|
INPATIENT MS-DRG 025: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
IP
|
$133,875.46
|
|
|
Service Code
|
MS-DRG 025
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$133,875.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$133,875.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$84,881.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$62,875.06
|
| Rate for Payer: IEHP Medicare Advantage |
$62,875.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62,875.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79,222.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84,252.58
|
| Rate for Payer: Multiplan WC |
$93,245.87
|
| Rate for Payer: Prime Health Services WC |
$92,294.38
|
| 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 026: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
IP
|
$89,526.18
|
|
|
Service Code
|
MS-DRG 026
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$89,526.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,526.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,983.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,654.39
|
| Rate for Payer: IEHP Medicare Advantage |
$46,654.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,654.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,784.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,516.88
|
| Rate for Payer: Multiplan WC |
$62,092.04
|
| Rate for Payer: Prime Health Services WC |
$61,458.44
|
| 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 027: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$73,755.80
|
|
|
Service Code
|
MS-DRG 027
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$73,755.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$73,755.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,196.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,886.40
|
| Rate for Payer: IEHP Medicare Advantage |
$40,886.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,886.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,516.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,787.78
|
| Rate for Payer: Multiplan WC |
$51,246.72
|
| Rate for Payer: Prime Health Services WC |
$50,723.79
|
| 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 028: SPINAL PROCEDURES WITH MCC
|
Facility
IP
|
$182,687.25
|
|
|
Service Code
|
MS-DRG 028
|
| Min. Negotiated Rate |
$25,608.00 |
| Max. Negotiated Rate |
$182,687.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$182,687.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$108,982.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$80,727.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,608.00
|
| Rate for Payer: IEHP Medicare Advantage |
$80,727.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$80,727.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101,717.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108,175.39
|
| Rate for Payer: Multiplan WC |
$120,703.14
|
| Rate for Payer: Prime Health Services WC |
$119,471.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$55,964.00
|
| Rate for Payer: United Healthcare All Other HMO |
$68,420.00
|
| Rate for Payer: United Healthcare HMO Rider |
$51,970.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47,523.00
|
|
|
INPATIENT MS-DRG 029: SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS
|
Facility
IP
|
$103,929.31
|
|
|
Service Code
|
MS-DRG 029
|
| Min. Negotiated Rate |
$25,608.00 |
| Max. Negotiated Rate |
$103,929.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$103,929.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,095.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,922.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,608.00
|
| Rate for Payer: IEHP Medicare Advantage |
$51,922.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,922.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,422.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,575.91
|
| Rate for Payer: Multiplan WC |
$70,185.46
|
| Rate for Payer: Prime Health Services WC |
$69,469.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$72,752.00
|
| Rate for Payer: United Healthcare All Other HMO |
$45,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,810.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,830.00
|
|
|
INPATIENT MS-DRG 030: SPINAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$70,302.80
|
|
|
Service Code
|
MS-DRG 030
|
| Min. Negotiated Rate |
$19,770.00 |
| Max. Negotiated Rate |
$70,302.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70,302.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,491.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,623.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,608.00
|
| Rate for Payer: IEHP Medicare Advantage |
$39,623.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,623.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,925.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,095.46
|
| Rate for Payer: Multiplan WC |
$48,080.00
|
| Rate for Payer: Prime Health Services WC |
$47,589.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$55,964.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,467.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,620.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,770.00
|
|
|
INPATIENT MS-DRG 031: VENTRICULAR SHUNT PROCEDURES WITH MCC
|
Facility
IP
|
$124,798.85
|
|
|
Service Code
|
MS-DRG 031
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$124,798.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$124,798.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,399.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59,555.32
|
| Rate for Payer: IEHP Medicare Advantage |
$59,555.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,555.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75,039.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,804.13
|
| Rate for Payer: Multiplan WC |
$84,630.82
|
| Rate for Payer: Prime Health Services WC |
$83,767.24
|
| 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 032: VENTRICULAR SHUNT PROCEDURES WITH CC
|
Facility
IP
|
$65,294.60
|
|
|
Service Code
|
MS-DRG 032
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$65,294.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,294.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,018.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,791.73
|
| Rate for Payer: IEHP Medicare Advantage |
