|
INPATIENT MS-DRG 155: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC
|
Facility
IP
|
$32,948.45
|
|
|
Service Code
|
MS-DRG 155
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,948.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,697.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,948.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,406.26
|
| Rate for Payer: IEHP Medicare Advantage |
$24,406.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,406.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,751.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,704.39
|
| Rate for Payer: Multiplan WC |
$18,879.18
|
| Rate for Payer: Prime Health Services WC |
$18,686.54
|
| 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 156: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC
|
Facility
IP
|
$28,591.04
|
|
|
Service Code
|
MS-DRG 156
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,591.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,872.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,591.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,178.55
|
| Rate for Payer: IEHP Medicare Advantage |
$21,178.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,178.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,684.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,379.26
|
| Rate for Payer: Multiplan WC |
$13,999.71
|
| Rate for Payer: Prime Health Services WC |
$13,856.86
|
| 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 157: DENTAL AND ORAL DISEASES WITH MCC
|
Facility
IP
|
$51,749.41
|
|
|
Service Code
|
MS-DRG 157
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$51,749.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,749.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,330.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,837.60
|
| Rate for Payer: IEHP Medicare Advantage |
$32,837.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,837.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,375.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,002.38
|
| Rate for Payer: Multiplan WC |
$34,332.88
|
| Rate for Payer: Prime Health Services WC |
$33,982.54
|
| 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 158: DENTAL AND ORAL DISEASES WITH CC
|
Facility
IP
|
$32,827.22
|
|
|
Service Code
|
MS-DRG 158
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,827.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,451.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,827.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,316.46
|
| Rate for Payer: IEHP Medicare Advantage |
$24,316.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,316.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,638.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,584.06
|
| Rate for Payer: Multiplan WC |
$19,080.44
|
| Rate for Payer: Prime Health Services WC |
$18,885.74
|
| 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 159: DENTAL AND ORAL DISEASES WITHOUT CC/MCC
|
Facility
IP
|
$28,885.90
|
|
|
Service Code
|
MS-DRG 159
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,885.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,469.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,885.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,396.96
|
| Rate for Payer: IEHP Medicare Advantage |
$21,396.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,396.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,960.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,671.93
|
| Rate for Payer: Multiplan WC |
$15,400.31
|
| Rate for Payer: Prime Health Services WC |
$15,243.16
|
| 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 163: MAJOR CHEST PROCEDURES WITH MCC
|
Facility
IP
|
$142,897.50
|
|
|
Service Code
|
MS-DRG 163
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$142,897.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$142,897.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$89,336.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$66,174.85
|
| Rate for Payer: IEHP Medicare Advantage |
$66,174.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66,174.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$83,380.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$88,674.30
|
| Rate for Payer: Multiplan WC |
$99,472.53
|
| Rate for Payer: Prime Health Services WC |
$98,457.50
|
| 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 164: MAJOR CHEST PROCEDURES WITH CC
|
Facility
IP
|
$77,317.93
|
|
|
Service Code
|
MS-DRG 164
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$77,317.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77,317.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,955.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,189.24
|
| Rate for Payer: IEHP Medicare Advantage |
$42,189.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,189.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,158.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,533.58
|
| Rate for Payer: Multiplan WC |
$53,039.56
|
| Rate for Payer: Prime Health Services WC |
$52,498.34
|
| 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 165: MAJOR CHEST PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$56,884.94
|
|
|
Service Code
|
MS-DRG 165
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$56,884.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,884.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,866.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,715.91
|
| Rate for Payer: IEHP Medicare Advantage |
$34,715.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,715.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,742.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,519.32
|
| Rate for Payer: Multiplan WC |
$39,571.73
|
| Rate for Payer: Prime Health Services WC |
$39,167.94
|
| 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 166: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
IP
|
$123,016.26
|
|
|
Service Code
|
MS-DRG 166
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$123,016.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$123,016.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$79,519.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$58,903.34
|
| Rate for Payer: IEHP Medicare Advantage |
$58,903.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,903.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$74,218.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,930.48
|
| Rate for Payer: Multiplan WC |
$75,282.61
|
| Rate for Payer: Prime Health Services WC |
$74,514.42
|
| 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 167: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC
|
Facility
IP
|
$55,169.06
|
|
|
Service Code
|
MS-DRG 167
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$55,169.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,169.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,019.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,088.33
|
| Rate for Payer: IEHP Medicare Advantage |
$34,088.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,088.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,951.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,678.36
|
| Rate for Payer: Multiplan WC |
$39,041.90
|
| Rate for Payer: Prime Health Services WC |
$38,643.51
|
| 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 168: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$41,099.40
|
|
|
Service Code
|
MS-DRG 168
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$41,099.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,099.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,072.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,942.38
|
| Rate for Payer: IEHP Medicare Advantage |
$28,942.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,942.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,467.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,782.79
|
| Rate for Payer: Multiplan WC |
$29,112.51
|
| Rate for Payer: Prime Health Services WC |
$28,815.44
|
| 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 173: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM
|
Facility
IP
|
$93,221.70
|
|
|
Service Code
|
MS-DRG 173
|
| Min. Negotiated Rate |
$48,006.03 |
| Max. Negotiated Rate |
$93,221.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$93,221.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$64,808.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$48,006.03
|
| Rate for Payer: IEHP Medicare Advantage |
$48,006.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,006.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60,487.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,328.08
|
|
|
INPATIENT MS-DRG 175: PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE
|
Facility
IP
|
$42,533.35
|
|
|
Service Code
|
MS-DRG 175
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,533.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,533.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,780.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,466.85
