|
INPATIENT MS-DRG 582: MASTECTOMY FOR MALIGNANCY WITH CC/MCC
|
Facility
IP
|
$50,539.80
|
|
|
Service Code
|
MS-DRG 582
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$50,539.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,539.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,844.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,217.91
|
| Rate for Payer: IEHP Medicare Advantage |
$33,217.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,217.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,854.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,512.00
|
| Rate for Payer: Multiplan WC |
$39,733.97
|
| Rate for Payer: Prime Health Services WC |
$39,328.52
|
| 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 583: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$46,137.92
|
|
|
Service Code
|
MS-DRG 583
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$46,137.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,137.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,560.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,785.20
|
| Rate for Payer: IEHP Medicare Advantage |
$30,785.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,785.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,789.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,252.17
|
| Rate for Payer: Multiplan WC |
$31,026.51
|
| Rate for Payer: Prime Health Services WC |
$30,709.91
|
| 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 584: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC
|
Facility
IP
|
$59,376.92
|
|
|
Service Code
|
MS-DRG 584
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$59,376.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,376.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,096.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,627.35
|
| Rate for Payer: IEHP Medicare Advantage |
$35,627.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,627.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,890.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,740.65
|
| Rate for Payer: Multiplan WC |
$43,861.80
|
| Rate for Payer: Prime Health Services WC |
$43,414.23
|
| 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 585: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$51,052.14
|
|
|
Service Code
|
MS-DRG 585
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,052.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,052.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,986.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,582.58
|
| Rate for Payer: IEHP Medicare Advantage |
$32,582.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,582.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,054.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,660.66
|
| Rate for Payer: Multiplan WC |
$37,809.70
|
| Rate for Payer: Prime Health Services WC |
$37,423.89
|
| 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 592: SKIN ULCERS WITH MCC
|
Facility
IP
|
$63,363.47
|
|
|
Service Code
|
MS-DRG 592
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$63,363.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,363.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,065.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,085.43
|
| Rate for Payer: IEHP Medicare Advantage |
$37,085.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,085.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,727.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,694.48
|
| Rate for Payer: Multiplan WC |
$36,637.07
|
| Rate for Payer: Prime Health Services WC |
$36,263.23
|
| 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 593: SKIN ULCERS WITH CC
|
Facility
IP
|
$36,889.76
|
|
|
Service Code
|
MS-DRG 593
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,889.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,679.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,889.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,325.75
|
| Rate for Payer: IEHP Medicare Advantage |
$27,325.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,325.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,430.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,616.50
|
| Rate for Payer: Multiplan WC |
$23,655.97
|
| Rate for Payer: Prime Health Services WC |
$23,414.58
|
| 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 594: SKIN ULCERS WITHOUT CC/MCC
|
Facility
IP
|
$30,565.43
|
|
|
Service Code
|
MS-DRG 594
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,565.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,870.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,565.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,641.06
|
| Rate for Payer: IEHP Medicare Advantage |
$22,641.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,641.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,527.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,339.02
|
| Rate for Payer: Multiplan WC |
$15,893.18
|
| Rate for Payer: Prime Health Services WC |
$15,731.00
|
| 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 595: MAJOR SKIN DISORDERS WITH MCC
|
Facility
IP
|
$65,937.30
|
|
|
Service Code
|
MS-DRG 595
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$65,937.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,937.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,336.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,026.79
|
| Rate for Payer: IEHP Medicare Advantage |
$38,026.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,026.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,913.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,955.90
|
| Rate for Payer: Multiplan WC |
$43,976.81
|
| Rate for Payer: Prime Health Services WC |
$43,528.07
|
| 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 596: MAJOR SKIN DISORDERS WITHOUT MCC
|
Facility
IP
|
$33,882.53
|
|
|
Service Code
|
MS-DRG 596
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,882.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,588.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,882.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,098.17
|
| Rate for Payer: IEHP Medicare Advantage |
$25,098.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,098.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,623.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,631.55
|
| Rate for Payer: Multiplan WC |
$22,421.72
|
| Rate for Payer: Prime Health Services WC |
$22,192.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 597: MALIGNANT BREAST DISORDERS WITH MCC
|
Facility
IP
|
$48,520.76
|
|
|
Service Code
|
MS-DRG 597
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$48,520.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,520.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,736.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,656.74
|
| Rate for Payer: IEHP Medicare Advantage |
$31,656.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,656.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,887.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,420.03
|
| Rate for Payer: Multiplan WC |
$34,583.43
|
| Rate for Payer: Prime Health Services WC |
$34,230.53
|
| 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 598: MALIGNANT BREAST DISORDERS WITH CC
|
Facility
IP
|
$36,723.60
|
|
|
Service Code
|
MS-DRG 598
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,723.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,342.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,723.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,202.67
|
| Rate for Payer: IEHP Medicare Advantage |
$27,202.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,202.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,275.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,451.58
|
| Rate for Payer: Multiplan WC |
$21,935.01
|
| Rate for Payer: Prime Health Services WC |
$21,711.18
|
| 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 599: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$28,849.99
|
|
|
Service Code
|
MS-DRG 599
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,849.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,838.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,849.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,370.36
|
| Rate for Payer: IEHP Medicare Advantage |
$21,370.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,370.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,926.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,636.28
|
| Rate for Payer: Multiplan WC |
$15,353.07
|
| Rate for Payer: Prime Health Services WC |
$15,196.41
|
| 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 600: NON-MALIGNANT BREAST DISORDERS WITH CC/MCC
|
Facility
IP
|
$34,129.50
|
|
|
Service Code
|
MS-DRG 600
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,129.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,089.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,129.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,281.11
|
| Rate for Payer: IEHP Medicare Advantage |
