|
INPATIENT MS-DRG 619: O.R. PROCEDURES FOR OBESITY WITH MCC
|
Facility
IP
|
$78,472.97
|
|
|
Service Code
|
MS-DRG 619
|
| Min. Negotiated Rate |
$12,166.00 |
| Max. Negotiated Rate |
$78,472.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78,472.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,735.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,766.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,166.00
|
| Rate for Payer: IEHP Medicare Advantage |
$42,766.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,766.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,886.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,307.69
|
| Rate for Payer: Multiplan WC |
$59,385.32
|
| Rate for Payer: Networks By Design Commercial |
$20,000.00
|
| Rate for Payer: Prime Health Services WC |
$58,779.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,450.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,988.00
|
| Rate for Payer: United Healthcare HMO Rider |
$26,936.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24,631.00
|
|
|
INPATIENT MS-DRG 620: O.R. PROCEDURES FOR OBESITY WITH CC
|
Facility
IP
|
$49,178.62
|
|
|
Service Code
|
MS-DRG 620
|
| Min. Negotiated Rate |
$12,166.00 |
| Max. Negotiated Rate |
$49,178.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,178.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,061.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,897.33
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,166.00
|
| Rate for Payer: IEHP Medicare Advantage |
$31,897.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,897.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,190.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,742.42
|
| Rate for Payer: Multiplan WC |
$34,616.29
|
| Rate for Payer: Networks By Design Commercial |
$20,000.00
|
| Rate for Payer: Prime Health Services WC |
$34,263.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,450.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,988.00
|
| Rate for Payer: United Healthcare HMO Rider |
$26,936.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24,631.00
|
|
|
INPATIENT MS-DRG 621: O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC
|
Facility
IP
|
$45,998.47
|
|
|
Service Code
|
MS-DRG 621
|
| Min. Negotiated Rate |
$12,166.00 |
| Max. Negotiated Rate |
$45,998.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,998.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,491.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,734.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,166.00
|
| Rate for Payer: IEHP Medicare Advantage |
$30,734.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,734.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,725.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,183.81
|
| Rate for Payer: Multiplan WC |
$31,934.22
|
| Rate for Payer: Networks By Design Commercial |
$20,000.00
|
| Rate for Payer: Prime Health Services WC |
$31,608.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,450.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,988.00
|
| Rate for Payer: United Healthcare HMO Rider |
$26,936.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24,631.00
|
|
|
INPATIENT MS-DRG 622: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
IP
|
$115,976.89
|
|
|
Service Code
|
MS-DRG 622
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$115,976.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$115,976.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$76,043.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$56,328.69
|
| Rate for Payer: IEHP Medicare Advantage |
$56,328.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,328.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$70,974.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75,480.44
|
| Rate for Payer: Multiplan WC |
$74,364.63
|
| Rate for Payer: Prime Health Services WC |
$73,605.81
|
| 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 623: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
IP
|
$56,430.20
|
|
|
Service Code
|
MS-DRG 623
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$56,430.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,430.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,641.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,549.60
|
| Rate for Payer: IEHP Medicare Advantage |
$34,549.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,549.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,532.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,296.46
|
| Rate for Payer: Multiplan WC |
$38,703.04
|
| Rate for Payer: Prime Health Services WC |
$38,308.11
|
| 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 624: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$35,461.75
|
|
|
Service Code
|
MS-DRG 624
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,461.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,787.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,461.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,267.96
|
| Rate for Payer: IEHP Medicare Advantage |
$26,267.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,267.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,097.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,199.07
|
| Rate for Payer: Multiplan WC |
$20,310.58
|
| Rate for Payer: Prime Health Services WC |
$20,103.33
|
| 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 625: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC
|
Facility
IP
|
$88,559.10
|
|
|
Service Code
|
MS-DRG 625
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$88,559.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$88,559.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,505.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,300.68
|
| Rate for Payer: IEHP Medicare Advantage |
$46,300.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,300.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,338.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,042.91
|
| Rate for Payer: Multiplan WC |
$59,087.55
|
| Rate for Payer: Prime Health Services WC |
$58,484.62
|
| 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 626: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC
|
Facility
IP
|
$45,228.44
|
|
|
Service Code
|
MS-DRG 626
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,228.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,228.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,110.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,452.57
|
| Rate for Payer: IEHP Medicare Advantage |