$37,791.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,791.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,617.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,640.92
|
| Rate for Payer: Multiplan WC |
$42,192.19
|
| Rate for Payer: Prime Health Services WC |
$41,761.66
|
| 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 033: VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$49,199.84
|
|
|
Service Code
|
MS-DRG 033
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,199.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,199.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,071.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,905.09
|
| Rate for Payer: IEHP Medicare Advantage |
$31,905.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,905.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,200.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,752.82
|
| Rate for Payer: Multiplan WC |
$34,881.21
|
| Rate for Payer: Prime Health Services WC |
$34,525.28
|
| 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 034: CAROTID ARTERY STENT PROCEDURES WITH MCC
|
Facility
IP
|
$118,274.84
|
|
|
Service Code
|
MS-DRG 034
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$118,274.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,274.84
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,178.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,169.16
|
| Rate for Payer: IEHP Medicare Advantage |
$57,169.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,169.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72,033.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,606.67
|
| Rate for Payer: Multiplan WC |
$82,133.58
|
| Rate for Payer: Prime Health Services WC |
$81,295.49
|
| 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 035: CAROTID ARTERY STENT PROCEDURES WITH CC
|
Facility
IP
|
$69,711.64
|
|
|
Service Code
|
MS-DRG 035
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$69,711.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,711.64
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,199.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,407.25
|
| Rate for Payer: IEHP Medicare Advantage |
$39,407.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,407.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,653.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,805.72
|
| Rate for Payer: Multiplan WC |
$46,901.20
|
| Rate for Payer: Prime Health Services WC |
$46,422.62
|
| 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 036: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$54,817.39
|
|
|
Service Code
|
MS-DRG 036
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$54,817.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,817.39
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,845.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,959.71
|
| Rate for Payer: IEHP Medicare Advantage |
$33,959.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,959.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,789.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,506.01
|
| Rate for Payer: Multiplan WC |
$38,622.95
|
| Rate for Payer: Prime Health Services WC |
$38,228.83
|
| 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 037: EXTRACRANIAL PROCEDURES WITH MCC
|
Facility
IP
|
$102,334.69
|
|
|
Service Code
|
MS-DRG 037
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$102,334.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,334.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,307.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,339.08
|
| Rate for Payer: IEHP Medicare Advantage |
$51,339.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,339.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,687.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,794.37
|
| Rate for Payer: Multiplan WC |
$69,269.54
|
| Rate for Payer: Prime Health Services WC |
$68,562.70
|
| 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 038: EXTRACRANIAL PROCEDURES WITH CC
|
Facility
IP
|
$48,502.57
|
|
|
Service Code
|
MS-DRG 038
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,502.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,502.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,727.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,650.07
|
| Rate for Payer: IEHP Medicare Advantage |
$31,650.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,650.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,879.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,411.09
|
| Rate for Payer: Multiplan WC |
$33,587.40
|
| Rate for Payer: Prime Health Services WC |
$33,244.67
|
| 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 039: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$35,858.38
|
|
|
Service Code
|
MS-DRG 039
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,858.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,590.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,858.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,561.76
|
| Rate for Payer: IEHP Medicare Advantage |
$26,561.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,561.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,467.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,592.76
|
| Rate for Payer: Multiplan WC |
$23,672.40
|
| Rate for Payer: Prime Health Services WC |
$23,430.84
|
| 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 040: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC
|
Facility
IP
|
$116,731.76
|
|
|
Service Code
|
MS-DRG 040
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$116,731.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$116,731.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$76,416.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$56,604.78
|
| Rate for Payer: IEHP Medicare Advantage |
$56,604.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,604.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,322.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75,850.41
|
| Rate for Payer: Multiplan WC |
$77,800.39
|
| Rate for Payer: Prime Health Services WC |
$77,006.51
|
| 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 041: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR
|
Facility
IP
|
$67,625.90
|
|
|
Service Code
|
MS-DRG 041
