|
INPATIENT MS-DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC
|
Facility
IP
|
$32,445.51
|
|
|
Service Code
|
MS-DRG 281
|
| Min. Negotiated Rate |
$14,736.00 |
| Max. Negotiated Rate |
$32,445.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,678.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,445.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,033.71
|
| Rate for Payer: IEHP Medicare Advantage |
$24,033.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,033.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,282.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,205.17
|
| Rate for Payer: Multiplan WC |
$18,864.80
|
| Rate for Payer: Prime Health Services WC |
$18,672.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$25,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,212.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,114.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,736.00
|
|
|
INPATIENT MS-DRG 282: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC
|
Facility
IP
|
$29,528.08
|
|
|
Service Code
|
MS-DRG 282
|
| Min. Negotiated Rate |
$11,917.00 |
| Max. Negotiated Rate |
$29,528.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,769.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,528.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,872.65
|
| Rate for Payer: IEHP Medicare Advantage |
$21,872.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,872.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,559.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,309.35
|
| Rate for Payer: Multiplan WC |
$14,718.49
|
| Rate for Payer: Prime Health Services WC |
$14,568.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$26,661.00
|
| Rate for Payer: United Healthcare All Other HMO |
$17,160.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,033.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,917.00
|
|
|
INPATIENT MS-DRG 283: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC
|
Facility
IP
|
$59,764.96
|
|
|
Service Code
|
MS-DRG 283
|
| Min. Negotiated Rate |
$17,720.00 |
| Max. Negotiated Rate |
$59,764.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,764.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,288.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,769.28
|
| Rate for Payer: IEHP Medicare Advantage |
$35,769.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,769.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,069.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,930.84
|
| Rate for Payer: Multiplan WC |
$39,401.28
|
| Rate for Payer: Prime Health Services WC |
$38,999.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,534.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,511.00
|
| Rate for Payer: United Healthcare HMO Rider |
$19,377.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,720.00
|
|
|
INPATIENT MS-DRG 284: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC
|
Facility
IP
|
$29,851.40
|
|
|
Service Code
|
MS-DRG 284
|
| Min. Negotiated Rate |
$13,549.00 |
| Max. Negotiated Rate |
$29,851.40 |
| Rate for Payer: United Healthcare HMO Rider |
$14,817.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22,424.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,851.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,112.15
|
| Rate for Payer: IEHP Medicare Advantage |
$22,112.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,112.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,861.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,630.28
|
| Rate for Payer: Multiplan WC |
$15,102.53
|
| Rate for Payer: Prime Health Services WC |
$14,948.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$26,839.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,513.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,549.00
|
|
|
INPATIENT MS-DRG 285: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC
|
Facility
IP
|
$26,450.00
|
|
|
Service Code
|
MS-DRG 285
|
| Min. Negotiated Rate |
$11,013.13 |
| Max. Negotiated Rate |
$26,450.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,815.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,094.23
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,329.06
|
| Rate for Payer: IEHP Medicare Advantage |
$19,329.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,329.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,354.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,900.94
|
| Rate for Payer: Multiplan WC |
$11,126.67
|
| Rate for Payer: Prime Health Services WC |
$11,013.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$26,450.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,841.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,697.00
|
|
|
INPATIENT MS-DRG 286: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
IP
|
$65,349.17
|
|
|
Service Code
|
MS-DRG 286
|
| Min. Negotiated Rate |
$4,504.00 |
| Max. Negotiated Rate |
$65,349.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,349.17
|
| 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 |
$51,045.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,811.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,504.00
|
| Rate for Payer: IEHP Medicare Advantage |
$37,811.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,811.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,642.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,667.66
|
| Rate for Payer: Multiplan WC |
$43,557.86
|
| Rate for Payer: Prime Health Services WC |
$43,113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$19,771.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,058.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,478.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,239.00
|
|
|
INPATIENT MS-DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
IP
|
$34,969.25
|
|
|
Service Code
|
MS-DRG 287
|
| Min. Negotiated Rate |
$4,504.00 |
| Max. Negotiated Rate |
$34,969.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,789.79
|
| 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 |
$34,969.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,903.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,504.00
|
| Rate for Payer: IEHP Medicare Advantage |
$25,903.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,903.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,637.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,710.22
|
| Rate for Payer: Multiplan WC |
$22,594.23
|
| Rate for Payer: Prime Health Services WC |
$22,363.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$25,632.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,442.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,007.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,809.00
|
|
|
INPATIENT MS-DRG 288: ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC
|
Facility
IP
