|
INPATIENT MS-DRG 519: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
|
Facility
IP
|
$59,680.08
|
|
|
Service Code
|
MS-DRG 519
|
| Min. Negotiated Rate |
$14,171.00 |
| Max. Negotiated Rate |
$59,680.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,680.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,246.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,738.24
|
| Rate for Payer: IEHP Medicare Advantage |
$35,738.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,738.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,030.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,889.24
|
| Rate for Payer: Multiplan WC |
$41,058.58
|
| Rate for Payer: Prime Health Services WC |
$40,639.61
|
| 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
|
|
|
INPATIENT MS-DRG 520: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
|
Facility
IP
|
$43,397.35
|
|
|
Service Code
|
MS-DRG 520
|
| Min. Negotiated Rate |
$10,755.00 |
| Max. Negotiated Rate |
$43,397.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,397.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,206.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,782.85
|
| Rate for Payer: IEHP Medicare Advantage |
$29,782.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,782.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,526.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,909.02
|
| Rate for Payer: Multiplan WC |
$30,389.88
|
| Rate for Payer: Prime Health Services WC |
$30,079.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$20,246.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,486.00
|
| Rate for Payer: United Healthcare HMO Rider |
$11,761.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10,755.00
|
|
|
INPATIENT MS-DRG 521: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
IP
|
$90,772.17
|
|
|
Service Code
|
MS-DRG 521
|
| Min. Negotiated Rate |
$47,110.11 |
| Max. Negotiated Rate |
$90,772.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,772.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,598.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,110.11
|
| Rate for Payer: IEHP Medicare Advantage |
$47,110.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,110.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,358.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,127.55
|
| Rate for Payer: Multiplan WC |
$62,003.73
|
| Rate for Payer: Prime Health Services WC |
$61,371.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,948.00
|
| Rate for Payer: United Healthcare All Other HMO |
$54,808.00
|
| Rate for Payer: United Healthcare HMO Rider |
$51,849.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,943.00
|
|
|
INPATIENT MS-DRG 522: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
IP
|
$71,343.00
|
|
|
Service Code
|
MS-DRG 522
|
| Min. Negotiated Rate |
$31,230.00 |
| Max. Negotiated Rate |
$71,343.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,033.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,396.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,330.46
|
| Rate for Payer: IEHP Medicare Advantage |
$37,330.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,330.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,036.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,022.82
|
| Rate for Payer: Multiplan WC |
$44,623.71
|
| Rate for Payer: Prime Health Services WC |
$44,168.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$71,343.00
|
| Rate for Payer: United Healthcare All Other HMO |
$44,961.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,152.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,230.00
|
|
|
INPATIENT MS-DRG 533: FRACTURES OF FEMUR WITH MCC
|
Facility
IP
|
$49,457.52
|
|
|
Service Code
|
MS-DRG 533
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,457.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,457.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,199.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,999.34
|
| Rate for Payer: IEHP Medicare Advantage |
$31,999.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,999.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,319.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,879.12
|
| Rate for Payer: Multiplan WC |
$29,291.18
|
| Rate for Payer: Prime Health Services WC |
$28,992.29
|
| 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 534: FRACTURES OF FEMUR WITHOUT MCC
|
Facility
IP
|
$30,903.73
|
|
|
Service Code
|
MS-DRG 534
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,903.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,555.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,903.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,891.65
|
| Rate for Payer: IEHP Medicare Advantage |
$22,891.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,891.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,843.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,674.81
|
| Rate for Payer: Multiplan WC |
$16,344.98
|
| Rate for Payer: Prime Health Services WC |
$16,178.19
|
| 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 535: FRACTURES OF HIP AND PELVIS WITH MCC
|
Facility
IP
|
$39,310.76
|
|
|
Service Code
|
MS-DRG 535
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,310.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,310.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,189.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,288.19
|
| Rate for Payer: IEHP Medicare Advantage |
$28,288.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,288.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,643.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,906.17
|
| Rate for Payer: Multiplan WC |
$26,481.79
|
| Rate for Payer: Prime Health Services WC |
$26,211.56
|
| 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 536: FRACTURES OF HIP AND PELVIS WITHOUT MCC
|
Facility
IP
|
$30,560.95
|
|
|
Service Code
|
MS-DRG 536
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,560.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,861.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,560.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,637.74
|
| Rate for Payer: IEHP Medicare Advantage |
$22,637.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,637.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,523.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,334.57
|
| Rate for Payer: Multiplan WC |
$15,958.90
