|
INPATIENT MS-DRG 435: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC
|
Facility
IP
|
$53,353.13
|
|
|
Service Code
|
MS-DRG 435
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$53,353.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,353.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,122.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,424.15
|
| Rate for Payer: IEHP Medicare Advantage |
$33,424.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,424.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,114.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,788.36
|
| Rate for Payer: Multiplan WC |
$35,901.87
|
| Rate for Payer: Prime Health Services WC |
$35,535.52
|
| 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 436: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC
|
Facility
IP
|
$35,255.16
|
|
|
Service Code
|
MS-DRG 436
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,255.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,368.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,255.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,114.93
|
| Rate for Payer: IEHP Medicare Advantage |
$26,114.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,114.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,904.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,994.01
|
| Rate for Payer: Multiplan WC |
$22,598.34
|
| Rate for Payer: Prime Health Services WC |
$22,367.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 437: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC
|
Facility
IP
|
$31,219.56
|
|
|
Service Code
|
MS-DRG 437
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,219.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,195.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,219.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,125.60
|
| Rate for Payer: IEHP Medicare Advantage |
$23,125.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,125.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,138.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,988.30
|
| Rate for Payer: Multiplan WC |
$17,371.80
|
| Rate for Payer: Prime Health Services WC |
$17,194.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 438: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC
|
Facility
IP
|
$50,591.34
|
|
|
Service Code
|
MS-DRG 438
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$50,591.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,591.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,758.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,414.03
|
| Rate for Payer: IEHP Medicare Advantage |
$32,414.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,414.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,841.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,434.80
|
| Rate for Payer: Multiplan WC |
$34,037.15
|
| Rate for Payer: Prime Health Services WC |
$33,689.84
|
| 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 439: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC
|
Facility
IP
|
$31,580.31
|
|
|
Service Code
|
MS-DRG 439
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,580.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,926.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,580.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,392.82
|
| Rate for Payer: IEHP Medicare Advantage |
$23,392.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,392.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,474.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,346.38
|
| Rate for Payer: Multiplan WC |
$17,862.63
|
| Rate for Payer: Prime Health Services WC |
$17,680.35
|
| 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 440: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$27,993.76
|
|
|
Service Code
|
MS-DRG 440
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,993.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,662.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,993.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,736.12
|
| Rate for Payer: IEHP Medicare Advantage |
$20,736.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,736.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,127.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,786.40
|
| Rate for Payer: Multiplan WC |
$12,453.32
|
| Rate for Payer: Prime Health Services WC |
$12,326.25
|
| 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 441: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC
|
Facility
IP
|
$55,423.71
|
|
|
Service Code
|
MS-DRG 441
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,423.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,423.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,144.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,181.47
|
| Rate for Payer: IEHP Medicare Advantage |
$34,181.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,181.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,068.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,803.17
|
| Rate for Payer: Multiplan WC |
$38,912.52
|
| Rate for Payer: Prime Health Services WC |
$38,515.45
|
| 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 442: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC
|
Facility
IP
|
$33,021.80
|
|
|
Service Code
|
MS-DRG 442
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,021.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,845.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,021.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,460.59
|
| Rate for Payer: IEHP Medicare Advantage |
$24,460.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,460.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,820.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,777.19
|
| Rate for Payer: Multiplan WC |
$19,427.51
|
| Rate for Payer: Prime Health Services WC |
$19,229.27
|
| 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 443: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
IP
|
$29,477.17
|
|
|
Service Code
|
MS-DRG 443
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,477.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,666.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,477.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,834.94
|
| Rate for Payer: IEHP Medicare Advantage |
$21,834.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,834.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,512.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,258.82
|
| Rate for Payer: Multiplan WC |
$13,387.73
|
| Rate for Payer: Prime Health Services WC |
$13,251.12
|
| 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 444: DISORDERS OF THE BILIARY TRACT WITH MCC
|
Facility
IP
|
$49,512.09
|
|
|
Service Code
|
MS-DRG 444
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,512.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,512.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,226.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,019.31
|
| Rate for Payer: IEHP Medicare Advantage |
$32,019.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,019.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,344.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,905.88