$30,452.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,452.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,370.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,806.44
|
| Rate for Payer: Multiplan WC |
$33,252.66
|
| Rate for Payer: Prime Health Services WC |
$32,913.35
|
| 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 627: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$37,470.58
|
|
|
Service Code
|
MS-DRG 627
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$37,470.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,470.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,280.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,615.14
|
| Rate for Payer: IEHP Medicare Advantage |
$27,615.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,615.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,795.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,004.29
|
| Rate for Payer: Multiplan WC |
$26,202.49
|
| Rate for Payer: Prime Health Services WC |
$25,935.11
|
| 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 628: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC
|
Facility
IP
|
$121,703.58
|
|
|
Service Code
|
MS-DRG 628
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$121,703.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$121,703.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$78,871.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$58,423.22
|
| Rate for Payer: IEHP Medicare Advantage |
$58,423.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,423.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73,613.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,287.11
|
| Rate for Payer: Multiplan WC |
$74,851.35
|
| Rate for Payer: Prime Health Services WC |
$74,087.56
|
| 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 629: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC
|
Facility
IP
|
$68,599.04
|
|
|
Service Code
|
MS-DRG 629
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$68,599.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,599.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,650.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,000.33
|
| Rate for Payer: IEHP Medicare Advantage |
$39,000.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,000.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,140.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,260.44
|
| Rate for Payer: Multiplan WC |
$46,079.75
|
| Rate for Payer: Prime Health Services WC |
$45,609.55
|
| 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 630: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$42,330.23
|
|
|
Service Code
|
MS-DRG 630
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,330.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,330.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,679.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,392.55
|
| Rate for Payer: IEHP Medicare Advantage |
$29,392.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,392.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,034.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,386.02
|
| Rate for Payer: Multiplan WC |
$28,837.32
|
| Rate for Payer: Prime Health Services WC |
$28,543.06
|
| 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 637: DIABETES WITH MCC
|
Facility
IP
|
$43,936.98
|
|
|
Service Code
|
MS-DRG 637
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$43,936.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,936.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,473.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,980.22
|
| Rate for Payer: IEHP Medicare Advantage |
$29,980.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,980.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,775.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,173.49
|
| Rate for Payer: Multiplan WC |
$28,662.76
|
| Rate for Payer: Prime Health Services WC |
$28,370.28
|
| 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 638: DIABETES WITH CC
|
Facility
IP
|
$32,241.94
|
|
|
Service Code
|
MS-DRG 638
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,241.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,266.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,241.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,882.92
|
| Rate for Payer: IEHP Medicare Advantage |
$23,882.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,882.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,092.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,003.11
|
| Rate for Payer: Multiplan WC |
$17,989.96
|
| Rate for Payer: Prime Health Services WC |
$17,806.39
|
| 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 639: DIABETES WITHOUT CC/MCC
|
Facility
IP
|
$28,097.06
|
|
|
Service Code
|
MS-DRG 639
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,097.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,871.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,097.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,812.64
|
| Rate for Payer: IEHP Medicare Advantage |
$20,812.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,812.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,223.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,888.94
|
| Rate for Payer: Multiplan WC |
$12,338.32
|
| Rate for Payer: Prime Health Services WC |
$12,212.42
|
| 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 640: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC
|
Facility
IP
|
$39,871.60
|
|
|
Service Code
|
MS-DRG 640
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,871.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,871.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,465.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,493.32
|
| Rate for Payer: IEHP Medicare Advantage |
$28,493.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,493.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,901.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,181.05
|
| Rate for Payer: Multiplan WC |
$25,984.81
|
| Rate for Payer: Prime Health Services WC |
$25,719.66
|
| 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 641: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC
|
Facility
IP
|
$30,475.62
|
|
|
Service Code
|
MS-DRG 641
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,475.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,688.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,475.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,574.53
|
| Rate for Payer: IEHP Medicare Advantage |
