|
INPATIENT MS-DRG 466: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
|
Facility
IP
|
$157,236.97
|
|
|
Service Code
|
MS-DRG 466
|
| Min. Negotiated Rate |
$37,472.00 |
| Max. Negotiated Rate |
$157,236.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$157,236.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$96,416.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$71,419.49
|
| Rate for Payer: IEHP Medicare Advantage |
$71,419.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71,419.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$89,988.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95,702.12
|
| Rate for Payer: Multiplan WC |
$107,715.87
|
| Rate for Payer: Prime Health Services WC |
$106,616.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$37,472.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41,372.00
|
| Rate for Payer: United Healthcare HMO Rider |
$43,467.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39,746.00
|
|
|
INPATIENT MS-DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH CC
|
Facility
IP
|
$105,690.67
|
|
|
Service Code
|
MS-DRG 467
|
| Min. Negotiated Rate |
$30,893.00 |
| Max. Negotiated Rate |
$105,690.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$105,690.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,964.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,566.53
|
| Rate for Payer: IEHP Medicare Advantage |
$52,566.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,566.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,233.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70,439.15
|
| Rate for Payer: Multiplan WC |
$74,463.21
|
| Rate for Payer: Prime Health Services WC |
$73,703.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$34,616.00
|
| Rate for Payer: United Healthcare All Other HMO |
$32,162.00
|
| Rate for Payer: United Healthcare HMO Rider |
$33,785.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,893.00
|
|
|
INPATIENT MS-DRG 468: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
|
Facility
IP
|
$80,931.59
|
|
|
Service Code
|
MS-DRG 468
|
| Min. Negotiated Rate |
$27,553.00 |
| Max. Negotiated Rate |
$80,931.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$80,931.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,739.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,510.93
|
| Rate for Payer: IEHP Medicare Advantage |
$43,510.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,510.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,823.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,304.65
|
| Rate for Payer: Multiplan WC |
$57,282.39
|
| Rate for Payer: Prime Health Services WC |
$56,697.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$37,472.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,682.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,132.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,553.00
|
|
|
INPATIENT MS-DRG 469: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
IP
|
$100,946.22
|
|
|
Service Code
|
MS-DRG 469
|
| Min. Negotiated Rate |
$23,506.00 |
| Max. Negotiated Rate |
$100,946.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$100,946.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,622.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,831.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,506.00
|
| Rate for Payer: IEHP Medicare Advantage |
$50,831.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,831.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,047.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,113.88
|
| Rate for Payer: Multiplan WC |
$66,361.57
|
| Rate for Payer: Prime Health Services WC |
$65,684.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$39,776.00
|
| Rate for Payer: United Healthcare All Other HMO |
$36,955.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,727.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29,927.00
|
|
|
INPATIENT MS-DRG 470: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
IP
|
$57,045.62
|
|
|
Service Code
|
MS-DRG 470
|
| Min. Negotiated Rate |
$22,307.00 |
| Max. Negotiated Rate |
$57,045.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,045.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,945.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,774.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,506.00
|
| Rate for Payer: IEHP Medicare Advantage |
$34,774.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,774.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,816.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,598.06
|
| Rate for Payer: Multiplan WC |
$39,263.69
|
| Rate for Payer: Prime Health Services WC |
$38,863.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$50,959.00
|
| Rate for Payer: United Healthcare All Other HMO |
$32,115.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,395.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,307.00
|
|
|
INPATIENT MS-DRG 471: CERVICAL SPINAL FUSION WITH MCC
|
Facility
IP
|
$149,124.40
|
|
|
Service Code
|
MS-DRG 471
|
| Min. Negotiated Rate |
$24,564.00 |
| Max. Negotiated Rate |
$149,124.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$149,124.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$92,410.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$68,452.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: IEHP Medicare Advantage |
$68,452.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68,452.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86,249.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91,726.15
|
| Rate for Payer: Multiplan WC |
$103,442.23
|
| Rate for Payer: Prime Health Services WC |
$102,386.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$39,970.00
|
| Rate for Payer: United Healthcare All Other HMO |
$37,136.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,944.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,125.00
|
|
|
INPATIENT MS-DRG 472: CERVICAL SPINAL FUSION WITH CC
|
Facility
IP
|
$89,595.91
|
|
|
Service Code
|
MS-DRG 472
|
| Min. Negotiated Rate |
$21,530.00 |
| Max. Negotiated Rate |
$89,595.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,595.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,017.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,679.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: IEHP Medicare Advantage |
$46,679.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,679.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,816.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,551.05
|
| Rate for Payer: Multiplan WC |
$63,067.52
|
| Rate for Payer: Prime Health Services WC |
$62,423.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,568.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40,108.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,544.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,530.00
|
|
|
INPATIENT MS-DRG 473: CERVICAL SPINAL FUSION WITHOUT CC/MCC
|
Facility
IP
|
$74,595.55
|
|
|
Service Code
|
MS-DRG 473
|
| Min. Negotiated Rate |
$21,828.00 |
| Max. Negotiated Rate |
$74,595.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$74,595.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,611.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,193.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: IEHP Medicare Advantage |