|
$78,609.39
|
|
|
Service Code
|
MS-DRG 288
|
| Min. Negotiated Rate |
$32,712.00 |
| Max. Negotiated Rate |
$78,609.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78,609.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,593.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,661.59
|
| Rate for Payer: IEHP Medicare Advantage |
$42,661.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,661.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,753.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,166.53
|
| Rate for Payer: Multiplan WC |
$55,376.61
|
| Rate for Payer: Prime Health Services WC |
$54,811.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$35,642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$47,097.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,774.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,712.00
|
|
|
INPATIENT MS-DRG 289: ACUTE AND SUBACUTE ENDOCARDITIS WITH CC
|
Facility
IP
|
$44,797.95
|
|
|
Service Code
|
MS-DRG 289
|
| Min. Negotiated Rate |
$25,901.00 |
| Max. Negotiated Rate |
$44,797.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,797.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,898.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,295.12
|
| Rate for Payer: IEHP Medicare Advantage |
$30,295.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,295.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,171.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,595.46
|
| Rate for Payer: Multiplan WC |
$33,004.18
|
| Rate for Payer: Prime Health Services WC |
$32,667.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,362.00
|
| Rate for Payer: United Healthcare All Other HMO |
$37,290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,325.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,901.00
|
|
|
INPATIENT MS-DRG 290: ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC
|
Facility
IP
|
$35,021.66
|
|
|
Service Code
|
MS-DRG 290
|
| Min. Negotiated Rate |
$22,150.00 |
| Max. Negotiated Rate |
$35,021.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,079.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,021.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,941.97
|
| Rate for Payer: IEHP Medicare Advantage |
$25,941.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,941.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,686.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,762.24
|
| Rate for Payer: Multiplan WC |
$24,760.83
|
| Rate for Payer: Prime Health Services WC |
$24,508.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,362.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31,886.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,225.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,150.00
|
|
|
INPATIENT MS-DRG 291: HEART FAILURE AND SHOCK WITH MCC
|
Facility
IP
|
$38,922.71
|
|
|
Service Code
|
MS-DRG 291
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$38,922.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,922.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,997.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,146.25
|
| Rate for Payer: IEHP Medicare Advantage |
$28,146.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,146.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,464.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,715.98
|
| Rate for Payer: Multiplan WC |
$26,282.58
|
| Rate for Payer: Prime Health Services WC |
$26,014.39
|
| 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 292: HEART FAILURE AND SHOCK WITH CC
|
Facility
IP
|
$31,599.76
|
|
|
Service Code
|
MS-DRG 292
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,599.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,965.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,599.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,407.23
|
| Rate for Payer: IEHP Medicare Advantage |
$23,407.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,407.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,493.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,365.69
|
| Rate for Payer: Multiplan WC |
$17,718.87
|
| Rate for Payer: Prime Health Services WC |
$17,538.07
|
| 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 293: HEART FAILURE AND SHOCK WITHOUT CC/MCC
|
Facility
IP
|
$27,183.95
|
|
|
Service Code
|
MS-DRG 293
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,183.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,022.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,183.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,136.26
|
| Rate for Payer: IEHP Medicare Advantage |
$20,136.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,136.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,371.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,982.59
|
| Rate for Payer: Multiplan WC |
$11,506.59
|
| Rate for Payer: Prime Health Services WC |
$11,389.18
|
| 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 294: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC
|
Facility
IP
|
$35,150.38
|
|
|
Service Code
|
MS-DRG 294
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,150.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,156.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,150.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,037.32
|
| Rate for Payer: IEHP Medicare Advantage |
$26,037.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,037.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,807.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,890.01
|
| Rate for Payer: Multiplan WC |
$23,709.37
|
| Rate for Payer: Prime Health Services WC |
$23,467.43
|
| 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 295: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC
|
Facility
IP
|
$30,710.61
|
|
|
Service Code
|
MS-DRG 295
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,710.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,144.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,710.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,748.60
|
| Rate for Payer: IEHP Medicare Advantage |
$22,748.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,748.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,663.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,483.12
|
| Rate for Payer: Multiplan WC |
$18,189.15
|
| Rate for Payer: Prime Health Services WC |
$18,003.55
|
| 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 296: CARDIAC ARREST, UNEXPLAINED WITH MCC
|
Facility
IP
|
$48,602.61
|
|
|
Service Code
|
MS-DRG 296
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$48,602.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,602.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,777.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,686.67
|
| Rate for Payer: IEHP Medicare Advantage |
