|
INPATIENT MS-DRG 256: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC
|
Facility
IP
|
$49,709.15
|
|
|
Service Code
|
MS-DRG 256
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,709.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,709.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,323.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,091.38
|
| Rate for Payer: IEHP Medicare Advantage |
$32,091.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,091.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,435.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,002.45
|
| Rate for Payer: Multiplan WC |
$33,519.64
|
| Rate for Payer: Prime Health Services WC |
$33,177.60
|
| 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 257: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$33,613.06
|
|
|
Service Code
|
MS-DRG 257
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$33,613.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,043.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,613.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,898.56
|
| Rate for Payer: IEHP Medicare Advantage |
$24,898.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,898.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,372.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,364.07
|
| Rate for Payer: Multiplan WC |
$21,536.61
|
| Rate for Payer: Prime Health Services WC |
$21,316.85
|
| 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 258: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
IP
|
$82,113.92
|
|
|
Service Code
|
MS-DRG 258
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$82,113.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,113.92
|
| 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 |
$59,323.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,943.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$43,943.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,943.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,368.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,884.12
|
| Rate for Payer: Multiplan WC |
$58,555.66
|
| Rate for Payer: Prime Health Services WC |
$57,958.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$36,575.00
|
| Rate for Payer: United Healthcare All Other HMO |
$30,425.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,636.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,698.00
|
|
|
INPATIENT MS-DRG 259: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
IP
|
$56,587.85
|
|
|
Service Code
|
MS-DRG 259
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$56,587.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,587.85
|
| 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 |
$46,719.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,607.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$34,607.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,607.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,605.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,373.73
|
| Rate for Payer: Multiplan WC |
$40,951.79
|
| Rate for Payer: Prime Health Services WC |
$40,533.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$36,575.00
|
| Rate for Payer: United Healthcare All Other HMO |
$29,086.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,636.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,698.00
|
|
|
INPATIENT MS-DRG 260: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
IP
|
$100,503.60
|
|
|
Service Code
|
MS-DRG 260
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$100,503.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$100,503.60
|
| 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 |
$68,403.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,669.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$50,669.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,669.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,843.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,896.96
|
| Rate for Payer: Multiplan WC |
$71,848.92
|
| Rate for Payer: Prime Health Services WC |
$71,115.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$48,768.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,253.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,600.00
|
|
|
INPATIENT MS-DRG 261: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
IP
|
$57,048.65
|
|
|
Service Code
|
MS-DRG 261
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$57,048.65 |
| Rate for Payer: IEHP Medicare Advantage |
$34,775.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57,048.65
|
| 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 |
$46,947.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,775.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,775.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,817.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,599.56
|
| Rate for Payer: Multiplan WC |
$39,241.10
|
| Rate for Payer: Prime Health Services WC |
$38,840.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$48,768.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40,571.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,600.00
|
|
|
INPATIENT MS-DRG 262: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
IP
|
$49,878.91
|
|
|
Service Code
|
MS-DRG 262
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$49,878.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,878.91
|
| 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 |
$43,407.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,153.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$32,153.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,153.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,513.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,085.65
|
| Rate for Payer: Multiplan WC |
$34,435.56
|
| Rate for Payer: Prime Health Services WC |
$34,084.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$48,768.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40,571.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,600.00
|
|
|
INPATIENT MS-DRG 263: VEIN LIGATION AND STRIPPING
|
Facility
IP
|
$85,648.76
|
|
|
Service Code
|
MS-DRG 263
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$85,648.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,648.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,068.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,236.22
|
| Rate for Payer: IEHP Medicare Advantage |
$45,236.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,236.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,997.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,616.53
|
| Rate for Payer: Multiplan WC |
$57,214.62
|
| Rate for Payer: Prime Health Services WC |
$56,630.80
|
| 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 264: OTHER CIRCULATORY SYSTEM O.R. PROCEDURES
|
Facility
IP
|
$99,012.06
|
|
|
Service Code
|
MS-DRG 264
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$99,012.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$99,012.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,667.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,123.83
