|
INPATIENT MS-DRG 494: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC
|
Facility
IP
|
$56,666.67
|
|
|
Service Code
|
MS-DRG 494
|
| Min. Negotiated Rate |
$14,312.00 |
| Max. Negotiated Rate |
$56,666.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,666.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,758.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,636.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,433.00
|
| Rate for Payer: IEHP Medicare Advantage |
$34,636.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,636.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,641.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,412.33
|
| Rate for Payer: Multiplan WC |
$38,789.29
|
| Rate for Payer: Prime Health Services WC |
$38,393.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,968.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,651.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,312.00
|
|
|
INPATIENT MS-DRG 495: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC
|
Facility
IP
|
$108,567.66
|
|
|
Service Code
|
MS-DRG 495
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$108,567.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$108,567.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,385.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$53,618.78
|
| Rate for Payer: IEHP Medicare Advantage |
$53,618.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,618.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67,559.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,849.17
|
| Rate for Payer: Multiplan WC |
$76,280.69
|
| Rate for Payer: Prime Health Services WC |
$75,502.32
|
| 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 496: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC
|
Facility
IP
|
$60,253.05
|
|
|
Service Code
|
MS-DRG 496
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$60,253.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,253.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,529.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,947.79
|
| Rate for Payer: IEHP Medicare Advantage |
$35,947.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,947.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,294.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,170.04
|
| Rate for Payer: Multiplan WC |
$43,120.44
|
| Rate for Payer: Prime Health Services WC |
$42,680.44
|
| 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 497: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC
|
Facility
IP
|
$43,273.06
|
|
|
Service Code
|
MS-DRG 497
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$43,273.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,273.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,145.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,737.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,083.00
|
| Rate for Payer: IEHP Medicare Advantage |
$29,737.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,737.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,469.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,848.10
|
| Rate for Payer: Multiplan WC |
$31,250.36
|
| Rate for Payer: Prime Health Services WC |
$30,931.48
|
| 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 498: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC
|
Facility
IP
|
$79,155.08
|
|
|
Service Code
|
MS-DRG 498
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$79,155.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$79,155.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,862.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,861.17
|
| Rate for Payer: IEHP Medicare Advantage |
$42,861.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,861.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,005.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,433.97
|
| Rate for Payer: Multiplan WC |
$52,637.04
|
| Rate for Payer: Prime Health Services WC |
$52,099.93
|
| 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 499: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC
|
Facility
IP
|
$39,101.58
|
|
|
Service Code
|
MS-DRG 499
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$39,101.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,101.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,085.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,211.68
|
| Rate for Payer: IEHP Medicare Advantage |
$28,211.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,211.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,546.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,803.65
|
| Rate for Payer: Multiplan WC |
$27,081.45
|
| Rate for Payer: Prime Health Services WC |
$26,805.11
|
| 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 500: SOFT TISSUE PROCEDURES WITH MCC
|
Facility
IP
|
$98,308.72
|
|
|
Service Code
|
MS-DRG 500
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$98,308.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98,308.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,319.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,866.59
|
| Rate for Payer: IEHP Medicare Advantage |
$49,866.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,866.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,831.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,821.23
|
| Rate for Payer: Multiplan WC |
$65,809.14
|
| Rate for Payer: Prime Health Services WC |
$65,137.61
|
| 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 501: SOFT TISSUE PROCEDURES WITH CC
|
Facility
IP
|
$52,619.48
|
|
|
Service Code
|
MS-DRG 501
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,619.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,619.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,760.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,155.83
|
| Rate for Payer: IEHP Medicare Advantage |
$33,155.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,155.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,776.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,428.81
|
| Rate for Payer: Multiplan WC |
$36,099.02
|
| Rate for Payer: Prime Health Services WC |
$35,730.66
|
| 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 502: SOFT TISSUE PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$41,917.93
|
|
|
Service Code
|
MS-DRG 502
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$41,917.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,917.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,476.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,241.76
|
| Rate for Payer: IEHP Medicare Advantage |
$29,241.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,241.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,844.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,183.96
|
| Rate for Payer: Multiplan WC |
$28,227.39
|
| Rate for Payer: Prime Health Services WC |
$27,939.36
|
| 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 503: FOOT PROCEDURES WITH MCC
|
Facility
IP
|
$81,304.48
|
|
|
Service Code
|
MS-DRG 503
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$81,304.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81,304.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,923.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,647.32
|
| Rate for Payer: IEHP Medicare Advantage |
$43,647.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,647.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,995.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,487.41
|
| Rate for Payer: Multiplan WC |
$52,025.05
|
| Rate for Payer: Prime Health Services WC |
$51,494.19
|
| 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 504: FOOT PROCEDURES WITH CC
|
Facility
IP
|
$52,358.76
|
|
|
Service Code
|
MS-DRG 504
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,358.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,358.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,631.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,060.47
|
| Rate for Payer: IEHP Medicare Advantage |
$33,060.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,060.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,656.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,301.03
|
| Rate for Payer: Multiplan WC |
$36,448.14
|
| Rate for Payer: Prime Health Services WC |
$36,076.22
|
| 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 505: FOOT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$51,710.00
|
|
|
Service Code
|
MS-DRG 505
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,710.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,710.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,311.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,823.19
|
| Rate for Payer: IEHP Medicare Advantage |
$32,823.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,823.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,357.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,983.07
|
| Rate for Payer: Multiplan WC |
$36,283.84
|
| Rate for Payer: Prime Health Services WC |
$35,913.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 506: MAJOR THUMB OR JOINT PROCEDURES
|
Facility
IP
|
$44,340.18
|
|
|
Service Code
|
MS-DRG 506
