|
INPATIENT MS-DRG 218: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
IP
|
$172,701.16
|
|
|
Service Code
|
MS-DRG 218
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$172,701.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$172,701.16
|
| 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 |
$104,051.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$77,075.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: IEHP Medicare Advantage |
$77,075.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77,075.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$97,115.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$103,281.17
|
| Rate for Payer: Multiplan WC |
$121,959.97
|
| Rate for Payer: Prime Health Services WC |
$120,715.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$156,273.00
|
| Rate for Payer: United Healthcare All Other HMO |
$110,848.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,200.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76,993.00
|
|
|
INPATIENT MS-DRG 219: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
IP
|
$233,772.74
|
|
|
Service Code
|
MS-DRG 219
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$233,772.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$233,772.74
|
| 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 |
$134,206.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$99,412.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: IEHP Medicare Advantage |
$99,412.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$99,412.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$125,259.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$133,212.51
|
| Rate for Payer: Multiplan WC |
$166,926.64
|
| Rate for Payer: Prime Health Services WC |
$165,223.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$140,190.00
|
| Rate for Payer: United Healthcare All Other HMO |
$139,384.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105,875.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96,814.00
|
|
|
INPATIENT MS-DRG 220: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC
|
Facility
IP
|
$158,995.29
|
|
|
Service Code
|
MS-DRG 220
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$158,995.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$158,995.29
|
| 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 |
$97,284.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$72,062.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: IEHP Medicare Advantage |
$72,062.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72,062.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90,798.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96,563.88
|
| Rate for Payer: Multiplan WC |
$111,617.81
|
| Rate for Payer: Prime Health Services WC |
$110,478.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$111,411.00
|
| Rate for Payer: United Healthcare All Other HMO |
$139,384.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105,875.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96,814.00
|
|
|
INPATIENT MS-DRG 221: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
IP
|
$162,555.00
|
|
|
Service Code
|
MS-DRG 221
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$162,555.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$140,926.96
|
| 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 |
$88,363.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$65,454.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,123.00
|
| Rate for Payer: IEHP Medicare Advantage |
$65,454.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65,454.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82,472.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87,708.53
|
| Rate for Payer: Multiplan WC |
$97,170.39
|
| Rate for Payer: Prime Health Services WC |
$96,178.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$162,555.00
|
| Rate for Payer: United Healthcare All Other HMO |
$139,384.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105,875.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96,814.00
|
|
|
INPATIENT MS-DRG 228: OTHER CARDIOTHORACIC PROCEDURES WITH MCC
|
Facility
IP
|
$152,753.23
|
|
|
Service Code
|
MS-DRG 228
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$152,753.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$152,753.23
|
| 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 |
$94,202.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$69,779.58
|
| Rate for Payer: IEHP Medicare Advantage |
$69,779.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69,779.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87,922.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93,504.64
|
| Rate for Payer: Multiplan WC |
$101,209.91
|
| Rate for Payer: Prime Health Services WC |
$100,177.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$114,283.00
|
| Rate for Payer: United Healthcare All Other HMO |
$79,615.00
|
| Rate for Payer: United Healthcare HMO Rider |
$82,735.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$75,655.00
|
|
|
INPATIENT MS-DRG 229: OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC
|
Facility
IP
|
$96,392.75
|
|
|
Service Code
|
MS-DRG 229
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$96,392.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96,392.75
|
| 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 |
$66,373.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,165.84
|
| Rate for Payer: IEHP Medicare Advantage |
$49,165.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,165.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61,948.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,882.23
|
| Rate for Payer: Multiplan WC |
$67,788.85
|
| Rate for Payer: Prime Health Services WC |
$67,097.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$67,625.00
|
| Rate for Payer: United Healthcare All Other HMO |
$62,832.00
|
| Rate for Payer: United Healthcare HMO Rider |
$65,291.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59,704.00
|
|
|
INPATIENT MS-DRG 231: CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
IP
|
$246,020.40
|
|
|
Service Code
|
MS-DRG 231
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$246,020.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$246,020.40
|
| 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 |
$140,254.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$103,891.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: IEHP Medicare Advantage |
$103,891.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$103,891.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$130,903.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$139,215.12
|
| Rate for Payer: Multiplan WC |
$172,366.75
|
| Rate for Payer: Prime Health Services WC |
$170,607.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$101,973.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,744.00
|
| Rate for Payer: United Healthcare HMO Rider |
$89,600.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81,931.00
|
|
|
INPATIENT MS-DRG 232: CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
IP
|
$180,337.76
|
|
|
Service Code
|
MS-DRG 232
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$180,337.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$180,337.76
|
| 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 |
$107,822.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$79,868.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: IEHP Medicare Advantage |
$79,868.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79,868.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$100,634.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$107,023.88
|
| Rate for Payer: Multiplan WC |
$120,298.57
|
| Rate for Payer: Prime Health Services WC |
$119,071.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$89,284.00