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$67,625.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67,625.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,169.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,644.40
|
| Rate for Payer: IEHP Medicare Advantage |
$38,644.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,644.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,691.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,783.50
|
| Rate for Payer: Multiplan WC |
$48,016.33
|
| Rate for Payer: Prime Health Services WC |
$47,526.37
|
| 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 042: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$52,743.78
|
|
|
Service Code
|
MS-DRG 042
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,743.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,743.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,821.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,201.29
|
| Rate for Payer: IEHP Medicare Advantage |
$33,201.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,201.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,833.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,489.73
|
| Rate for Payer: Multiplan WC |
$37,986.32
|
| Rate for Payer: Prime Health Services WC |
$37,598.70
|
| 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 052: SPINAL DISORDERS AND INJURIES WITH CC/MCC
|
Facility
IP
|
$58,949.46
|
|
|
Service Code
|
MS-DRG 052
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$58,949.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,949.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,885.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,471.00
|
| Rate for Payer: IEHP Medicare Advantage |
$35,471.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,471.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,693.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,531.14
|
| Rate for Payer: Multiplan WC |
$36,561.09
|
| Rate for Payer: Prime Health Services WC |
$36,188.01
|
| 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 053: SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC
|
Facility
IP
|
$33,505.30
|
|
|
Service Code
|
MS-DRG 053
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,505.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,824.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,505.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,818.74
|
| Rate for Payer: IEHP Medicare Advantage |
$24,818.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,818.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,271.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,257.11
|
| Rate for Payer: Multiplan WC |
$21,004.71
|
| Rate for Payer: Prime Health Services WC |
$20,790.38
|
| 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 054: NERVOUS SYSTEM NEOPLASMS WITH MCC
|
Facility
IP
|
$44,670.63
|
|
|
Service Code
|
MS-DRG 054
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$44,670.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,670.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,835.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,248.53
|
| Rate for Payer: IEHP Medicare Advantage |
$30,248.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,248.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,113.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,533.03
|
| Rate for Payer: Multiplan WC |
$28,484.09
|
| Rate for Payer: Prime Health Services WC |
$28,193.44
|
| 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 055: NERVOUS SYSTEM NEOPLASMS WITHOUT MCC
|
Facility
IP
|
$34,843.51
|
|
|
Service Code
|
MS-DRG 055
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,843.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,535.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,843.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,810.01
|
| Rate for Payer: IEHP Medicare Advantage |
$25,810.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,810.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,520.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,585.41
|
| Rate for Payer: Multiplan WC |
$20,706.93
|
| Rate for Payer: Prime Health Services WC |
$20,495.63
|
| 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 056: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC
|
Facility
IP
|
$72,576.50
|
|
|
Service Code
|
MS-DRG 056
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$72,576.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,576.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,614.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,455.08
|
| Rate for Payer: IEHP Medicare Advantage |
$40,455.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,455.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,973.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,209.81
|
| Rate for Payer: Multiplan WC |
$45,812.78
|
| Rate for Payer: Prime Health Services WC |
$45,345.30
|
| 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 057: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC
|
Facility
IP
|
$41,326.77
|
|
|
Service Code
|
MS-DRG 057
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$41,326.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,326.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,184.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,025.54
|
| Rate for Payer: IEHP Medicare Advantage |
$29,025.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,025.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,572.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,894.22
|
| Rate for Payer: Multiplan WC |
$26,728.23
|
| Rate for Payer: Prime Health Services WC |
$26,455.49
|
| 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 058: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC
|
Facility
IP
|
$52,383.02
|
|
|
Service Code
|
MS-DRG 058
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$52,383.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,383.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,643.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,069.35
|
| Rate for Payer: IEHP Medicare Advantage |
$33,069.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,069.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,667.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,312.93
|
| Rate for Payer: Multiplan WC |
$35,431.59
|
| Rate for Payer: Prime Health Services WC |
$35,070.04
|
| 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
|
|
