|
INPATIENT MS-DRG 794: NEONATE WITH OTHER SIGNIFICANT PROBLEMS
|
Facility
IP
|
$45,167.81
|
|
|
Service Code
|
MS-DRG 794
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,167.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,167.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,081.03
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,430.39
|
| Rate for Payer: IEHP Medicare Advantage |
$30,430.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,430.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,342.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,776.72
|
| Rate for Payer: Multiplan WC |
$30,704.09
|
| Rate for Payer: Prime Health Services WC |
$30,390.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,260.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 795: NORMAL NEWBORN
|
Facility
IP
|
$21,798.17
|
|
|
Service Code
|
MS-DRG 795
|
| Min. Negotiated Rate |
$1,001.00 |
| Max. Negotiated Rate |
$21,798.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,114.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,798.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16,146.79
|
| Rate for Payer: IEHP Medicare Advantage |
$16,146.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,146.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,344.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,636.70
|
| Rate for Payer: Multiplan WC |
$4,156.58
|
| Rate for Payer: Prime Health Services WC |
$4,114.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,566.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,278.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,094.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,001.00
|
|
|
INPATIENT MS-DRG 796: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC
|
Facility
IP
|
$43,000.21
|
|
|
Service Code
|
MS-DRG 796
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$43,000.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,000.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,010.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,637.59
|
| Rate for Payer: IEHP Medicare Advantage |
$29,637.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,637.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,343.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,714.37
|
| Rate for Payer: Multiplan WC |
$26,964.40
|
| Rate for Payer: Prime Health Services WC |
$26,689.25
|
| 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 797: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC
|
Facility
IP
|
$33,686.43
|
|
|
Service Code
|
MS-DRG 797
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$33,686.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,191.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,686.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,952.91
|
| Rate for Payer: IEHP Medicare Advantage |
$24,952.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,952.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,440.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,436.90
|
| Rate for Payer: Multiplan WC |
$19,055.80
|
| Rate for Payer: Prime Health Services WC |
$18,861.35
|
| 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 798: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC
|
Facility
IP
|
$31,279.45
|
|
|
Service Code
|
MS-DRG 798
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$31,279.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,592.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,279.45
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,169.96
|
| Rate for Payer: IEHP Medicare Advantage |
$23,169.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,169.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,194.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,047.75
|
| Rate for Payer: Multiplan WC |
$19,055.80
|
| Rate for Payer: Prime Health Services WC |
$18,861.35
|
| 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 799: SPLENIC PROCEDURES WITH MCC
|
Facility
IP
|
$150,203.65
|
|
|
Service Code
|
MS-DRG 799
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$150,203.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$150,203.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$92,943.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$68,847.08
|
| Rate for Payer: IEHP Medicare Advantage |
$68,847.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68,847.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86,747.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$92,255.09
|
| Rate for Payer: Multiplan WC |
$106,947.81
|
| Rate for Payer: Prime Health Services WC |
$105,856.51
|
| 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 800: SPLENIC PROCEDURES WITH CC
|
Facility
IP
|
$85,421.39
|
|
|
Service Code
|
MS-DRG 800
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$85,421.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,421.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,956.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,153.07
|
| Rate for Payer: IEHP Medicare Advantage |
$45,153.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,153.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,892.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,505.11
|
| Rate for Payer: Multiplan WC |
$54,596.22
|
| Rate for Payer: Prime Health Services WC |
$54,039.12
|
| 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 801: SPLENIC PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$54,256.55
|
|
|
Service Code
|
MS-DRG 801
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$54,256.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,256.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,568.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,754.58
|
| Rate for Payer: IEHP Medicare Advantage |
$33,754.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,754.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,530.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,231.14
|
| Rate for Payer: Multiplan WC |
$36,883.52
|
| Rate for Payer: Prime Health Services WC |
$36,507.15
|
| 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 802: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC
|
Facility
IP
|
$102,780.33
|
|
|
Service Code
|
MS-DRG 802
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$102,780.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,780.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,134.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,951.14
|
| Rate for Payer: IEHP Medicare Advantage |
$51,951.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,951.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,458.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,614.53
|
| Rate for Payer: Multiplan WC |
$78,285.05
|
| Rate for Payer: Prime Health Services WC |
$77,486.22
|
| 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 803: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC
|
Facility
IP
|
$56,333.19
|
|
|
Service Code
|
MS-DRG 803
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$56,333.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,333.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,594.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,514.10
|
| Rate for Payer: IEHP Medicare Advantage |
$34,514.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,514.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,487.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,248.89
|
| Rate for Payer: Multiplan WC |
$42,167.55
|
| Rate for Payer: Prime Health Services WC |
$41,737.27
|
| 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 804: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC
|
Facility
IP
|
$36,897.24
|
|
|
Service Code
|
MS-DRG 804
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$36,897.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,694.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,897.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,331.29
|
| Rate for Payer: IEHP Medicare Advantage |
$27,331.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,331.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,437.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,623.93
|
| Rate for Payer: Multiplan WC |
$25,912.92
|
| Rate for Payer: Prime Health Services WC |
$25,648.51
|
| 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 805: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC
|
Facility
IP
|
$33,870.53
|
|
|
Service Code
|
MS-DRG 805
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,870.53 |
| Rate for Payer: IEHP Medicare Advantage |
$25,089.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30,564.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,870.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,089.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,089.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,612.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,619.64
|
| Rate for Payer: Multiplan WC |
$20,651.48
|
| Rate for Payer: Prime Health Services WC |
$20,440.75
|
| 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 806: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC
|
Facility
IP
|
$29,956.20
|
|
|
Service Code
|
MS-DRG 806