|
| Rate for Payer: United Healthcare All Other HMO |
$82,953.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76,039.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69,531.00
|
|
|
INPATIENT MS-DRG 233: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC
|
Facility
IP
|
$236,452.67
|
|
|
Service Code
|
MS-DRG 233
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$236,452.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$236,452.67
|
| 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 |
$135,529.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$100,392.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: IEHP Medicare Advantage |
$100,392.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$100,392.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126,494.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$134,525.96
|
| Rate for Payer: Multiplan WC |
$159,052.95
|
| Rate for Payer: Prime Health Services WC |
$157,429.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$135,867.00
|
| Rate for Payer: United Healthcare All Other HMO |
$101,161.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76,840.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$70,265.00
|
|
|
INPATIENT MS-DRG 234: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC
|
Facility
IP
|
$157,579.54
|
|
|
Service Code
|
MS-DRG 234
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$157,579.54 |
| Rate for Payer: IEHP Medicare Advantage |
$71,544.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157,579.54
|
| 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 |
$96,585.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$71,544.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71,544.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90,146.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95,870.01
|
| Rate for Payer: Multiplan WC |
$106,508.33
|
| Rate for Payer: Prime Health Services WC |
$105,421.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$97,821.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,922.00
|
| Rate for Payer: United Healthcare HMO Rider |
$70,582.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64,541.00
|
|
|
INPATIENT MS-DRG 235: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
IP
|
$178,276.27
|
|
|
Service Code
|
MS-DRG 235
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$178,276.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$178,276.27
|
| 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 |
$106,804.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$79,114.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: IEHP Medicare Advantage |
$79,114.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79,114.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$99,684.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$106,013.55
|
| Rate for Payer: Multiplan WC |
$123,013.49
|
| Rate for Payer: Prime Health Services WC |
$121,758.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$79,536.00
|
| Rate for Payer: United Healthcare All Other HMO |
$70,702.00
|
| Rate for Payer: United Healthcare HMO Rider |
$53,703.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,106.00
|
|
|
INPATIENT MS-DRG 236: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
IP
|
$122,513.02
|
|
|
Service Code
|
MS-DRG 236
|
| Min. Negotiated Rate |
$11,745.00 |
| Max. Negotiated Rate |
$122,513.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122,513.02
|
| 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 |
$79,271.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$58,719.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,409.00
|
| Rate for Payer: IEHP Medicare Advantage |
$58,719.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,719.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73,986.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,683.81
|
| Rate for Payer: Multiplan WC |
$83,755.96
|
| Rate for Payer: Prime Health Services WC |
$82,901.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$72,566.00
|
| Rate for Payer: United Healthcare All Other HMO |
$65,316.00
|
| Rate for Payer: United Healthcare HMO Rider |
$49,615.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45,367.00
|
|
|
INPATIENT MS-DRG 239: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC
|
Facility
IP
|
$145,722.95
|
|
|
Service Code
|
MS-DRG 239
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$145,722.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$145,722.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$90,731.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$67,208.26
|
| Rate for Payer: IEHP Medicare Advantage |
$67,208.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,208.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84,682.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,059.07
|
| Rate for Payer: Multiplan WC |
$95,496.67
|
| Rate for Payer: Prime Health Services WC |
$94,522.21
|
| 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 240: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC
|
Facility
IP
|
$85,163.71
|
|
|
Service Code
|
MS-DRG 240
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$85,163.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,163.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,829.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,058.82
|
| Rate for Payer: IEHP Medicare Advantage |
$45,058.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,058.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,774.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,378.82
|
| Rate for Payer: Multiplan WC |
$55,740.11
|
| Rate for Payer: Prime Health Services WC |
$55,171.33
|
| 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 241: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC
|
Facility
IP
|
$42,133.18
|
|
|
Service Code
|
MS-DRG 241
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,133.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,133.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,645.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,367.05
|
| Rate for Payer: IEHP Medicare Advantage |
$29,367.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,367.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,002.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,351.85
|
| Rate for Payer: Multiplan WC |
$31,808.95
|
| Rate for Payer: Prime Health Services WC |
$31,484.37
|
| 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 242: PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC
|
Facility
IP
|
$104,744.81
|
|
|
Service Code
|
MS-DRG 242
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$104,744.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,744.81
|
| 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 |
$70,497.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,220.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$52,220.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,220.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,797.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,975.56
|
| Rate for Payer: Multiplan WC |
$71,333.45
|
| Rate for Payer: Prime Health Services WC |
$70,605.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$36,319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$33,743.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,370.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,428.00
|
|
|
INPATIENT MS-DRG 243: PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC
|
Facility
IP
|
$69,047.72
|
|
|
Service Code
|
MS-DRG 243
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$69,047.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,047.72
|
| 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 |