|
| Rate for Payer: IEHP Medicare Advantage |
$29,466.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,466.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,128.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,485.58
|
| Rate for Payer: Multiplan WC |
$28,685.35
|
| Rate for Payer: Prime Health Services WC |
$28,392.65
|
| 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 176: PULMONARY EMBOLISM WITHOUT MCC
|
Facility
IP
|
$30,987.54
|
|
|
Service Code
|
MS-DRG 176
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,987.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,725.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,987.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,953.73
|
| Rate for Payer: IEHP Medicare Advantage |
$22,953.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,953.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,921.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,758.00
|
| Rate for Payer: Multiplan WC |
$16,790.62
|
| Rate for Payer: Prime Health Services WC |
$16,619.29
|
| 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 177: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC
|
Facility
IP
|
$51,428.06
|
|
|
Service Code
|
MS-DRG 177
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$51,428.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,428.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,172.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,720.07
|
| Rate for Payer: IEHP Medicare Advantage |
$32,720.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,720.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,227.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,844.89
|
| Rate for Payer: Multiplan WC |
$36,552.87
|
| Rate for Payer: Prime Health Services WC |
$36,179.88
|
| 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 178: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC
|
Facility
IP
|
$33,548.72
|
|
|
Service Code
|
MS-DRG 178
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,548.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,912.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,548.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,850.90
|
| Rate for Payer: IEHP Medicare Advantage |
$24,850.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,850.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,312.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,300.21
|
| Rate for Payer: Multiplan WC |
$22,323.15
|
| Rate for Payer: Prime Health Services WC |
$22,095.36
|
| 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 179: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC
|
Facility
IP
|
$30,204.67
|
|
|
Service Code
|
MS-DRG 179
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,204.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,140.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,204.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,373.83
|
| Rate for Payer: IEHP Medicare Advantage |
$22,373.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,373.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,191.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,980.93
|
| Rate for Payer: Multiplan WC |
$16,129.35
|
| Rate for Payer: Prime Health Services WC |
$15,964.76
|
| 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 180: RESPIRATORY NEOPLASMS WITH MCC
|
Facility
IP
|
$52,695.27
|
|
|
Service Code
|
MS-DRG 180
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$52,695.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,695.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,797.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,183.54
|
| Rate for Payer: IEHP Medicare Advantage |
$33,183.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,183.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,811.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,465.94
|
| Rate for Payer: Multiplan WC |
$34,786.74
|
| Rate for Payer: Prime Health Services WC |
$34,431.77
|
| 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 181: RESPIRATORY NEOPLASMS WITH CC
|
Facility
IP
|
$35,261.15
|
|
|
Service Code
|
MS-DRG 181
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,261.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,380.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,261.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,119.37
|
| Rate for Payer: IEHP Medicare Advantage |
$26,119.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,119.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,910.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,999.96
|
| Rate for Payer: Multiplan WC |
$23,282.20
|
| Rate for Payer: Prime Health Services WC |
$23,044.63
|
| 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 182: RESPIRATORY NEOPLASMS WITHOUT CC/MCC
|
Facility
IP
|
$30,736.07
|
|
|
Service Code
|
MS-DRG 182
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,736.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,009.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,736.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,767.46
|
| Rate for Payer: IEHP Medicare Advantage |
$22,767.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,767.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,687.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,508.40
|
| Rate for Payer: Multiplan WC |
$18,226.12
|
| Rate for Payer: Prime Health Services WC |
$18,040.14
|
| 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 183: MAJOR CHEST TRAUMA WITH MCC
|
Facility
IP
|
$47,732.54
|
|
|
Service Code
|
MS-DRG 183
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,732.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,732.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,347.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,368.43
|
| Rate for Payer: IEHP Medicare Advantage |
$31,368.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,368.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,524.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,033.70
|
| Rate for Payer: Multiplan WC |
$30,849.89
|
| Rate for Payer: Prime Health Services WC |
$30,535.10
|
| 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 184: MAJOR CHEST TRAUMA WITH CC
|
Facility
IP
|
$34,524.67
|
|
|
Service Code
|
MS-DRG 184
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,524.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,889.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,524.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,573.83
|
| Rate for Payer: IEHP Medicare Advantage |
$25,573.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,573.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,223.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,268.93
|
| Rate for Payer: Multiplan WC |
$21,464.72
|
| Rate for Payer: Prime Health Services WC |
$21,245.70
|
| 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 185: MAJOR CHEST TRAUMA WITHOUT CC/MCC
|
Facility
IP
|
$30,090.89
|
|
|
Service Code
|
MS-DRG 185
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,090.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,909.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,090.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,289.55
|
| Rate for Payer: IEHP Medicare Advantage |
$22,289.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,289.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,084.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,868.00
|
| Rate for Payer: Multiplan WC |
$15,505.04
|
| Rate for Payer: Prime Health Services WC |
$15,346.83
|
| 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 186: PLEURAL EFFUSION WITH MCC
|
Facility
IP
|
$47,053.46
|
|
|
Service Code
|
MS-DRG 186
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,053.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,053.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,012.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,120.07
|
| Rate for Payer: IEHP Medicare Advantage |
$31,120.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,120.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,211.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,700.89
|
| Rate for Payer: Multiplan WC |
$31,355.09
|
| Rate for Payer: Prime Health Services WC |
$31,035.14
|
| 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 187: PLEURAL EFFUSION WITH CC
|
Facility
IP
|
$33,692.41
|
|
|
Service Code
|
MS-DRG 187
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,692.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,203.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,692.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,957.34
|
| Rate for Payer: IEHP Medicare Advantage |
$24,957.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,957.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,446.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,442.84
|
| Rate for Payer: Multiplan WC |
$21,479.10
|
| Rate for Payer: Prime Health Services WC |
$21,259.93
|
| 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
|
|