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,956.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,636.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,956.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,189.78
|
| Rate for Payer: IEHP Medicare Advantage |
$22,189.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,189.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,959.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,734.31
|
| Rate for Payer: Multiplan WC |
$14,330.35
|
| Rate for Payer: Prime Health Services WC |
$14,184.13
|
| 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 807: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC
|
Facility
IP
|
$28,573.07
|
|
|
Service Code
|
MS-DRG 807
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,573.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,835.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,573.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,165.24
|
| Rate for Payer: IEHP Medicare Advantage |
$21,165.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,165.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,668.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,361.42
|
| Rate for Payer: Multiplan WC |
$12,966.73
|
| Rate for Payer: Prime Health Services WC |
$12,834.42
|
| 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 808: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
IP
|
$66,395.07
|
|
|
Service Code
|
MS-DRG 808
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$66,395.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66,395.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,562.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,194.22
|
| Rate for Payer: IEHP Medicare Advantage |
$38,194.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,194.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,124.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,180.25
|
| Rate for Payer: Multiplan WC |
$43,968.59
|
| Rate for Payer: Prime Health Services WC |
$43,519.93
|
| 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 809: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
IP
|
$36,807.41
|
|
|
Service Code
|
MS-DRG 809
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,807.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,512.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,807.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,264.75
|
| Rate for Payer: IEHP Medicare Advantage |
$27,264.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,264.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,353.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,534.76
|
| Rate for Payer: Multiplan WC |
$24,966.20
|
| Rate for Payer: Prime Health Services WC |
$24,711.44
|
| 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 810: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$33,815.16
|
|
|
Service Code
|
MS-DRG 810
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,815.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,452.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,815.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,048.27
|
| Rate for Payer: IEHP Medicare Advantage |
$25,048.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,048.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,560.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,564.68
|
| Rate for Payer: Multiplan WC |
$19,279.65
|
| Rate for Payer: Prime Health Services WC |
$19,082.92
|
| 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 811: RED BLOOD CELL DISORDERS WITH MCC
|
Facility
IP
|
$42,551.54
|
|
|
Service Code
|
MS-DRG 811
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,551.54 |
| Rate for Payer: IEHP Medicare Advantage |
$29,473.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42,551.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,789.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,473.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,473.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,136.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,494.48
|
| Rate for Payer: Multiplan WC |
$28,551.86
|
| Rate for Payer: Prime Health Services WC |
$28,260.51
|
| 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 812: RED BLOOD CELL DISORDERS WITHOUT MCC
|
Facility
IP
|
$32,261.38
|
|
|
Service Code
|
MS-DRG 812
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,261.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,305.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,261.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,897.32
|
| Rate for Payer: IEHP Medicare Advantage |
$23,897.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,897.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,110.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,022.41
|
| Rate for Payer: Multiplan WC |
$18,441.76
|
| Rate for Payer: Prime Health Services WC |
$18,253.58
|
| 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 813: COAGULATION DISORDERS
|
Facility
IP
|
$47,292.96
|
|
|
Service Code
|
MS-DRG 813
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,292.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,292.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,130.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,207.66
|
| Rate for Payer: IEHP Medicare Advantage |
$31,207.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,207.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,321.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,818.26
|
| Rate for Payer: Multiplan WC |
$32,141.64
|
| Rate for Payer: Prime Health Services WC |
$31,813.66
|
| 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 814: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC
|
Facility
IP
|
$64,515.48
|
|
|
Service Code
|
MS-DRG 814
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$64,515.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,515.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,634.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,506.77
|
| Rate for Payer: IEHP Medicare Advantage |
$37,506.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,506.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47,258.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,259.07
|
| Rate for Payer: Multiplan WC |
$38,590.10
|
| Rate for Payer: Prime Health Services WC |
$38,196.32
|
| 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 815: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC
|
Facility
IP
|
$33,660.98
|
|
|
Service Code
|
MS-DRG 815
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,660.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,140.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,660.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,934.06
|
| Rate for Payer: IEHP Medicare Advantage |
$24,934.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,934.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,416.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,411.64
|
| Rate for Payer: Multiplan WC |
$21,175.16
|
| Rate for Payer: Prime Health Services WC |
$20,959.09
|
| 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 816: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$29,409.82
|
|
|
Service Code
|
MS-DRG 816
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,409.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,530.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,409.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,785.05
|
| Rate for Payer: IEHP Medicare Advantage |
$21,785.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,785.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,449.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,191.97
|
| Rate for Payer: Multiplan WC |
$14,971.09
|
| Rate for Payer: Prime Health Services WC |
$14,818.32
|
| 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 817: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC
|
Facility
IP
|
$68,362.58
|
|
|
Service Code
|
MS-DRG 817
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$68,362.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,362.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,943.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,143.09
|
| Rate for Payer: IEHP Medicare Advantage |
$45,143.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,143.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,880.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,491.74
|
| Rate for Payer: Multiplan WC |
$64,275.06
|
| Rate for Payer: Prime Health Services WC |
$63,619.20
|
| 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 818: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC
|
Facility
IP
|
$40,200.85
|
|
|
Service Code
|
MS-DRG 818
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,200.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,563.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,200.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,778.41
|
| Rate for Payer: IEHP Medicare Advantage |
$29,778.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,778.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,520.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,903.07
|
| Rate for Payer: Multiplan WC |
$32,655.05
|
| Rate for Payer: Prime Health Services WC |
$32,321.84
|
| 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
|
|
