|
INPATIENT MS-DRG 722: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
IP
|
$56,836.44
|
|
|
Service Code
|
MS-DRG 722
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$56,836.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,836.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,842.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,698.17
|
| Rate for Payer: IEHP Medicare Advantage |
$34,698.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,698.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,719.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,495.55
|
| Rate for Payer: Multiplan WC |
$34,864.77
|
| Rate for Payer: Prime Health Services WC |
$34,509.01
|
| 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 723: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
IP
|
$35,458.72
|
|
|
Service Code
|
MS-DRG 723
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,458.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,781.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,458.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,265.72
|
| Rate for Payer: IEHP Medicare Advantage |
$26,265.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,265.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,094.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,196.06
|
| Rate for Payer: Multiplan WC |
$23,666.24
|
| Rate for Payer: Prime Health Services WC |
$23,424.74
|
| 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 724: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
IP
|
$30,896.22
|
|
|
Service Code
|
MS-DRG 724
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,896.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,540.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,896.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,886.09
|
| Rate for Payer: IEHP Medicare Advantage |
$22,886.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,886.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,836.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,667.36
|
| Rate for Payer: Multiplan WC |
$15,712.46
|
| Rate for Payer: Prime Health Services WC |
$15,552.13
|
| 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 725: BENIGN PROSTATIC HYPERTROPHY WITH MCC
|
Facility
IP
|
$37,619.12
|
|
|
Service Code
|
MS-DRG 725
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$37,619.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,619.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,353.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,669.47
|
| Rate for Payer: IEHP Medicare Advantage |
$27,669.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,669.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,863.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,077.09
|
| Rate for Payer: Multiplan WC |
$25,656.22
|
| Rate for Payer: Prime Health Services WC |
$25,394.43
|
| 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 726: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC
|
Facility
IP
|
$29,719.68
|
|
|
Service Code
|
MS-DRG 726
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,719.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,157.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,719.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,014.58
|
| Rate for Payer: IEHP Medicare Advantage |
$22,014.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,014.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,738.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,499.54
|
| Rate for Payer: Multiplan WC |
$15,845.94
|
| Rate for Payer: Prime Health Services WC |
$15,684.25
|
| 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 727: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
IP
|
$49,142.24
|
|
|
Service Code
|
MS-DRG 727
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,142.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,142.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,043.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,884.04
|
| Rate for Payer: IEHP Medicare Advantage |
$31,884.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,884.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,173.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,724.61
|
| Rate for Payer: Multiplan WC |
$29,506.81
|
| Rate for Payer: Prime Health Services WC |
$29,205.72
|
| 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
|
|
|
INPATIENT MS-DRG 728: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC
|
Facility
IP
|
$30,755.52
|
|
|
Service Code
|
MS-DRG 728
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,755.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,255.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,755.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,781.87
|
| Rate for Payer: IEHP Medicare Advantage |
$22,781.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,781.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,705.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,527.71
|
| Rate for Payer: Multiplan WC |
$16,874.83
|
| Rate for Payer: Prime Health Services WC |
$16,702.63
|
| 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 729: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
|
Facility
IP
|
$33,806.19
|
|
|
Service Code
|
MS-DRG 729
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,806.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,434.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,806.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,041.62
|
| Rate for Payer: IEHP Medicare Advantage |
$25,041.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,041.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,552.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,555.77
|
| Rate for Payer: Multiplan WC |
$22,134.21
|
| Rate for Payer: Prime Health Services WC |
$21,908.35
|
| 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 730: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
IP
|
$28,083.59
|
|
|
Service Code
|
MS-DRG 730
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,083.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,844.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,083.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,802.66
|
| Rate for Payer: IEHP Medicare Advantage |
$20,802.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,802.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,211.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,875.56
|
| Rate for Payer: Multiplan WC |
$13,467.82
|
| Rate for Payer: Prime Health Services WC |
$13,330.39
|
| 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 734: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC
|
Facility
IP
|
$65,894.86
|
|
|
Service Code
|
MS-DRG 734
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$65,894.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,894.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,315.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,011.27
|
| Rate for Payer: IEHP Medicare Advantage |
$38,011.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,011.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,894.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,935.10
|
| Rate for Payer: Multiplan WC |
$44,876.31
|
| Rate for Payer: Prime Health Services WC |
$44,418.39
|
| 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 735: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC
|
Facility
IP
|
$38,204.22
|
|
|
Service Code
|
MS-DRG 735
|
| Min. Negotiated Rate |
$21,291.00 |
| Max. Negotiated Rate |
$38,204.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,204.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,642.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,883.46
|
| Rate for Payer: IEHP Medicare Advantage |
$27,883.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,883.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,133.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,363.84
|
| Rate for Payer: Multiplan WC |
$26,126.51
|
| Rate for Payer: Prime Health Services WC |
$25,859.91
|
| 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 736: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC
|
Facility
IP
|
$117,844.36
|
|
|
Service Code
|
MS-DRG 736
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$117,844.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$117,844.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$76,965.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,011.71
|
| Rate for Payer: IEHP Medicare Advantage |
$57,011.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,011.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,834.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$76,395.69
|
| Rate for Payer: Multiplan WC |
$87,592.17
|
| Rate for Payer: Prime Health Services WC |
$86,698.38
|
| 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 737: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC
|
Facility
IP
|
$59,837.72
|
|
|
Service Code
|
MS-DRG 737
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$59,837.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,837.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,324.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,795.88
|
