 2471
|
| Min. Negotiated Rate |
$5,723.33 |
| Max. Negotiated Rate |
$7,460.94 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5,723.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,460.94
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02BF3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02B53ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 025H3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 025K3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02BH3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02B73ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02BJ3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02B83ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 025J3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02583ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 025L3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 025M3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 025G3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02593ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02BG3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 025F3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02573ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02T83ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Intracardiac Ablation (EPS Studies Included)
|
Facility
|
IP
|
$10,022.00
|
|
|
Service Code
|
ICD 02553ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$10,022.00 |
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
