|
INPATIENT MS-DRG 399: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$35,440.77
|
|
|
Service Code
|
MS-DRG 399
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,440.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,744.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,440.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,252.42
|
| Rate for Payer: IEHP Medicare Advantage |
$26,252.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,252.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,078.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,178.24
|
| 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 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC
|
Facility
IP
|
$166,895.64
|
|
|
Service Code
|
MS-DRG 405
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$166,895.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$166,895.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$101,185.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$74,952.14
|
| Rate for Payer: IEHP Medicare Advantage |
$74,952.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74,952.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$94,439.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$100,435.87
|
| Rate for Payer: Multiplan WC |
$113,811.09
|
| Rate for Payer: Prime Health Services WC |
$112,649.76
|
| 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 406: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC
|
Facility
IP
|
$87,534.42
|
|
|
Service Code
|
MS-DRG 406
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$87,534.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87,534.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,999.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,925.91
|
| Rate for Payer: IEHP Medicare Advantage |
$45,925.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,925.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,866.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$61,540.72
|
| Rate for Payer: Multiplan WC |
$60,165.72
|
| Rate for Payer: Prime Health Services WC |
$59,551.78
|
| 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 407: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$65,209.72
|
|
|
Service Code
|
MS-DRG 407
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$65,209.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,209.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,976.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,760.69
|
| Rate for Payer: IEHP Medicare Advantage |
$37,760.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,760.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,578.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,599.32
|
| Rate for Payer: Multiplan WC |
$45,708.03
|
| Rate for Payer: Prime Health Services WC |
$45,241.62
|
| 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 408: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
IP
|
$112,842.22
|
|
|
Service Code
|
MS-DRG 408
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$112,842.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$112,842.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,495.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$55,182.19
|
| Rate for Payer: IEHP Medicare Advantage |
$55,182.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,182.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69,529.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,944.13
|
| Rate for Payer: Multiplan WC |
$75,358.60
|
| Rate for Payer: Prime Health Services WC |
$74,589.63
|
| 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 409: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
IP
|
$59,337.51
|
|
|
Service Code
|
MS-DRG 409
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$59,337.51 |
| Rate for Payer: Prime Health Services WC |
$43,324.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59,337.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,077.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,612.94
|
| Rate for Payer: IEHP Medicare Advantage |
$35,612.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,612.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,872.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,721.34
|
| Rate for Payer: Multiplan WC |
$43,771.45
|
| 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 410: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
IP
|
$47,450.60
|
|
|
Service Code
|
MS-DRG 410
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$47,450.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,450.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,208.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,265.33
|
| Rate for Payer: IEHP Medicare Advantage |
$31,265.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,265.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,394.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,895.54
|
| Rate for Payer: Multiplan WC |
$34,864.77
|
| Rate for Payer: Prime Health Services WC |
$34,509.01
|
| 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 411: CHOLECYSTECTOMY WITH C.D.E. WITH MCC
|
Facility
IP
|
$87,325.24
|
|
|
Service Code
|
MS-DRG 411
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$87,325.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87,325.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$64,290.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,622.38
|
| Rate for Payer: IEHP Medicare Advantage |
$47,622.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,622.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60,004.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,813.99
|
| Rate for Payer: Multiplan WC |
$69,376.33
|
| Rate for Payer: Prime Health Services WC |
$68,668.40
|
| 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 412: CHOLECYSTECTOMY WITH C.D.E. WITH CC
|
Facility
IP
|
$62,011.38
|
|
|
Service Code
|
MS-DRG 412
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$62,011.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,011.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,706.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,819.32
|
| Rate for Payer: IEHP Medicare Advantage |
$36,819.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,819.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,392.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,337.89
|
| Rate for Payer: Multiplan WC |
$47,145.59
|
| Rate for Payer: Prime Health Services WC |
$46,664.51
|
| 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 413: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC
|
Facility
IP
|
$45,765.03
|
|
|
Service Code
|
MS-DRG 413
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,765.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,765.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,375.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,648.83
|
| Rate for Payer: IEHP Medicare Advantage |
$30,648.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,648.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,617.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,069.43
|
| Rate for Payer: Multiplan WC |
$33,277.30
|
| Rate for Payer: Prime Health Services WC |
$32,937.74
|
| 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 414: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC
|
Facility
IP
|
$106,869.96
|
|
|
Service Code
|
MS-DRG 414
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$106,869.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$106,869.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$71,547.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,997.84
|
| Rate for Payer: IEHP Medicare Advantage |
$52,997.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,997.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,777.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,017.11
|
| Rate for Payer: Multiplan WC |
$72,590.29
|
| Rate for Payer: Prime Health Services WC |
$71,849.57
|
| 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 415: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
IP
|
$59,898.35
|
|
|
Service Code
|
MS-DRG 415
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$59,898.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,898.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,354.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,818.07
|
| Rate for Payer: IEHP Medicare Advantage |
$35,818.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,818.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,130.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,996.21
|
| Rate for Payer: Multiplan WC |
$41,072.96
|
| Rate for Payer: Prime Health Services WC |
$40,653.84
|
| 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 416: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
IP
|
$40,599.19
|
|
|
Service Code
|
MS-DRG 416
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,599.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,599.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,825.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,759.42
|
| Rate for Payer: IEHP Medicare Advantage |