| Rate for Payer: IEHP Medicare Advantage |
$35,795.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,795.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,102.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,966.48
|
| Rate for Payer: Multiplan WC |
$41,555.56
|
| Rate for Payer: Prime Health Services WC |
$41,131.52
|
| 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 738: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$41,369.21
|
|
|
Service Code
|
MS-DRG 738
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$41,369.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,369.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,205.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,041.06
|
| Rate for Payer: IEHP Medicare Advantage |
$29,041.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,041.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,591.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,915.02
|
| Rate for Payer: Multiplan WC |
$28,829.10
|
| Rate for Payer: Prime Health Services WC |
$28,534.93
|
| 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 739: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC
|
Facility
IP
|
$109,631.75
|
|
|
Service Code
|
MS-DRG 739
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$109,631.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$109,631.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,910.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$54,007.97
|
| Rate for Payer: IEHP Medicare Advantage |
$54,007.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,007.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,050.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,370.68
|
| Rate for Payer: Multiplan WC |
$80,139.49
|
| Rate for Payer: Prime Health Services WC |
$79,321.74
|
| 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 740: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC
|
Facility
IP
|
$54,174.69
|
|
|
Service Code
|
MS-DRG 740
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$54,174.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,174.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,528.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,724.65
|
| Rate for Payer: IEHP Medicare Advantage |
$33,724.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,724.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,493.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,191.03
|
| Rate for Payer: Multiplan WC |
$37,014.94
|
| Rate for Payer: Prime Health Services WC |
$36,637.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 741: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$39,389.58
|
|
|
Service Code
|
MS-DRG 741
|
| Min. Negotiated Rate |
$21,291.00 |
| Max. Negotiated Rate |
$39,389.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,389.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,227.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,317.01
|
| Rate for Payer: IEHP Medicare Advantage |
$28,317.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,317.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,679.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,944.79
|
| Rate for Payer: Multiplan WC |
$26,962.34
|
| Rate for Payer: Prime Health Services WC |
$26,687.21
|
| 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 742: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC
|
Facility
IP
|
$54,020.08
|
|
|
Service Code
|
MS-DRG 742
|
| Min. Negotiated Rate |
$21,291.00 |
| Max. Negotiated Rate |
$54,020.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,020.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,451.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,668.10
|
| Rate for Payer: IEHP Medicare Advantage |
$33,668.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,668.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,421.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,115.25
|
| Rate for Payer: Multiplan WC |
$37,008.79
|
| Rate for Payer: Prime Health Services WC |
$36,631.15
|
| 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 743: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$36,172.75
|
|
|
Service Code
|
MS-DRG 743
|
| Min. Negotiated Rate |
$21,291.00 |
| Max. Negotiated Rate |
$36,172.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,227.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,172.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,794.63
|
| Rate for Payer: IEHP Medicare Advantage |
$26,794.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,794.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,761.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,904.80
|
| Rate for Payer: Multiplan WC |
$24,040.00
|
| Rate for Payer: Prime Health Services WC |
$23,794.69
|
| 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 744: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC
|
Facility
IP
|
$57,066.84
|
|
|
Service Code
|
MS-DRG 744
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$57,066.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,066.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,956.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,782.44
|
| Rate for Payer: IEHP Medicare Advantage |
$34,782.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,782.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,825.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,608.47
|
| Rate for Payer: Multiplan WC |
$38,984.39
|
| Rate for Payer: Prime Health Services WC |
$38,586.59
|
| 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 745: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC
|
Facility
IP
|
$34,285.17
|
|
|
Service Code
|
MS-DRG 745
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$34,285.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,404.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,285.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,396.42
|
| Rate for Payer: IEHP Medicare Advantage |
$25,396.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,396.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,999.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,031.20
|
| Rate for Payer: Multiplan WC |
$23,633.38
|
| Rate for Payer: Prime Health Services WC |
$23,392.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 746: VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC
|
Facility
IP
|
$50,812.65
|
|
|
Service Code
|
MS-DRG 746
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$50,812.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,812.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,868.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,494.98
|
| Rate for Payer: IEHP Medicare Advantage |
$32,494.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,494.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,943.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,543.27
|
| Rate for Payer: Multiplan WC |
$32,106.73
|
| Rate for Payer: Prime Health Services WC |
$31,779.11
|
| 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 747: VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$32,059.30
|
|
|
Service Code
|
MS-DRG 747
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$32,059.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,896.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,059.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,747.63
|
| Rate for Payer: IEHP Medicare Advantage |
$23,747.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,747.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,922.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,821.82
|
| Rate for Payer: Multiplan WC |
$20,097.00
|
| Rate for Payer: Prime Health Services WC |
$19,891.93
|
| 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 748: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
|
Facility
IP
|
$42,590.95
|
|
|
Service Code
|
MS-DRG 748
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,590.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,590.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,808.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,487.91
|
| Rate for Payer: IEHP Medicare Advantage |
$29,487.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,487.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,154.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,513.80
|
| Rate for Payer: Multiplan WC |
$29,104.29
|
| Rate for Payer: Prime Health Services WC |
$28,807.31
|
| 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 749: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC
|
Facility
IP
|
$76,311.44
|
|
|
Service Code
|
MS-DRG 749
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$76,311.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$76,311.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,458.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,821.11
|
| Rate for Payer: IEHP Medicare Advantage |
$41,821.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,821.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52,694.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,040.29
|
| Rate for Payer: Multiplan WC |
$51,879.25
|
| Rate for Payer: Prime Health Services WC |
$51,349.87
|
| 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
|
|