|
| Rate for Payer: Multiplan WC |
$34,187.07
|
| Rate for Payer: Prime Health Services WC |
$33,838.23
|
| 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 445: DISORDERS OF THE BILIARY TRACT WITH CC
|
Facility
IP
|
$35,047.09
|
|
|
Service Code
|
MS-DRG 445
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,047.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,947.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,047.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,960.81
|
| Rate for Payer: IEHP Medicare Advantage |
$25,960.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,960.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,710.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,787.49
|
| Rate for Payer: Multiplan WC |
$22,581.90
|
| Rate for Payer: Prime Health Services WC |
$22,351.48
|
| 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 446: DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC
|
Facility
IP
|
$30,776.48
|
|
|
Service Code
|
MS-DRG 446
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,776.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,298.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,776.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,797.39
|
| Rate for Payer: IEHP Medicare Advantage |
$22,797.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,797.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,724.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,548.50
|
| Rate for Payer: Multiplan WC |
$16,669.46
|
| Rate for Payer: Prime Health Services WC |
$16,499.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 453: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC
|
Facility
IP
|
$268,642.20
|
|
|
Service Code
|
MS-DRG 453
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$268,642.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$268,642.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$151,423.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$112,165.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: IEHP Medicare Advantage |
$112,165.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$112,165.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$141,328.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$150,302.15
|
| Rate for Payer: Multiplan WC |
$188,007.34
|
| Rate for Payer: Prime Health Services WC |
$186,088.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$145,048.00
|
| Rate for Payer: United Healthcare All Other HMO |
$121,204.00
|
| Rate for Payer: United Healthcare HMO Rider |
$92,062.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84,184.00
|
|
|
INPATIENT MS-DRG 454: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC
|
Facility
IP
|
$185,421.75
|
|
|
Service Code
|
MS-DRG 454
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$185,421.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$185,421.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$110,332.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$81,728.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: IEHP Medicare Advantage |
$81,728.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,728.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102,977.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,515.56
|
| Rate for Payer: Multiplan WC |
$125,085.62
|
| Rate for Payer: Prime Health Services WC |
$123,809.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$122,371.00
|
| Rate for Payer: United Healthcare All Other HMO |
$94,605.00
|
| Rate for Payer: United Healthcare HMO Rider |
$71,860.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65,709.00
|
|
|
INPATIENT MS-DRG 455: COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC
|
Facility
IP
|
$139,623.37
|
|
|
Service Code
|
MS-DRG 455
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$139,623.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$139,623.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$87,719.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$64,977.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: IEHP Medicare Advantage |
$64,977.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64,977.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$81,871.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87,069.66
|
| Rate for Payer: Multiplan WC |
$98,328.65
|
| Rate for Payer: Prime Health Services WC |
$97,325.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,035.00
|
| Rate for Payer: United Healthcare All Other HMO |
$79,476.00
|
| Rate for Payer: United Healthcare HMO Rider |
$60,371.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55,204.00
|
|
|
INPATIENT MS-DRG 456: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC
|
Facility
IP
|
$255,545.69
|
|
|
Service Code
|
MS-DRG 456
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$255,545.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$255,545.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$144,957.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$107,375.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: IEHP Medicare Advantage |
$107,375.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$107,375.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$135,293.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$143,883.50
|
| Rate for Payer: Multiplan WC |
$173,516.79
|
| Rate for Payer: Prime Health Services WC |
$171,746.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,453.00
|
| Rate for Payer: United Healthcare All Other HMO |
$94,833.00
|
| Rate for Payer: United Healthcare HMO Rider |
$72,034.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65,869.00
|
|
|
INPATIENT MS-DRG 457: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC
|
Facility
IP
|
$184,178.79
|
|
|
Service Code
|
MS-DRG 457
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$184,178.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$184,178.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$109,719.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$81,273.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: IEHP Medicare Advantage |
$81,273.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,273.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102,404.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108,906.38
|
| Rate for Payer: Multiplan WC |
$123,974.60
|
| Rate for Payer: Prime Health Services WC |
$122,709.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$85,975.00
|
| Rate for Payer: United Healthcare All Other HMO |
$78,109.00
|
| Rate for Payer: United Healthcare HMO Rider |
$59,327.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54,251.00
|
|
|
INPATIENT MS-DRG 458: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC
|
Facility
IP
|
$137,361.80
|
|
|
Service Code
|
MS-DRG 458
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$137,361.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$137,361.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$86,602.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$64,150.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: IEHP Medicare Advantage |
