|
INPATIENT MS-DRG 059: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC
|
Facility
IP
|
$36,549.95
|
|
|
Service Code
|
MS-DRG 059
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,549.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,991.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,549.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,074.04
|
| Rate for Payer: IEHP Medicare Advantage |
$27,074.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,074.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,113.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,279.21
|
| Rate for Payer: Multiplan WC |
$23,483.46
|
| Rate for Payer: Prime Health Services WC |
$23,243.83
|
| 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 060: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC
|
Facility
IP
|
$32,212.00
|
|
|
Service Code
|
MS-DRG 060
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,212.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,205.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,212.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,860.74
|
| Rate for Payer: IEHP Medicare Advantage |
$23,860.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,860.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,064.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,973.39
|
| Rate for Payer: Multiplan WC |
$18,612.21
|
| Rate for Payer: Prime Health Services WC |
$18,422.29
|
| 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 061: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC
|
Facility
IP
|
$84,969.68
|
|
|
Service Code
|
MS-DRG 061
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$84,969.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$84,969.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,733.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,987.87
|
| Rate for Payer: IEHP Medicare Advantage |
$44,987.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,987.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,684.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,283.75
|
| Rate for Payer: Multiplan WC |
$60,225.27
|
| Rate for Payer: Prime Health Services WC |
$59,610.73
|
| 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 062: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC
|
Facility
IP
|
$56,742.46
|
|
|
Service Code
|
MS-DRG 062
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$56,742.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,742.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,796.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,663.81
|
| Rate for Payer: IEHP Medicare Advantage |
$34,663.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,663.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,676.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,449.51
|
| Rate for Payer: Multiplan WC |
$39,372.53
|
| Rate for Payer: Prime Health Services WC |
$38,970.77
|
| 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 063: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC
|
Facility
IP
|
$45,073.83
|
|
|
Service Code
|
MS-DRG 063
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,073.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,073.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,034.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,396.02
|
| Rate for Payer: IEHP Medicare Advantage |
$30,396.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,396.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,298.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,730.67
|
| Rate for Payer: Multiplan WC |
$32,468.16
|
| Rate for Payer: Prime Health Services WC |
$32,136.86
|
| 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 064: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC
|
Facility
IP
|
$60,722.95
|
|
|
Service Code
|
MS-DRG 064
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$60,722.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,722.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,761.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,119.65
|
| Rate for Payer: IEHP Medicare Advantage |
$36,119.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,119.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,510.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,400.33
|
| Rate for Payer: Multiplan WC |
$40,497.93
|
| Rate for Payer: Prime Health Services WC |
$40,084.69
|
| 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 065: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS
|
Facility
IP
|
$33,993.28
|
|
|
Service Code
|
MS-DRG 065
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,993.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,813.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,993.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,180.21
|
| Rate for Payer: IEHP Medicare Advantage |
$25,180.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,180.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,727.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,741.48
|
| Rate for Payer: Multiplan WC |
$20,873.27
|
| Rate for Payer: Prime Health Services WC |
$20,660.28
|
| 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
|
|
|
INPATIENT MS-DRG 066: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC
|
Facility
IP
|
$29,070.04
|
|
|
Service Code
|
MS-DRG 066
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,070.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,842.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,070.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,533.36
|
| Rate for Payer: IEHP Medicare Advantage |
$21,533.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,533.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,132.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,854.70
|
| Rate for Payer: Multiplan WC |
$14,344.73
|
| Rate for Payer: Prime Health Services WC |
$14,198.36
|
| 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 067: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC
|
Facility
IP
|
$42,954.74
|
|
|
Service Code
|
MS-DRG 067
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,954.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,954.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,988.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,620.97
|
| Rate for Payer: IEHP Medicare Advantage |
$29,620.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,620.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,322.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,692.10
|
| Rate for Payer: Multiplan WC |
$29,040.63
|
| Rate for Payer: Prime Health Services WC |
$28,744.30
|
| 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 068: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC
|
Facility
IP
|
$31,816.83
|
|
|
Service Code
|
MS-DRG 068
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,816.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,405.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,816.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,568.02
|
| Rate for Payer: IEHP Medicare Advantage |
$23,568.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,568.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,695.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,581.15
|
| Rate for Payer: Multiplan WC |
$18,558.81
|
| Rate for Payer: Prime Health Services WC |
$18,369.43
|
| 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 069: TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC
|
Facility
IP
|
$30,734.57
|
|
|
Service Code
|
MS-DRG 069
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,734.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,213.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,734.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,766.35
|
| Rate for Payer: IEHP Medicare Advantage |
$22,766.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,766.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,685.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,506.91
|
| Rate for Payer: Multiplan WC |
$16,386.05
|
| Rate for Payer: Prime Health Services WC |
$16,218.85
|
| 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 070: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC
|
Facility
IP
|
$54,250.48
|
|
|
Service Code
|
MS-DRG 070
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$54,250.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,250.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,565.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,752.37
|
| Rate for Payer: IEHP Medicare Advantage |
$33,752.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,752.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,527.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,228.18
|
| Rate for Payer: Multiplan WC |
$35,408.99
|
| Rate for Payer: Prime Health Services WC |
$35,047.67
|
| 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 071: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC
|
Facility
IP
|
$34,672.87
|
|
|
Service Code
|
MS-DRG 071
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,672.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,189.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,672.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,683.61