|
| Rate for Payer: Prime Health Services WC |
$15,796.05
|
| 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 537: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC
|
Facility
IP
|
$33,253.82
|
|
|
Service Code
|
MS-DRG 537
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,253.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,315.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,253.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,632.46
|
| Rate for Payer: IEHP Medicare Advantage |
$24,632.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,632.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,036.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,007.50
|
| Rate for Payer: Multiplan WC |
$20,400.93
|
| Rate for Payer: Prime Health Services WC |
$20,192.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 538: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC
|
Facility
IP
|
$29,393.35
|
|
|
Service Code
|
MS-DRG 538
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,393.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,497.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,393.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,772.85
|
| Rate for Payer: IEHP Medicare Advantage |
$21,772.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,772.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,433.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,175.62
|
| Rate for Payer: Multiplan WC |
$14,297.49
|
| Rate for Payer: Prime Health Services WC |
$14,151.60
|
| 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 539: OSTEOMYELITIS WITH MCC
|
Facility
IP
|
$60,159.07
|
|
|
Service Code
|
MS-DRG 539
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$60,159.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,159.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,483.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,913.43
|
| Rate for Payer: IEHP Medicare Advantage |
$35,913.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,913.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,250.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,124.00
|
| Rate for Payer: Multiplan WC |
$40,988.75
|
| Rate for Payer: Prime Health Services WC |
$40,570.50
|
| 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 540: OSTEOMYELITIS WITH CC
|
Facility
IP
|
$39,356.23
|
|
|
Service Code
|
MS-DRG 540
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,356.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,356.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,211.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,304.81
|
| Rate for Payer: IEHP Medicare Advantage |
$28,304.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,304.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,664.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,928.45
|
| Rate for Payer: Multiplan WC |
$27,654.41
|
| Rate for Payer: Prime Health Services WC |
$27,372.23
|
| 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 541: OSTEOMYELITIS WITHOUT CC/MCC
|
Facility
IP
|
$31,620.73
|
|
|
Service Code
|
MS-DRG 541
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,620.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,008.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,620.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,422.76
|
| Rate for Payer: IEHP Medicare Advantage |
$23,422.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,422.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,512.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,386.50
|
| Rate for Payer: Multiplan WC |
$16,798.84
|
| Rate for Payer: Prime Health Services WC |
$16,627.42
|
| 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 542: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
|
Facility
IP
|
$55,287.29
|
|
|
Service Code
|
MS-DRG 542
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,287.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,287.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,077.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,131.56
|
| Rate for Payer: IEHP Medicare Advantage |
$34,131.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,131.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,005.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,736.29
|
| Rate for Payer: Multiplan WC |
$37,540.67
|
| Rate for Payer: Prime Health Services WC |
$37,157.61
|
| 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 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
|
Facility
IP
|
$35,105.47
|
|
|
Service Code
|
MS-DRG 543
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,105.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,065.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,105.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,004.05
|
| Rate for Payer: IEHP Medicare Advantage |
$26,004.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,004.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,765.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,845.43
|
| Rate for Payer: Multiplan WC |
$22,364.23
|
| Rate for Payer: Prime Health Services WC |
$22,136.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 544: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$30,267.55
|
|
|
Service Code
|
MS-DRG 544
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,267.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,267.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,267.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,420.41
|
| Rate for Payer: IEHP Medicare Advantage |
$22,420.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,420.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,249.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,043.35
|
| Rate for Payer: Multiplan WC |
$15,979.43
|
| Rate for Payer: Prime Health Services WC |
$15,816.37
|
| 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 545: CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
IP
|
$75,583.85
|
|
|
Service Code
|
MS-DRG 545
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$75,583.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$75,583.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,099.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,555.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,258.00
|
| Rate for Payer: IEHP Medicare Advantage |