$22,574.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,574.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,443.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,249.87
|
| Rate for Payer: Multiplan WC |
$15,817.19
|
| Rate for Payer: Prime Health Services WC |
$15,655.79
|
| 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 642: INBORN AND OTHER DISORDERS OF METABOLISM
|
Facility
IP
|
$39,510.84
|
|
|
Service Code
|
MS-DRG 642
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,510.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,510.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,287.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,361.35
|
| Rate for Payer: IEHP Medicare Advantage |
$28,361.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,361.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,735.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,004.21
|
| Rate for Payer: Multiplan WC |
$28,818.84
|
| Rate for Payer: Prime Health Services WC |
$28,524.77
|
| 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 643: ENDOCRINE DISORDERS WITH MCC
|
Facility
IP
|
$49,872.85
|
|
|
Service Code
|
MS-DRG 643
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,872.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,872.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,404.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,151.25
|
| Rate for Payer: IEHP Medicare Advantage |
$32,151.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,151.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,510.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,082.68
|
| Rate for Payer: Multiplan WC |
$33,755.81
|
| Rate for Payer: Prime Health Services WC |
$33,411.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 644: ENDOCRINE DISORDERS WITH CC
|
Facility
IP
|
$34,671.38
|
|
|
Service Code
|
MS-DRG 644
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,671.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,186.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,671.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,682.50
|
| Rate for Payer: IEHP Medicare Advantage |
$25,682.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,682.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,359.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,414.55
|
| Rate for Payer: Multiplan WC |
$20,928.72
|
| Rate for Payer: Prime Health Services WC |
$20,715.16
|
| 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 645: ENDOCRINE DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$30,168.75
|
|
|
Service Code
|
MS-DRG 645
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,168.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,067.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,168.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,347.22
|
| Rate for Payer: IEHP Medicare Advantage |
$22,347.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,347.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,157.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,945.27
|
| Rate for Payer: Multiplan WC |
$15,250.39
|
| Rate for Payer: Prime Health Services WC |
$15,094.77
|
| 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 650: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC
|
Facility
IP
|
$136,346.21
|
|
|
Service Code
|
MS-DRG 650
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$136,346.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$136,346.21
|
| Rate for Payer: BCBS Transplant Transplant |
$113,455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$86,101.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$63,778.74
|
| Rate for Payer: IEHP Medicare Advantage |
$63,778.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63,778.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80,361.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,463.51
|
| Rate for Payer: Multiplan WC |
$95,369.35
|
| Rate for Payer: Prime Health Services WC |
$94,396.19
|
| 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 651: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC
|
Facility
IP
|
$113,455.00
|
|
|
Service Code
|
MS-DRG 651
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$113,455.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,844.85
|
| Rate for Payer: BCBS Transplant Transplant |
$113,455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,547.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,257.16
|
| Rate for Payer: IEHP Medicare Advantage |
$52,257.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,257.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,844.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70,024.59
|
| Rate for Payer: Multiplan WC |
$72,826.46
|
| Rate for Payer: Prime Health Services WC |
$72,083.33
|
| 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 652: KIDNEY TRANSPLANT
|
Facility
IP
|
$113,455.00
|
|
|
Service Code
|
MS-DRG 652
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$113,455.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$91,081.39
|
| Rate for Payer: BCBS Transplant Transplant |
$113,455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,751.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,223.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$105,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$63,280.00
|
| Rate for Payer: IEHP Medicare Advantage |
$47,223.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,223.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,501.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,279.09
|
| Rate for Payer: Multiplan WC |
$63,357.08
|
| Rate for Payer: Networks By Design Commercial |
$85,000.00
|
| Rate for Payer: Prime Health Services WC |
$62,710.58
|
| 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 653: MAJOR BLADDER PROCEDURES WITH MCC
|
Facility
IP
|
$164,118.70
|
|
|
Service Code
|
MS-DRG 653
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$164,118.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$164,118.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$99,814.23
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$73,936.47
|
| Rate for Payer: IEHP Medicare Advantage |
$73,936.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73,936.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93,159.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,074.87
|
| Rate for Payer: Multiplan WC |
$114,115.04
|
| Rate for Payer: Prime Health Services WC |
$112,950.60
|
| 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
|
|