|
| Rate for Payer: IEHP Medicare Advantage |
$25,683.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,683.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,361.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,416.04
|
| Rate for Payer: Multiplan WC |
$21,953.49
|
| Rate for Payer: Prime Health Services WC |
$21,729.47
|
| 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 072: NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$30,499.55
|
|
|
Service Code
|
MS-DRG 072
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,499.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,737.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,499.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,592.26
|
| Rate for Payer: IEHP Medicare Advantage |
$22,592.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,592.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,466.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,273.63
|
| Rate for Payer: Multiplan WC |
$15,854.16
|
| Rate for Payer: Prime Health Services WC |
$15,692.38
|
| 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 073: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC
|
Facility
IP
|
$45,868.11
|
|
|
Service Code
|
MS-DRG 073
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,868.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,868.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,426.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,686.52
|
| Rate for Payer: IEHP Medicare Advantage |
$30,686.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,686.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,665.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,119.94
|
| Rate for Payer: Multiplan WC |
$30,790.34
|
| Rate for Payer: Prime Health Services WC |
$30,476.15
|
| 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 074: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC
|
Facility
IP
|
$34,139.97
|
|
|
Service Code
|
MS-DRG 074
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,139.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,110.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,139.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,288.87
|
| Rate for Payer: IEHP Medicare Advantage |
$25,288.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,288.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,863.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,887.09
|
| Rate for Payer: Multiplan WC |
$21,021.14
|
| Rate for Payer: Prime Health Services WC |
$20,806.64
|
| 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 075: VIRAL MENINGITIS WITH CC/MCC
|
Facility
IP
|
$58,018.76
|
|
|
Service Code
|
MS-DRG 075
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$58,018.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,018.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,426.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,130.60
|
| Rate for Payer: IEHP Medicare Advantage |
$35,130.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,130.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,264.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,075.00
|
| Rate for Payer: Multiplan WC |
$37,479.07
|
| Rate for Payer: Prime Health Services WC |
$37,096.63
|
| 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 076: VIRAL MENINGITIS WITHOUT CC/MCC
|
Facility
IP
|
$32,587.70
|
|
|
Service Code
|
MS-DRG 076
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,587.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,966.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,587.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,139.04
|
| Rate for Payer: IEHP Medicare Advantage |
$24,139.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,139.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,415.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,346.31
|
| Rate for Payer: Multiplan WC |
$20,275.66
|
| Rate for Payer: Prime Health Services WC |
$20,068.77
|
| 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 077: HYPERTENSIVE ENCEPHALOPATHY WITH MCC
|
Facility
IP
|
$45,804.44
|
|
|
Service Code
|
MS-DRG 077
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,804.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,804.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,395.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,663.23
|
| Rate for Payer: IEHP Medicare Advantage |
$30,663.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,663.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,635.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,088.73
|
| Rate for Payer: Multiplan WC |
$32,123.16
|
| Rate for Payer: Prime Health Services WC |
$31,795.37
|
| 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 078: HYPERTENSIVE ENCEPHALOPATHY WITH CC
|
Facility
IP
|
$34,000.76
|
|
|
Service Code
|
MS-DRG 078
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,000.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,828.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,000.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,185.75
|
| Rate for Payer: IEHP Medicare Advantage |
$25,185.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,185.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,734.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,748.90
|
| Rate for Payer: Multiplan WC |
$20,388.62
|
| Rate for Payer: Prime Health Services WC |
$20,180.57
|
| 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 079: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC
|
Facility
IP
|
$29,867.87
|
|
|
Service Code
|
MS-DRG 079
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,867.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,458.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,867.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,124.35
|
| Rate for Payer: IEHP Medicare Advantage |
$22,124.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,124.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,876.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,646.63
|
| Rate for Payer: Multiplan WC |
$15,071.72
|
| Rate for Payer: Prime Health Services WC |
$14,917.93
|
| 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 080: NONTRAUMATIC STUPOR AND COMA WITH MCC
|
Facility
IP
|
$66,958.95
|
|
|
Service Code
|
MS-DRG 080
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$66,958.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66,958.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,840.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,400.47
|
| Rate for Payer: IEHP Medicare Advantage |
$38,400.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,400.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,384.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,456.63
|
| Rate for Payer: Multiplan WC |
$41,890.31
|
| Rate for Payer: Prime Health Services WC |
$41,462.85
|
| 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 081: NONTRAUMATIC STUPOR AND COMA WITHOUT MCC
|
Facility
IP
|
$32,393.12
|
|
|
Service Code
|
MS-DRG 081
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,393.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,572.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,393.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,994.90
|
| Rate for Payer: IEHP Medicare Advantage |
$23,994.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,994.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,233.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,153.17
|
| Rate for Payer: Multiplan WC |
$18,452.03
|
| Rate for Payer: Prime Health Services WC |
$18,263.74
|
| 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 082: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC
|
Facility
IP
|
$69,068.94
|
|
|
Service Code
|
MS-DRG 082
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$69,068.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,068.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,882.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,172.18
|
| Rate for Payer: IEHP Medicare Advantage |
$39,172.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,172.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,356.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,490.72
|
| Rate for Payer: Multiplan WC |
$46,521.28
|
| Rate for Payer: Prime Health Services WC |
$46,046.57
|
| 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 083: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC
|
Facility
IP
|
$41,120.62
|
|
|
Service Code
|
MS-DRG 083
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$41,120.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,120.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,082.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,950.13
|
| Rate for Payer: IEHP Medicare Advantage |
$28,950.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,950.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,477.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,793.17
|
| Rate for Payer: Multiplan WC |
$27,687.27
|
| Rate for Payer: Prime Health Services WC |
$27,404.75
|
| 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
|
|
