|
INPATIENT MS-DRG 654: MAJOR BLADDER PROCEDURES WITH CC
|
Facility
IP
|
$82,990.05
|
|
|
Service Code
|
MS-DRG 654
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$82,990.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,990.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,756.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,263.82
|
| Rate for Payer: IEHP Medicare Advantage |
$44,263.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,263.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,772.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,313.52
|
| Rate for Payer: Multiplan WC |
$58,374.93
|
| Rate for Payer: Prime Health Services WC |
$57,779.27
|
| 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 655: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$63,900.06
|
|
|
Service Code
|
MS-DRG 655
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$63,900.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,900.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,330.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,281.68
|
| Rate for Payer: IEHP Medicare Advantage |
$37,281.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,281.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,974.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,957.45
|
| Rate for Payer: Multiplan WC |
$44,332.09
|
| Rate for Payer: Prime Health Services WC |
$43,879.73
|
| 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 656: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC
|
Facility
IP
|
$95,119.48
|
|
|
Service Code
|
MS-DRG 656
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$95,119.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95,119.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,745.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$48,700.12
|
| Rate for Payer: IEHP Medicare Advantage |
$48,700.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,700.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61,362.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,258.16
|
| Rate for Payer: Multiplan WC |
$67,879.22
|
| Rate for Payer: Prime Health Services WC |
$67,186.57
|
| 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 657: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC
|
Facility
IP
|
$55,908.77
|
|
|
Service Code
|
MS-DRG 657
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$55,908.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,908.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,384.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,358.87
|
| Rate for Payer: IEHP Medicare Advantage |
$34,358.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,358.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,292.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,040.89
|
| Rate for Payer: Multiplan WC |
$38,567.50
|
| Rate for Payer: Prime Health Services WC |
$38,173.95
|
| 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 658: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC
|
Facility
IP
|
$44,879.81
|
|
|
Service Code
|
MS-DRG 658
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,879.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,879.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,938.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,325.05
|
| Rate for Payer: IEHP Medicare Advantage |
$30,325.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,325.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,209.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,635.57
|
| Rate for Payer: Multiplan WC |
$32,427.09
|
| Rate for Payer: Prime Health Services WC |
$32,096.20
|
| 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 659: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
|
Facility
IP
|
$78,485.09
|
|
|
Service Code
|
MS-DRG 659
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$78,485.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78,485.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,531.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,616.13
|
| Rate for Payer: IEHP Medicare Advantage |
$42,616.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,616.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,696.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,105.61
|
| Rate for Payer: Multiplan WC |
$52,920.44
|
| Rate for Payer: Prime Health Services WC |
$52,380.44
|
| 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 660: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC
|
Facility
IP
|
$40,802.30
|
|
|
Service Code
|
MS-DRG 660
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,802.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,802.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,925.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,833.72
|
| Rate for Payer: IEHP Medicare Advantage |
$28,833.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,833.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,330.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,637.18
|
| Rate for Payer: Multiplan WC |
$28,981.08
|
| Rate for Payer: Prime Health Services WC |
$28,685.35
|
| 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 661: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
|
Facility
IP
|
$34,472.29
|
|
|
Service Code
|
MS-DRG 661
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$34,472.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,783.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,472.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,535.03
|
| Rate for Payer: IEHP Medicare Advantage |
$25,535.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,535.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,174.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,216.94
|
| Rate for Payer: Multiplan WC |
$22,136.27
|
| Rate for Payer: Prime Health Services WC |
$21,910.39
|
| 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 662: MINOR BLADDER PROCEDURES WITH MCC
|
Facility
IP
|
$90,847.96
|
|
|
Service Code
|
MS-DRG 662
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$90,847.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,847.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,636.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,137.83
|
| Rate for Payer: IEHP Medicare Advantage |
$47,137.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,137.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,393.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,164.69
|
| Rate for Payer: Multiplan WC |
$62,404.20
|
| Rate for Payer: Prime Health Services WC |
$61,767.42
|
| 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 663: MINOR BLADDER PROCEDURES WITH CC
|
Facility
IP
|
$44,231.04
|
|
|
Service Code
|
MS-DRG 663
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,231.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,231.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,618.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,087.78
|
| Rate for Payer: IEHP Medicare Advantage |
$30,087.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,087.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,910.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,317.63
|
| Rate for Payer: Multiplan WC |
$31,318.12
|
| Rate for Payer: Prime Health Services WC |
$30,998.55
|
| 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 664: MINOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$34,669.88
|
|
|
Service Code
|
MS-DRG 664
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$34,669.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,183.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,669.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,681.39
|
| Rate for Payer: IEHP Medicare Advantage |
$25,681.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,681.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,358.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,413.06
|
| Rate for Payer: Multiplan WC |
$23,138.45
|
| Rate for Payer: Prime Health Services WC |
$22,902.34
|
| 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 665: PROSTATECTOMY WITH MCC
|
Facility
IP
|
$93,649.16
|
|
|
Service Code
|
MS-DRG 665
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$93,649.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$93,649.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,019.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$48,162.36
|
| Rate for Payer: IEHP Medicare Advantage |
$48,162.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,162.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60,684.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,537.56
|
| Rate for Payer: Multiplan WC |
$62,847.78
|
| Rate for Payer: Prime Health Services WC |
$62,206.48
|
| 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 666: PROSTATECTOMY WITH CC
|
Facility
IP
|
$52,064.70
|
|
|
Service Code
|
MS-DRG 666
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,064.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,064.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,486.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,952.91
|
| Rate for Payer: IEHP Medicare Advantage |