$28,759.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,759.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,236.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,537.62
|
| Rate for Payer: Multiplan WC |
$28,266.40
|
| Rate for Payer: Prime Health Services WC |
$27,977.97
|
| 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 417: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC
|
Facility
IP
|
$70,266.42
|
|
|
Service Code
|
MS-DRG 417
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$70,266.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70,266.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,473.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,610.16
|
| Rate for Payer: IEHP Medicare Advantage |
$39,610.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,610.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,908.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,077.61
|
| Rate for Payer: Multiplan WC |
$48,829.58
|
| Rate for Payer: Prime Health Services WC |
$48,331.32
|
| 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 418: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC
|
Facility
IP
|
$49,557.57
|
|
|
Service Code
|
MS-DRG 418
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,557.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,557.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,248.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,035.94
|
| Rate for Payer: IEHP Medicare Advantage |
$32,035.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,035.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,365.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,928.16
|
| Rate for Payer: Multiplan WC |
$34,111.09
|
| Rate for Payer: Prime Health Services WC |
$33,763.01
|
| 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 419: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
IP
|
$39,810.97
|
|
|
Service Code
|
MS-DRG 419
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$39,810.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,810.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,436.03
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,471.13
|
| Rate for Payer: IEHP Medicare Advantage |
$28,471.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,471.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,873.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,151.31
|
| Rate for Payer: Multiplan WC |
$26,800.10
|
| Rate for Payer: Prime Health Services WC |
$26,526.63
|
| 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 420: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
IP
|
$97,035.45
|
|
|
Service Code
|
MS-DRG 420
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$97,035.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97,035.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,691.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,400.89
|
| Rate for Payer: IEHP Medicare Advantage |
$49,400.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,400.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,245.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,197.19
|
| Rate for Payer: Multiplan WC |
$66,973.55
|
| Rate for Payer: Prime Health Services WC |
$66,290.15
|
| 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 421: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
IP
|
$51,828.23
|
|
|
Service Code
|
MS-DRG 421
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,828.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,828.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,369.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,866.44
|
| Rate for Payer: IEHP Medicare Advantage |
$32,866.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,866.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,411.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,041.03
|
| Rate for Payer: Multiplan WC |
$37,203.88
|
| Rate for Payer: Prime Health Services WC |
$36,824.25
|
| 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 422: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$42,775.88
|
|
|
Service Code
|
MS-DRG 422
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,775.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,775.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,900.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,555.56
|
| Rate for Payer: IEHP Medicare Advantage |
$29,555.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,555.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,240.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,604.45
|
| Rate for Payer: Multiplan WC |
$28,455.34
|
| Rate for Payer: Prime Health Services WC |
$28,164.98
|
| 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 423: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC
|
Facility
IP
|
$118,562.84
|
|
|
Service Code
|
MS-DRG 423
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$118,562.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,562.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,320.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,274.50
|
| Rate for Payer: IEHP Medicare Advantage |
$57,274.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,274.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72,165.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,747.83
|
| Rate for Payer: Multiplan WC |
$80,747.37
|
| Rate for Payer: Prime Health Services WC |
$79,923.42
|
| 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 424: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC
|
Facility
IP
|
$63,278.59
|
|
|
Service Code
|
MS-DRG 424
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$63,278.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,278.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,688.03
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,546.69
|
| Rate for Payer: IEHP Medicare Advantage |
$37,546.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,546.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,308.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,312.56
|
| Rate for Payer: Multiplan WC |
$48,642.70
|
| Rate for Payer: Prime Health Services WC |
$48,146.35
|
| 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 425: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$48,563.20
|
|
|
Service Code
|
MS-DRG 425
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,563.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,563.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,757.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,672.25
|
| Rate for Payer: IEHP Medicare Advantage |
$31,672.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,672.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,907.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,440.82
|
| Rate for Payer: Multiplan WC |
$29,379.48
|
| Rate for Payer: Prime Health Services WC |
$29,079.69
|
| 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 432: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
IP
|
$58,085.46
|
|
|
Service Code
|
MS-DRG 432
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$58,085.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,085.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,459.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,155.00
|
| Rate for Payer: IEHP Medicare Advantage |
$35,155.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,155.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,295.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,107.70
|
| Rate for Payer: Multiplan WC |
$38,776.97
|
| Rate for Payer: Prime Health Services WC |
$38,381.29
|
| 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 433: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
IP
|
$34,211.82
|
|
|
Service Code
|
MS-DRG 433
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,211.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,255.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,211.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,342.09
|
| Rate for Payer: IEHP Medicare Advantage |
$25,342.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,342.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,931.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,958.40
|
| Rate for Payer: Multiplan WC |
$21,353.83
|
| Rate for Payer: Prime Health Services WC |
$21,135.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 434: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
IP
|
$28,800.58
|
|
|
Service Code
|
MS-DRG 434
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,800.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,296.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,800.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,333.76
|
| Rate for Payer: IEHP Medicare Advantage |
$21,333.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,333.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,880.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,587.24
|
| Rate for Payer: Multiplan WC |
$12,890.74
|
| Rate for Payer: Prime Health Services WC |
$12,759.21
|
| 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
|
|