$52,871.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,164.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$39,164.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,164.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,347.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,480.32
|
| Rate for Payer: Multiplan WC |
$48,137.50
|
| Rate for Payer: Prime Health Services WC |
$47,646.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,403.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,388.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,412.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,408.00
|
|
|
INPATIENT MS-DRG 244: PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC
|
Facility
IP
|
$55,463.12
|
|
|
Service Code
|
MS-DRG 244
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$55,463.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,463.12
|
| 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 |
$46,164.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,195.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$34,195.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,195.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,086.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,822.49
|
| 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 |
$23,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$22,125.00
|
| Rate for Payer: United Healthcare HMO Rider |
$19,630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,951.00
|
|
|
INPATIENT MS-DRG 245: AICD GENERATOR PROCEDURES
|
Facility
IP
|
$137,373.92
|
|
|
Service Code
|
MS-DRG 245
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$137,373.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$137,373.92
|
| 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 |
$86,608.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$64,154.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,547.00
|
| Rate for Payer: IEHP Medicare Advantage |
$64,154.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64,154.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80,834.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,967.18
|
| Rate for Payer: Multiplan WC |
$100,135.86
|
| Rate for Payer: Prime Health Services WC |
$99,114.07
|
| 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 250: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC
|
Facility
IP
|
$71,266.85
|
|
|
Service Code
|
MS-DRG 250
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$71,266.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71,266.85
|
| 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 |
$53,967.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,976.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$39,976.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,976.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,369.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,567.93
|
| Rate for Payer: Multiplan WC |
$49,692.12
|
| Rate for Payer: Prime Health Services WC |
$49,185.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$30,903.00
|
| Rate for Payer: United Healthcare All Other HMO |
$33,938.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25,777.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23,570.00
|
|
|
INPATIENT MS-DRG 251: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
IP
|
$48,108.46
|
|
|
Service Code
|
MS-DRG 251
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$48,108.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,108.46
|
| 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 |
$42,533.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,505.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$31,505.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,505.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,697.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,217.96
|
| Rate for Payer: Multiplan WC |
$33,377.94
|
| Rate for Payer: Prime Health Services WC |
$33,037.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$39,303.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,244.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,458.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,621.00
|
|
|
INPATIENT MS-DRG 252: OTHER VASCULAR PROCEDURES WITH MCC
|
Facility
IP
|
$101,673.80
|
|
|
Service Code
|
MS-DRG 252
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$101,673.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101,673.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,981.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,097.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$51,097.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,097.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,382.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,470.46
|
| Rate for Payer: Multiplan WC |
$68,659.60
|
| Rate for Payer: Prime Health Services WC |
$67,959.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$40,038.00
|
| Rate for Payer: United Healthcare All Other HMO |
$39,861.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,281.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,688.00
|
|
|
INPATIENT MS-DRG 253: OTHER VASCULAR PROCEDURES WITH CC
|
Facility
IP
|
$77,339.15
|
|
|
Service Code
|
MS-DRG 253
|
| Min. Negotiated Rate |
$25,295.00 |
| Max. Negotiated Rate |
$77,339.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77,339.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,965.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,197.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$42,197.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,197.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,168.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,543.98
|
| Rate for Payer: Multiplan WC |
$54,914.54
|
| Rate for Payer: Prime Health Services WC |
$54,354.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,705.00
|
| Rate for Payer: United Healthcare All Other HMO |
$36,415.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,663.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,295.00
|
|
|
INPATIENT MS-DRG 254: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$53,818.00
|
|
|
Service Code
|
MS-DRG 254
|
| Min. Negotiated Rate |
$18,843.00 |
| Max. Negotiated Rate |
$53,818.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,601.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,751.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,149.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$33,149.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,149.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,767.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,419.90
|
| Rate for Payer: Multiplan WC |
$37,550.94
|
| Rate for Payer: Prime Health Services WC |
$37,167.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$53,818.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,125.00
|
| Rate for Payer: United Healthcare HMO Rider |
$20,606.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18,843.00
|
|
|
INPATIENT MS-DRG 255: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC
|
Facility
IP
|
$83,290.18
|
|
|
Service Code
|
MS-DRG 255
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$83,290.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$83,290.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,904.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,373.59
|
| Rate for Payer: IEHP Medicare Advantage |
$44,373.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,373.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,910.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,460.61
|
| Rate for Payer: Multiplan WC |
$52,688.39
|
| Rate for Payer: Prime Health Services WC |
$52,150.75
|
| 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
|
|