$31,686.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,686.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,925.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,460.14
|
| Rate for Payer: Multiplan WC |
$33,644.91
|
| Rate for Payer: Prime Health Services WC |
$33,301.59
|
| 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 297: CARDIAC ARREST, UNEXPLAINED WITH CC
|
Facility
IP
|
$29,685.24
|
|
|
Service Code
|
MS-DRG 297
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,685.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,088.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,685.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,989.07
|
| Rate for Payer: IEHP Medicare Advantage |
$21,989.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,989.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,706.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,465.35
|
| Rate for Payer: Multiplan WC |
$13,067.36
|
| Rate for Payer: Prime Health Services WC |
$12,934.02
|
| 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 298: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC
|
Facility
IP
|
$25,360.75
|
|
|
Service Code
|
MS-DRG 298
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$25,360.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,305.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,360.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,785.74
|
| Rate for Payer: IEHP Medicare Advantage |
$18,785.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,785.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,670.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,172.89
|
| Rate for Payer: Multiplan WC |
$10,032.06
|
| Rate for Payer: Prime Health Services WC |
$9,929.70
|
| 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 299: PERIPHERAL VASCULAR DISORDERS WITH MCC
|
Facility
IP
|
$47,784.08
|
|
|
Service Code
|
MS-DRG 299
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,784.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,784.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,372.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,387.28
|
| Rate for Payer: IEHP Medicare Advantage |
$31,387.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,387.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,547.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,058.96
|
| Rate for Payer: Multiplan WC |
$31,585.10
|
| Rate for Payer: Prime Health Services WC |
$31,262.80
|
| 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 300: PERIPHERAL VASCULAR DISORDERS WITH CC
|
Facility
IP
|
$34,750.71
|
|
|
Service Code
|
MS-DRG 300
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,750.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,347.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,750.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,741.27
|
| Rate for Payer: IEHP Medicare Advantage |
$25,741.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,741.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,434.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,493.30
|
| Rate for Payer: Multiplan WC |
$21,175.16
|
| Rate for Payer: Prime Health Services WC |
$20,959.09
|
| 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 301: PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$29,403.84
|
|
|
Service Code
|
MS-DRG 301
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,403.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,518.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,403.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,780.62
|
| Rate for Payer: IEHP Medicare Advantage |
$21,780.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,780.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,443.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,186.03
|
| Rate for Payer: Multiplan WC |
$14,708.22
|
| Rate for Payer: Prime Health Services WC |
$14,558.14
|
| 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 302: ATHEROSCLEROSIS WITH MCC
|
Facility
IP
|
$35,560.50
|
|
|
Service Code
|
MS-DRG 302
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,560.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,987.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,560.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,341.11
|
| Rate for Payer: IEHP Medicare Advantage |
$26,341.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,341.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,189.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,297.09
|
| Rate for Payer: Multiplan WC |
$24,762.88
|
| Rate for Payer: Prime Health Services WC |
$24,510.20
|
| 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 303: ATHEROSCLEROSIS WITHOUT MCC
|
Facility
IP
|
$28,629.94
|
|
|
Service Code
|
MS-DRG 303
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,629.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,950.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,629.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,207.36
|
| Rate for Payer: IEHP Medicare Advantage |
$21,207.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,207.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,721.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,417.86
|
| Rate for Payer: Multiplan WC |
$13,884.71
|
| Rate for Payer: Prime Health Services WC |
$13,743.03
|
| 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 304: HYPERTENSION WITH MCC
|
Facility
IP
|
$35,978.13
|
|
|
Service Code
|
MS-DRG 304
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,978.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,833.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,978.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,650.47
|
| Rate for Payer: IEHP Medicare Advantage |
$26,650.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,650.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,579.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,711.63
|
| Rate for Payer: Multiplan WC |
$22,561.37
|
| Rate for Payer: Prime Health Services WC |
$22,331.16
|
| 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 305: HYPERTENSION WITHOUT MCC
|
Facility
IP
|
$30,057.98
|
|
|
Service Code
|
MS-DRG 305
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,057.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,843.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,057.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,265.17
|
| Rate for Payer: IEHP Medicare Advantage |
$22,265.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,265.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,054.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,835.33
|
| Rate for Payer: Multiplan WC |
$15,312.00
|
| Rate for Payer: Prime Health Services WC |
$15,155.76
|
| 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
|
|