$25,281.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,281.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,854.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,876.69
|
| Rate for Payer: Multiplan WC |
$21,380.52
|
| Rate for Payer: Prime Health Services WC |
$21,162.35
|
| 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 601: NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$28,261.72
|
|
|
Service Code
|
MS-DRG 601
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,261.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,874.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,261.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,934.61
|
| Rate for Payer: IEHP Medicare Advantage |
$20,934.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,934.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,377.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,052.38
|
| Rate for Payer: Multiplan WC |
$14,455.63
|
| Rate for Payer: Prime Health Services WC |
$14,308.12
|
| 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 602: CELLULITIS WITH MCC
|
Facility
IP
|
$45,095.05
|
|
|
Service Code
|
MS-DRG 602
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,095.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,095.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,045.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,403.78
|
| Rate for Payer: IEHP Medicare Advantage |
$30,403.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,403.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,308.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,741.07
|
| Rate for Payer: Multiplan WC |
$29,597.17
|
| Rate for Payer: Prime Health Services WC |
$29,295.15
|
| 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 603: CELLULITIS WITHOUT MCC
|
Facility
IP
|
$32,021.89
|
|
|
Service Code
|
MS-DRG 603
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,021.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,820.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,021.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,719.92
|
| Rate for Payer: IEHP Medicare Advantage |
$23,719.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,719.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,887.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,784.69
|
| Rate for Payer: Multiplan WC |
$18,109.07
|
| Rate for Payer: Prime Health Services WC |
$17,924.28
|
| 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 604: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC
|
Facility
IP
|
$45,661.96
|
|
|
Service Code
|
MS-DRG 604
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,661.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,661.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,325.03
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,611.13
|
| Rate for Payer: IEHP Medicare Advantage |
$30,611.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,611.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,570.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,018.91
|
| Rate for Payer: Multiplan WC |
$30,993.65
|
| Rate for Payer: Prime Health Services WC |
$30,677.38
|
| 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 605: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC
|
Facility
IP
|
$32,382.63
|
|
|
Service Code
|
MS-DRG 605
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,382.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,551.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,382.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,987.13
|
| Rate for Payer: IEHP Medicare Advantage |
$23,987.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,987.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,223.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,142.75
|
| Rate for Payer: Multiplan WC |
$18,696.41
|
| Rate for Payer: Prime Health Services WC |
$18,505.63
|
| 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 606: MINOR SKIN DISORDERS WITH MCC
|
Facility
IP
|
$48,075.11
|
|
|
Service Code
|
MS-DRG 606
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$48,075.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,075.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,516.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,493.72
|
| Rate for Payer: IEHP Medicare Advantage |
$31,493.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,493.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,682.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,201.58
|
| Rate for Payer: Multiplan WC |
$31,521.44
|
| Rate for Payer: Prime Health Services WC |
$31,199.79
|
| 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 607: MINOR SKIN DISORDERS WITHOUT MCC
|
Facility
IP
|
$32,153.61
|
|
|
Service Code
|
MS-DRG 607
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,153.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,087.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,153.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,817.49
|
| Rate for Payer: IEHP Medicare Advantage |
$23,817.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,817.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,010.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,915.44
|
| Rate for Payer: Multiplan WC |
$17,419.04
|
| Rate for Payer: Prime Health Services WC |
$17,241.29
|
| 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 614: ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC
|
Facility
IP
|
$68,283.76
|
|
|
Service Code
|
MS-DRG 614
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$68,283.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,283.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,494.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,885.00
|
| Rate for Payer: IEHP Medicare Advantage |
$38,885.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,885.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,995.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,105.90
|
| Rate for Payer: Multiplan WC |
$48,258.67
|
| Rate for Payer: Prime Health Services WC |
$47,766.23
|
| 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 615: ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$44,597.87
|
|
|
Service Code
|
MS-DRG 615
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,597.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,597.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,799.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,221.93
|
| Rate for Payer: IEHP Medicare Advantage |
$30,221.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,221.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,079.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,497.39
|
| Rate for Payer: Multiplan WC |
$30,307.73
|
| Rate for Payer: Prime Health Services WC |
$29,998.47
|
| 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 616: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
IP
|
$119,981.63
|
|
|
Service Code
|
MS-DRG 616
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$119,981.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$119,981.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$78,021.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,793.42
|
| Rate for Payer: IEHP Medicare Advantage |
$57,793.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,793.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72,819.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77,443.18
|
| Rate for Payer: Multiplan WC |
$77,309.56
|
| Rate for Payer: Prime Health Services WC |
$76,520.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 617: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
IP
|
$60,162.10
|
|
|
Service Code
|
MS-DRG 617
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$60,162.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,162.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,484.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,914.53
|
| Rate for Payer: IEHP Medicare Advantage |
$35,914.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,914.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,252.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,125.47
|
| Rate for Payer: Multiplan WC |
$39,922.91
|
| Rate for Payer: Prime Health Services WC |
$39,515.53
|
| 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 618: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$36,165.24
|
|
|
Service Code
|
MS-DRG 618
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$36,165.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,212.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,165.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,789.07
|
| Rate for Payer: IEHP Medicare Advantage |
$26,789.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,789.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,754.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,897.35
|
| Rate for Payer: Multiplan WC |
$24,087.23
|
| Rate for Payer: Prime Health Services WC |
$23,841.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