$64,150.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64,150.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80,829.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,961.24
|
| Rate for Payer: Multiplan WC |
$98,844.11
|
| Rate for Payer: Prime Health Services WC |
$97,835.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$77,772.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$51,399.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53,693.00
|
|
|
INPATIENT MS-DRG 459: SPINAL FUSION EXCEPT CERVICAL WITH MCC
|
Facility
IP
|
$201,064.81
|
|
|
Service Code
|
MS-DRG 459
|
| Min. Negotiated Rate |
$29,434.00 |
| Max. Negotiated Rate |
$201,064.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$201,064.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$118,056.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$87,449.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: IEHP Medicare Advantage |
$87,449.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$87,449.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$110,186.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$117,182.28
|
| Rate for Payer: Multiplan WC |
$136,218.45
|
| Rate for Payer: Prime Health Services WC |
$134,828.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$72,883.00
|
| 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 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
IP
|
$110,892.90
|
|
|
Service Code
|
MS-DRG 460
|
| Min. Negotiated Rate |
$28,489.00 |
| Max. Negotiated Rate |
$110,892.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$110,892.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,533.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,469.24
|
| Rate for Payer: Heritage Provider Network Commercial |
$29,434.00
|
| Rate for Payer: IEHP Medicare Advantage |
$54,469.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,469.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,631.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,988.78
|
| Rate for Payer: Multiplan WC |
$77,340.37
|
| Rate for Payer: Prime Health Services WC |
$76,551.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$77,654.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41,017.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,155.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,489.00
|
|
|
INPATIENT MS-DRG 461: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
IP
|
$206,709.65
|
|
|
Service Code
|
MS-DRG 461
|
| Min. Negotiated Rate |
$43,041.00 |
| Max. Negotiated Rate |
$206,709.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$206,709.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$120,843.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$89,514.04
|
| Rate for Payer: IEHP Medicare Advantage |
$89,514.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$89,514.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$112,787.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119,948.81
|
| Rate for Payer: Multiplan WC |
$131,745.60
|
| Rate for Payer: Prime Health Services WC |
$130,401.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$61,219.00
|
| Rate for Payer: United Healthcare All Other HMO |
$61,965.00
|
| Rate for Payer: United Healthcare HMO Rider |
$47,070.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43,041.00
|
|
|
INPATIENT MS-DRG 462: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
IP
|
$86,288.43
|
|
|
Service Code
|
MS-DRG 462
|
| Min. Negotiated Rate |
$34,787.00 |
| Max. Negotiated Rate |
$86,288.43 |
| Rate for Payer: Multiplan WC |
$61,313.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$86,288.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,384.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,470.19
|
| Rate for Payer: IEHP Medicare Advantage |
$45,470.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,470.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,292.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,930.05
|
| Rate for Payer: Prime Health Services WC |
$60,688.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$49,480.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,083.00
|
| Rate for Payer: United Healthcare HMO Rider |
$38,042.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,787.00
|
|
|
INPATIENT MS-DRG 463: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
IP
|
$171,700.73
|
|
|
Service Code
|
MS-DRG 463
|
| Min. Negotiated Rate |
$44,466.00 |
| Max. Negotiated Rate |
$171,700.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$171,700.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$103,557.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76,709.59
|
| Rate for Payer: IEHP Medicare Advantage |
$76,709.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76,709.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96,654.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102,790.85
|
| Rate for Payer: Multiplan WC |
$107,643.99
|
| Rate for Payer: Prime Health Services WC |
$106,545.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
| Rate for Payer: United Healthcare All Other HMO |
$64,022.00
|
| Rate for Payer: United Healthcare HMO Rider |
$48,627.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44,466.00
|
|
|
INPATIENT MS-DRG 464: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
IP
|
$106,647.00
|
|
|
Service Code
|
MS-DRG 464
|
| Min. Negotiated Rate |
$32,351.00 |
| Max. Negotiated Rate |
$106,647.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,990.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,706.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,189.94
|
| Rate for Payer: IEHP Medicare Advantage |
$47,189.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,189.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,459.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,234.52
|
| Rate for Payer: Multiplan WC |
$61,346.56
|
| Rate for Payer: Prime Health Services WC |
$60,720.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
| Rate for Payer: United Healthcare All Other HMO |
$46,576.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,378.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,351.00
|
|
|
INPATIENT MS-DRG 465: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$106,647.00
|
|
|
Service Code
|
MS-DRG 465
|
| Min. Negotiated Rate |
$26,283.00 |
| Max. Negotiated Rate |
$106,647.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,715.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,782.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,653.82
|
| Rate for Payer: IEHP Medicare Advantage |
$34,653.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,653.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,663.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,436.12
|
| Rate for Payer: Multiplan WC |
$40,923.04
|
| Rate for Payer: Prime Health Services WC |
$40,505.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
| Rate for Payer: United Healthcare All Other HMO |
$37,843.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,743.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26,283.00
|
|