$32,952.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,952.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,520.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,156.90
|
| Rate for Payer: Multiplan WC |
$35,361.76
|
| Rate for Payer: Prime Health Services WC |
$35,000.93
|
| 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 667: PROSTATECTOMY WITHOUT CC/MCC
|
Facility
IP
|
$34,490.25
|
|
|
Service Code
|
MS-DRG 667
|
| Min. Negotiated Rate |
$19,999.65 |
| Max. Negotiated Rate |
$34,490.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,819.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,490.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,548.33
|
| Rate for Payer: IEHP Medicare Advantage |
$25,548.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,548.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,190.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,234.76
|
| Rate for Payer: Multiplan WC |
$20,205.84
|
| Rate for Payer: Prime Health Services WC |
$19,999.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$23,727.00
|
| Rate for Payer: United Healthcare All Other HMO |
$23,328.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,284.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,291.00
|
|
|
INPATIENT MS-DRG 668: TRANSURETHRAL PROCEDURES WITH MCC
|
Facility
IP
|
$85,430.49
|
|
|
Service Code
|
MS-DRG 668
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$85,430.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,430.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,961.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,156.40
|
| Rate for Payer: IEHP Medicare Advantage |
$45,156.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,156.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,897.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,509.58
|
| Rate for Payer: Multiplan WC |
$57,972.42
|
| Rate for Payer: Prime Health Services WC |
$57,380.86
|
| 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 669: TRANSURETHRAL PROCEDURES WITH CC
|
Facility
IP
|
$46,522.93
|
|
|
Service Code
|
MS-DRG 669
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$46,522.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,522.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,750.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,926.03
|
| Rate for Payer: IEHP Medicare Advantage |
$30,926.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,926.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,966.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,440.88
|
| Rate for Payer: Multiplan WC |
$32,328.52
|
| Rate for Payer: Prime Health Services WC |
$31,998.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 670: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$33,187.95
|
|
|
Service Code
|
MS-DRG 670
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$33,187.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,182.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,187.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,583.67
|
| Rate for Payer: IEHP Medicare Advantage |
$24,583.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,583.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,975.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,942.12
|
| Rate for Payer: Multiplan WC |
$20,279.77
|
| Rate for Payer: Prime Health Services WC |
$20,072.83
|
| 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 671: URETHRAL PROCEDURES WITH CC/MCC
|
Facility
IP
|
$51,897.96
|
|
|
Service Code
|
MS-DRG 671
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,897.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,897.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,404.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,891.93
|
| Rate for Payer: IEHP Medicare Advantage |
$32,891.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,891.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,443.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,075.19
|
| Rate for Payer: Multiplan WC |
$37,612.56
|
| Rate for Payer: Prime Health Services WC |
$37,228.76
|
| 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 672: URETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$32,812.25
|
|
|
Service Code
|
MS-DRG 672
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$32,812.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,972.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,812.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,305.37
|
| Rate for Payer: IEHP Medicare Advantage |
$24,305.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,305.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,624.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,569.20
|
| Rate for Payer: Multiplan WC |
$21,392.85
|
| Rate for Payer: Prime Health Services WC |
$21,174.56
|
| 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 673: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC
|
Facility
IP
|
$112,108.57
|
|
|
Service Code
|
MS-DRG 673
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$112,108.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$112,108.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,133.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,913.87
|
| Rate for Payer: IEHP Medicare Advantage |
$54,913.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,913.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69,191.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,584.59
|
| Rate for Payer: Multiplan WC |
$71,754.44
|
| Rate for Payer: Prime Health Services WC |
$71,022.26
|
| 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 674: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC
|
Facility
IP
|
$72,218.78
|
|
|
Service Code
|
MS-DRG 674
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$72,218.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,218.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,437.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,324.24
|
| Rate for Payer: IEHP Medicare Advantage |
$40,324.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,324.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,808.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,034.48
|
| Rate for Payer: Multiplan WC |
$48,681.72
|
| Rate for Payer: Prime Health Services WC |
$48,184.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 675: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$48,096.33
|
|
|
Service Code
|
MS-DRG 675
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,096.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,096.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,527.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,501.49
|
| Rate for Payer: IEHP Medicare Advantage |
$31,501.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,501.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,691.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,212.00
|
| Rate for Payer: Multiplan WC |
$34,632.71
|
| Rate for Payer: Prime Health Services WC |
$34,279.32
|
| 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 682: RENAL FAILURE WITH MCC
|
Facility
IP
|
$45,498.25
|
|
|
Service Code
|
MS-DRG 682
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,498.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,498.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,244.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,551.25
|
| Rate for Payer: IEHP Medicare Advantage |
$30,551.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,551.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,494.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,938.68
|
| Rate for Payer: Multiplan WC |
$30,529.53
|
| Rate for Payer: Prime Health Services WC |
$30,218.00
|
| 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 683: RENAL FAILURE WITH CC
|
Facility
IP
|
$32,262.89
|
|
|
Service Code
|
MS-DRG 683
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,262.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,308.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,262.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,898.44
|
| Rate for Payer: IEHP Medicare Advantage |
$23,898.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,898.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,112.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,023.91
|
| Rate for Payer: Multiplan WC |
$18,378.10
|
| Rate for Payer: Prime Health Services WC |
$18,190.57
|
| 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 684: RENAL FAILURE WITHOUT CC/MCC
|
Facility
IP
|
$27,887.49
|
|
|
Service Code
|
MS-DRG 684
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,887.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,447.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,887.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,657.40
|
| Rate for Payer: IEHP Medicare Advantage |
$20,657.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,657.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,028.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,680.92
|
| Rate for Payer: Multiplan WC |
$12,420.46
|
| Rate for Payer: Prime Health Services WC |
$12,293.72
|
| 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
|
|