|
| Rate for Payer: IEHP Medicare Advantage |
$50,123.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,123.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,156.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,165.93
|
| Rate for Payer: Multiplan WC |
$67,969.58
|
| Rate for Payer: Prime Health Services WC |
$67,276.01
|
| 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 265: AICD LEAD PROCEDURES
|
Facility
IP
|
$107,139.78
|
|
|
Service Code
|
MS-DRG 265
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$107,139.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107,139.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$71,680.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$53,096.52
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,547.00
|
| Rate for Payer: IEHP Medicare Advantage |
$53,096.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,096.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,901.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,149.34
|
| Rate for Payer: Multiplan WC |
$69,456.41
|
| Rate for Payer: Prime Health Services WC |
$68,747.67
|
| 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 266: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC
|
Facility
IP
|
$205,698.00
|
|
|
Service Code
|
MS-DRG 266
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$205,698.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$189,356.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$112,275.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$83,167.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$83,167.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$83,167.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104,790.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111,444.12
|
| Rate for Payer: Multiplan WC |
$135,555.12
|
| Rate for Payer: Prime Health Services WC |
$134,171.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$205,698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$194,804.00
|
| Rate for Payer: United Healthcare HMO Rider |
$147,969.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135,306.00
|
|
|
INPATIENT MS-DRG 267: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC
|
Facility
IP
|
$154,449.00
|
|
|
Service Code
|
MS-DRG 267
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$154,449.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$147,948.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$91,829.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$68,022.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$68,022.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68,022.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85,707.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91,149.64
|
| Rate for Payer: Multiplan WC |
$105,980.54
|
| Rate for Payer: Prime Health Services WC |
$104,899.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$154,449.00
|
| Rate for Payer: United Healthcare All Other HMO |
$146,267.00
|
| Rate for Payer: United Healthcare HMO Rider |
$111,104.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101,596.00
|
|
|
INPATIENT MS-DRG 268: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC
|
Facility
IP
|
$207,807.09
|
|
|
Service Code
|
MS-DRG 268
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$207,807.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$207,807.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$121,385.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$89,915.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$89,915.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$89,915.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$113,293.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$120,486.66
|
| Rate for Payer: Multiplan WC |
$142,128.84
|
| Rate for Payer: Prime Health Services WC |
$140,678.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$120,710.00
|
| Rate for Payer: United Healthcare All Other HMO |
$106,481.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,883.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,960.00
|
|
|
INPATIENT MS-DRG 269: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
|
Facility
IP
|
$126,072.12
|
|
|
Service Code
|
MS-DRG 269
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$126,072.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$126,072.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$81,028.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$60,021.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$60,021.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60,021.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75,626.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80,428.14
|
| Rate for Payer: Multiplan WC |
$87,820.13
|
| Rate for Payer: Prime Health Services WC |
$86,924.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$75,032.00
|
| Rate for Payer: United Healthcare All Other HMO |
$66,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$50,278.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45,974.00
|
|
|
INPATIENT MS-DRG 270: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC
|
Facility
IP
|
$153,304.98
|
|
|
Service Code
|
MS-DRG 270
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$153,304.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$153,304.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$94,474.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$69,981.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$69,981.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69,981.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88,176.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93,775.06
|
| Rate for Payer: Multiplan WC |
$104,994.79
|
| Rate for Payer: Prime Health Services WC |
$103,923.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$91,000.00
|
| Rate for Payer: United Healthcare All Other HMO |
$80,275.00
|
| Rate for Payer: United Healthcare HMO Rider |
$60,976.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55,758.00
|
|
|
INPATIENT MS-DRG 271: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC
|
Facility
IP
|
$104,778.16
|
|
|
Service Code
|
MS-DRG 271
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$104,778.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,778.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,514.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,232.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$52,232.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,232.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,813.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,991.94
|
| Rate for Payer: Multiplan WC |
$71,544.98
|
| Rate for Payer: Prime Health Services WC |
$70,814.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,398.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,280.00
|
| Rate for Payer: United Healthcare HMO Rider |
$40,470.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50,192.00
|
|
|