$41,193.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,193.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,903.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,199.34
|
| Rate for Payer: Multiplan WC |
$52,062.02
|
| Rate for Payer: Prime Health Services WC |
$51,530.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$40,144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31,425.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,871.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,828.00
|
|
|
INPATIENT MS-DRG 474: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
IP
|
$130,443.68
|
|
|
Service Code
|
MS-DRG 474
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$130,443.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$130,443.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$83,186.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$61,619.90
|
| Rate for Payer: IEHP Medicare Advantage |
$61,619.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61,619.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77,641.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82,570.67
|
| Rate for Payer: Multiplan WC |
$84,135.89
|
| Rate for Payer: Prime Health Services WC |
$83,277.36
|
| 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 475: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
IP
|
$65,018.73
|
|
|
Service Code
|
MS-DRG 475
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$65,018.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,018.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,882.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,690.82
|
| Rate for Payer: IEHP Medicare Advantage |
$37,690.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,690.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,490.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,505.70
|
| Rate for Payer: Multiplan WC |
$45,615.62
|
| Rate for Payer: Prime Health Services WC |
$45,150.15
|
| 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 476: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$36,395.78
|
|
|
Service Code
|
MS-DRG 476
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$36,395.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,678.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,395.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,959.84
|
| Rate for Payer: IEHP Medicare Advantage |
$26,959.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,959.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,969.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,126.19
|
| Rate for Payer: Multiplan WC |
$25,208.52
|
| Rate for Payer: Prime Health Services WC |
$24,951.29
|
| 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 477: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
IP
|
$102,134.60
|
|
|
Service Code
|
MS-DRG 477
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$102,134.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,134.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,208.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,265.90
|
| Rate for Payer: IEHP Medicare Advantage |
$51,265.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,265.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,595.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,696.31
|
| Rate for Payer: Multiplan WC |
$69,881.52
|
| Rate for Payer: Prime Health Services WC |
$69,168.44
|
| 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 478: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
IP
|
$72,264.25
|
|
|
Service Code
|
MS-DRG 478
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$72,264.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,264.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,460.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,340.88
|
| Rate for Payer: IEHP Medicare Advantage |
$40,340.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,340.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,829.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,056.78
|
| Rate for Payer: Multiplan WC |
$48,238.13
|
| Rate for Payer: Prime Health Services WC |
$47,745.90
|
| 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 479: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
IP
|
$56,509.02
|
|
|
Service Code
|
MS-DRG 479
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$56,509.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,509.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,680.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,578.42
|
| Rate for Payer: IEHP Medicare Advantage |
$34,578.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,578.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,568.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,335.08
|
| Rate for Payer: Multiplan WC |
$36,316.70
|
| Rate for Payer: Prime Health Services WC |
$35,946.12
|
| 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 480: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
IP
|
$89,398.85
|
|
|
Service Code
|
MS-DRG 480
|
| Min. Negotiated Rate |
$24,564.00 |
| Max. Negotiated Rate |
$89,398.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,398.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,920.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,607.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: IEHP Medicare Advantage |
$46,607.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,607.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,725.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,454.47
|
| Rate for Payer: Multiplan WC |
$60,911.18
|
| Rate for Payer: Prime Health Services WC |
$60,289.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$53,801.00
|
| Rate for Payer: United Healthcare All Other HMO |
$38,830.00
|
| Rate for Payer: United Healthcare HMO Rider |
$29,495.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26,969.00
|
|
|
INPATIENT MS-DRG 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
IP
|
$70,749.00
|
|
|
Service Code
|
MS-DRG 481
|
| Min. Negotiated Rate |
$20,751.00 |
| Max. Negotiated Rate |
$70,749.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,902.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,837.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,916.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: IEHP Medicare Advantage |
$36,916.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,916.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,515.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,468.63
|
| Rate for Payer: Multiplan WC |
$43,381.25
|
| Rate for Payer: Prime Health Services WC |
$42,938.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$70,749.00
|
| Rate for Payer: United Healthcare All Other HMO |
$29,870.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,693.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,751.00
|
|
|
INPATIENT MS-DRG 482: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
IP
|
$57,674.00
|
|
|
Service Code
|
MS-DRG 482
|
| Min. Negotiated Rate |
$17,559.00 |
| Max. Negotiated Rate |