$41,555.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,555.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52,359.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,683.71
|
| Rate for Payer: Multiplan WC |
$51,517.81
|
| Rate for Payer: Prime Health Services WC |
$50,992.11
|
| 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 546: CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
IP
|
$36,731.07
|
|
|
Service Code
|
MS-DRG 546
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,731.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,357.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,731.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,208.20
|
| Rate for Payer: IEHP Medicare Advantage |
$27,208.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,208.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,282.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,458.99
|
| Rate for Payer: Multiplan WC |
$24,758.78
|
| Rate for Payer: Prime Health Services WC |
$24,506.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 547: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$31,102.80
|
|
|
Service Code
|
MS-DRG 547
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,102.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,659.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,102.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,039.11
|
| Rate for Payer: IEHP Medicare Advantage |
$23,039.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,039.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,029.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,872.41
|
| Rate for Payer: Multiplan WC |
$18,786.77
|
| Rate for Payer: Prime Health Services WC |
$18,595.06
|
| 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 548: SEPTIC ARTHRITIS WITH MCC
|
Facility
IP
|
$59,110.14
|
|
|
Service Code
|
MS-DRG 548
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$59,110.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,110.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,965.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,529.78
|
| Rate for Payer: IEHP Medicare Advantage |
$35,529.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,529.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,767.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,609.91
|
| Rate for Payer: Multiplan WC |
$39,838.72
|
| Rate for Payer: Prime Health Services WC |
$39,432.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 549: SEPTIC ARTHRITIS WITH CC
|
Facility
IP
|
$36,834.37
|
|
|
Service Code
|
MS-DRG 549
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,834.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,567.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,834.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,284.72
|
| Rate for Payer: IEHP Medicare Advantage |
$27,284.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,284.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,378.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,561.52
|
| Rate for Payer: Multiplan WC |
$24,884.05
|
| Rate for Payer: Prime Health Services WC |
$24,630.13
|
| 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 550: SEPTIC ARTHRITIS WITHOUT CC/MCC
|
Facility
IP
|
$32,902.05
|
|
|
Service Code
|
MS-DRG 550
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,902.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,914.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,902.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,371.89
|
| Rate for Payer: IEHP Medicare Advantage |
$24,371.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,371.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,708.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,658.33
|
| Rate for Payer: Multiplan WC |
$21,528.39
|
| Rate for Payer: Prime Health Services WC |
$21,308.71
|
| 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 551: MEDICAL BACK PROBLEMS WITH MCC
|
Facility
IP
|
$56,843.00
|
|
|
Service Code
|
MS-DRG 551
|
| Min. Negotiated Rate |
$13,055.00 |
| Max. Negotiated Rate |
$56,843.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,594.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,254.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,781.04
|
| Rate for Payer: IEHP Medicare Advantage |
$32,781.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,781.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,304.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,926.59
|
| Rate for Payer: Multiplan WC |
$34,365.74
|
| Rate for Payer: Prime Health Services WC |
$34,015.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,843.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,276.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,055.00
|
|
|
INPATIENT MS-DRG 552: MEDICAL BACK PROBLEMS WITHOUT MCC
|
Facility
IP
|
$56,843.00
|
|
|
Service Code
|
MS-DRG 552
|
| Min. Negotiated Rate |
$13,097.00 |
| Max. Negotiated Rate |
$56,843.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,294.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,243.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,624.69
|
| Rate for Payer: IEHP Medicare Advantage |
$24,624.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,624.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,027.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,997.08
|
| Rate for Payer: Multiplan WC |
$19,725.28
|
| Rate for Payer: Prime Health Services WC |
$19,524.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,843.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,854.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,322.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,097.00
|
|
|
INPATIENT MS-DRG 553: BONE DISEASES AND ARTHROPATHIES WITH MCC
|
Facility
IP
|
$40,972.07
|
|
|
Service Code
|
MS-DRG 553
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$40,972.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,972.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,009.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,895.81
|
| Rate for Payer: IEHP Medicare Advantage |
$28,895.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,895.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,408.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,720.39
|
| Rate for Payer: Multiplan WC |
$27,229.31
|
| Rate for Payer: Prime Health Services WC |
$26,951.46
|
| 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
|
|