INPATIENT MS-DRG 272: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$73,955.88
|
|
|
Service Code
|
MS-DRG 272
|
| Min. Negotiated Rate |
$25,651.00 |
| Max. Negotiated Rate |
$73,955.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$73,955.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,295.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,959.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$25,651.00
|
| Rate for Payer: IEHP Medicare Advantage |
$40,959.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,959.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,609.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,885.85
|
| Rate for Payer: Multiplan WC |
$53,320.91
|
| Rate for Payer: Prime Health Services WC |
$52,776.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,259.00
|
| Rate for Payer: United Healthcare All Other HMO |
$38,161.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,986.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26,505.00
|
|
|
INPATIENT MS-DRG 273: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC
|
Facility
IP
|
$118,141.45
|
|
|
Service Code
|
MS-DRG 273
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$118,141.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,141.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,112.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,120.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$57,120.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,120.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,971.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,541.31
|
| Rate for Payer: Multiplan WC |
$82,412.87
|
| Rate for Payer: Prime Health Services WC |
$81,571.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$58,981.00
|
| Rate for Payer: United Healthcare All Other HMO |
$49,688.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,951.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,961.00
|
|
|
INPATIENT MS-DRG 274: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC
|
Facility
IP
|
$98,248.09
|
|
|
Service Code
|
MS-DRG 274
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$98,248.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98,248.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,289.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,844.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$49,844.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,844.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,803.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,791.52
|
| Rate for Payer: Multiplan WC |
$68,992.29
|
| Rate for Payer: Prime Health Services WC |
$68,288.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$40,202.00
|
| Rate for Payer: United Healthcare All Other HMO |
$33,869.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,824.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,785.00
|
|
|
INPATIENT MS-DRG 275: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
IP
|
$213,297.31
|
|
|
Service Code
|
MS-DRG 275
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$213,297.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$213,297.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$124,096.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$91,923.47
|
| Rate for Payer: IEHP Medicare Advantage |
$91,923.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$91,923.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$115,823.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$123,177.45
|
| 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 276: CARDIAC DEFIBRILLATOR IMPLANT WITH MCC
|
Facility
IP
|
$188,268.42
|
|
|
Service Code
|
MS-DRG 276
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$188,268.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188,268.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$111,738.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$82,769.20
|
| Rate for Payer: IEHP Medicare Advantage |
$82,769.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,769.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104,289.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$110,910.73
|
| 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 277: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
IP
|
$144,983.24
|
|
|
Service Code
|
MS-DRG 277
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$144,983.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$144,983.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$90,365.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$66,937.71
|
| Rate for Payer: IEHP Medicare Advantage |
$66,937.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66,937.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84,341.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$89,696.53
|
| 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 278: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC
|
Facility
IP
|
$135,221.49
|
|
|
Service Code
|
MS-DRG 278
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$135,221.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$135,221.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$85,545.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$63,367.37
|
| Rate for Payer: IEHP Medicare Advantage |
$63,367.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63,367.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79,842.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84,912.28
|
| 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 279: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC
|
Facility
IP
|
$97,029.39
|
|
|
Service Code
|
MS-DRG 279
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$97,029.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97,029.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,688.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,398.68
|
| Rate for Payer: IEHP Medicare Advantage |
$49,398.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,398.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,242.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,194.23
|
| 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 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC
|
Facility
IP
|
$48,096.33
|
|
|
Service Code
|
MS-DRG 280
|
| Min. Negotiated Rate |
$19,520.00 |
| Max. Negotiated Rate |
$48,096.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,096.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,527.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,501.49
|
| Rate for Payer: IEHP Medicare Advantage |
$31,501.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,501.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,691.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,212.00
|
| Rate for Payer: Multiplan WC |
$32,989.80
|
| Rate for Payer: Prime Health Services WC |
$32,653.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$25,665.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,106.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,346.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,520.00
|
|