$57,674.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,153.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,555.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,522.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$24,564.00
|
| Rate for Payer: IEHP Medicare Advantage |
$31,522.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,522.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,718.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,240.22
|
| Rate for Payer: Multiplan WC |
$33,805.09
|
| Rate for Payer: Prime Health Services WC |
$33,460.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,674.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$19,203.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,559.00
|
|
|
INPATIENT MS-DRG 483: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
IP
|
$75,311.01
|
|
|
Service Code
|
MS-DRG 483
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$75,311.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$75,311.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,964.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,455.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,506.00
|
| Rate for Payer: IEHP Medicare Advantage |
$41,455.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,455.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52,233.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,549.97
|
| Rate for Payer: Multiplan WC |
$48,416.79
|
| Rate for Payer: Prime Health Services WC |
$47,922.74
|
| 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 485: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC
|
Facility
IP
|
$99,860.90
|
|
|
Service Code
|
MS-DRG 485
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$99,860.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$99,860.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,086.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,434.29
|
| Rate for Payer: IEHP Medicare Advantage |
$50,434.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,434.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,547.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,581.95
|
| Rate for Payer: Multiplan WC |
$66,764.09
|
| Rate for Payer: Prime Health Services WC |
$66,082.82
|
| 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 486: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC
|
Facility
IP
|
$60,883.62
|
|
|
Service Code
|
MS-DRG 486
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$60,883.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,883.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,840.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,178.42
|
| Rate for Payer: IEHP Medicare Advantage |
$36,178.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,178.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,584.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,479.08
|
| Rate for Payer: Multiplan WC |
$42,839.09
|
| Rate for Payer: Prime Health Services WC |
$42,401.96
|
| 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 487: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
IP
|
$46,835.19
|
|
|
Service Code
|
MS-DRG 487
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$46,835.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,835.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,904.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,040.23
|
| Rate for Payer: IEHP Medicare Advantage |
$31,040.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,040.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,110.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,593.91
|
| Rate for Payer: Multiplan WC |
$32,940.50
|
| Rate for Payer: Prime Health Services WC |
$32,604.38
|
| 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 488: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC
|
Facility
IP
|
$63,863.69
|
|
|
Service Code
|
MS-DRG 488
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$63,863.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,863.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,312.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,268.37
|
| Rate for Payer: IEHP Medicare Advantage |
$37,268.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,268.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,958.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,939.62
|
| Rate for Payer: Multiplan WC |
$46,601.37
|
| Rate for Payer: Prime Health Services WC |
$46,125.85
|
| 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 489: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC
|
Facility
IP
|
$37,522.11
|
|
|
Service Code
|
MS-DRG 489
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$37,522.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,522.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,305.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,633.99
|
| Rate for Payer: IEHP Medicare Advantage |
$27,633.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,633.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,818.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,029.55
|
| Rate for Payer: Multiplan WC |
$27,303.24
|
| Rate for Payer: Prime Health Services WC |
$27,024.64
|
| 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 492: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC
|
Facility
IP
|
$104,957.02
|
|
|
Service Code
|
MS-DRG 492
|
| Min. Negotiated Rate |
$21,433.00 |
| Max. Negotiated Rate |
$104,957.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,957.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,602.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,298.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,433.00
|
| Rate for Payer: IEHP Medicare Advantage |
$52,298.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,298.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,895.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70,079.59
|
| Rate for Payer: Multiplan WC |
$71,588.10
|
| Rate for Payer: Prime Health Services WC |
$70,857.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$35,472.00
|
| Rate for Payer: United Healthcare All Other HMO |
$36,220.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,513.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,159.00
|
|
|
INPATIENT MS-DRG 493: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC
|
Facility
IP
|
$72,809.94
|
|
|
Service Code
|
MS-DRG 493
|
| Min. Negotiated Rate |
$16,835.00 |
| Max. Negotiated Rate |
$72,809.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,809.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,729.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,540.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,433.00
|
| Rate for Payer: IEHP Medicare Advantage |
$40,540.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,540.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,080.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,324.20
|
| Rate for Payer: Multiplan WC |
$48,790.56
|
| Rate for Payer: Prime Health Services WC |
$48,292.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$34,314.00
|
| Rate for Payer: United Healthcare All Other HMO |
$24,243.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,411.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,835.00
|
|