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,340.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,340.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,672.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,127.69
|
| Rate for Payer: IEHP Medicare Advantage |
$30,127.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,127.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,960.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,371.10
|
| Rate for Payer: Multiplan WC |
$28,952.33
|
| Rate for Payer: Prime Health Services WC |
$28,656.89
|
| 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 507: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC
|
Facility
IP
|
$64,624.62
|
|
|
Service Code
|
MS-DRG 507
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$64,624.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,624.62
|
| 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 |
$38,091.05
|
| Rate for Payer: Prime Health Services WC |
$37,702.37
|
| 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 508: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$43,473.14
|
|
|
Service Code
|
MS-DRG 508
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$43,473.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,473.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,244.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,810.57
|
| Rate for Payer: IEHP Medicare Advantage |
$29,810.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,810.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,561.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,946.16
|
| Rate for Payer: Multiplan WC |
$29,740.92
|
| Rate for Payer: Prime Health Services WC |
$29,437.44
|
| 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 509: ARTHROSCOPY
|
Facility
IP
|
$40,205.08
|
|
|
Service Code
|
MS-DRG 509
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,205.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,205.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,227.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,057.69
|
| Rate for Payer: IEHP Medicare Advantage |
$29,057.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,057.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,612.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,937.30
|
| Rate for Payer: Multiplan WC |
$31,172.32
|
| Rate for Payer: Prime Health Services WC |
$30,854.24
|
| 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 510: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC
|
Facility
IP
|
$82,477.71
|
|
|
Service Code
|
MS-DRG 510
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$82,477.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,477.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,503.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,076.43
|
| Rate for Payer: IEHP Medicare Advantage |
$44,076.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,076.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,536.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,062.42
|
| Rate for Payer: Multiplan WC |
$59,311.39
|
| Rate for Payer: Prime Health Services WC |
$58,706.18
|
| 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 511: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
|
Facility
IP
|
$60,444.04
|
|
|
Service Code
|
MS-DRG 511
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$60,444.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,444.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,623.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,017.65
|
| Rate for Payer: IEHP Medicare Advantage |
$36,017.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,017.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,382.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,263.65
|
| Rate for Payer: Multiplan WC |
$40,641.69
|
| Rate for Payer: Prime Health Services WC |
$40,226.98
|
| 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 512: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$48,923.96
|
|
|
Service Code
|
MS-DRG 512
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,923.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,923.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,935.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,804.20
|
| Rate for Payer: IEHP Medicare Advantage |
$31,804.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,804.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,073.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,617.63
|
| Rate for Payer: Multiplan WC |
$32,991.85
|
| Rate for Payer: Prime Health Services WC |
$32,655.20
|
| 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 513: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
|
Facility
IP
|
$49,142.24
|
|
|
Service Code
|
MS-DRG 513
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,142.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,142.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,043.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,884.04
|
| Rate for Payer: IEHP Medicare Advantage |
$31,884.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,884.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,173.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,724.61
|
| Rate for Payer: Multiplan WC |
$32,735.15
|
| Rate for Payer: Prime Health Services WC |
$32,401.11
|
| 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 514: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$34,369.00
|
|
|
Service Code
|
MS-DRG 514
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$34,369.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,574.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,369.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,458.52
|
| Rate for Payer: IEHP Medicare Advantage |
$25,458.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,458.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,077.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,114.42
|
| Rate for Payer: Multiplan WC |
$21,208.02
|
| Rate for Payer: Prime Health Services WC |
$20,991.61
|
| 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 515: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC
|
Facility
IP
|
$95,844.03
|
|
|
Service Code
|
MS-DRG 515
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$95,844.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95,844.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,102.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$48,965.12
|
| Rate for Payer: IEHP Medicare Advantage |
$48,965.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,965.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61,696.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,613.26
|
| Rate for Payer: Multiplan WC |
$64,028.62
|
| Rate for Payer: Prime Health Services WC |
$63,375.27
|
| 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 516: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
|
Facility
IP
|
$61,868.89
|
|
|
Service Code
|
MS-DRG 516
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$61,868.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61,868.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,327.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,538.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,258.00
|
| Rate for Payer: IEHP Medicare Advantage |
$36,538.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,538.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,038.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,961.98
|
| Rate for Payer: Multiplan WC |
$41,767.08
|
| Rate for Payer: Prime Health Services WC |
$41,340.89
|
| 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 517: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$45,304.23
|
|
|
Service Code
|
MS-DRG 517
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,304.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,304.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,148.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,480.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,258.00
|
| Rate for Payer: IEHP Medicare Advantage |
$30,480.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,480.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,405.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,843.58
|
| Rate for Payer: Multiplan WC |
$31,008.02
|
| Rate for Payer: Prime Health Services WC |
$30,691.61
|
| 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 518: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
|
Facility
IP
|
$110,707.97
|
|
|
Service Code
|
MS-DRG 518
|
| Min. Negotiated Rate |
$14,171.00 |
| Max. Negotiated Rate |
$110,707.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$110,707.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,442.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,401.59
|
| Rate for Payer: IEHP Medicare Advantage |
$54,401.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,401.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,546.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,898.13
|
| Rate for Payer: Multiplan WC |
$76,553.83
|
| Rate for Payer: Prime Health Services WC |
$75,772.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,330.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,102.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,498.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,171.00
|
|
