|
INPATIENT MS-DRG 017: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC
|
Facility
IP
|
$162,572.46
|
|
|
Service Code
|
MS-DRG 017
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$162,572.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$162,572.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$74,296.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91,260.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$92,069.49
|
| Rate for Payer: Caremore Medicare Advantage |
$84,243.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$113,728.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$84,243.47
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$90,244.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$158,516.00
|
| Rate for Payer: IEHP Medicare Advantage |
$84,243.47
|
| Rate for Payer: Innovage PACE Commercial |
$126,365.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84,243.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$112,886.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$112,886.25
|
| Rate for Payer: Multiplan WC |
$92,069.49
|
| Rate for Payer: Networks By Design Commercial |
$110,000.00
|
| Rate for Payer: OptumHealth/URN Transplant Commercial |
$120,000.00
|
| Rate for Payer: Preferred Health Network WC |
$93,948.46
|
| Rate for Payer: Prime Health Services Medicare |
$89,298.08
|
| Rate for Payer: Prime Health Services WC |
$88,830.68
|
| 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 018: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
IP
|
$969,663.02
|
|
|
Service Code
|
MS-DRG 018
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$969,663.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$969,663.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$614,504.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$754,820.21
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$761,508.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$671,962.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497,750.28
|
| Rate for Payer: IEHP Medicare Advantage |
$497,750.28
|
| Rate for Payer: Innovage PACE Commercial |
$746,625.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497,750.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$666,985.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$666,985.38
|
| Rate for Payer: Multiplan WC |
$761,508.94
|
| Rate for Payer: Preferred Health Network WC |
$777,049.94
|
| Rate for Payer: Prime Health Services Medicare |
$527,615.30
|
| Rate for Payer: Prime Health Services WC |
$734,720.60
|
| 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 019: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS
|
Facility
IP
|
$210,380.93
|
|
|
Service Code
|
MS-DRG 019
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$210,380.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$210,380.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$121,295.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148,991.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$150,312.13
|
| Rate for Payer: BCBS Transplant Transplant |
$135,605.00
|
| Rate for Payer: Blue Shield of California Transplant |
$102,000.00
|
| Rate for Payer: Caremore Medicare Advantage |
$108,737.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$146,795.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$108,737.77
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$90,300.00
|
| Rate for Payer: IEHP Medicare Advantage |
$108,737.77
|
| Rate for Payer: Innovage PACE Commercial |
$163,106.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$108,737.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$145,708.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$145,708.61
|
| Rate for Payer: Multiplan WC |
$150,312.13
|
| Rate for Payer: OptumHealth/URN Transplant Commercial |
$100,600.00
|
| Rate for Payer: Preferred Health Network WC |
$153,379.72
|
| Rate for Payer: Prime Health Services Medicare |
$115,262.04
|
| Rate for Payer: Prime Health Services WC |
$145,024.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 020: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC
|
Facility
IP
|
$222,458.72
|
|
|
Service Code
|
MS-DRG 020
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$222,458.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$222,458.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$158,165.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$194,280.81
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$196,002.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$155,149.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$114,925.74
|
| Rate for Payer: IEHP Medicare Advantage |
$114,925.74
|
| Rate for Payer: Innovage PACE Commercial |
$172,388.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$114,925.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$154,000.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$154,000.49
|
| Rate for Payer: Multiplan WC |
$196,002.41
|
| Rate for Payer: Preferred Health Network WC |
$200,002.46
|
| Rate for Payer: Prime Health Services Medicare |
$121,821.28
|
| Rate for Payer: Prime Health Services WC |
$189,107.44
|
| 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 021: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC
|
Facility
IP
|
$161,635.51
|
|
|
Service Code
|
MS-DRG 021
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$161,635.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$161,635.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115,423.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141,778.86
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$143,035.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$113,080.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$83,763.44
|
| Rate for Payer: IEHP Medicare Advantage |
$83,763.44
|
| Rate for Payer: Innovage PACE Commercial |
$125,645.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$83,763.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$112,243.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$112,243.01
|
| Rate for Payer: Multiplan WC |
$143,035.21
|
| Rate for Payer: Preferred Health Network WC |
$145,954.30
|
| Rate for Payer: Prime Health Services Medicare |
$88,789.25
|
| Rate for Payer: Prime Health Services WC |
$138,003.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 022: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC
|
Facility
IP
|
$93,699.09
|
|
|
Service Code
|
MS-DRG 022
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$93,699.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$91,503.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$74,098.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91,018.56
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$91,825.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,691.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$53,845.73
|
| Rate for Payer: IEHP Medicare Advantage |
$53,845.73
|
| Rate for Payer: Innovage PACE Commercial |
$80,768.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,845.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72,153.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72,153.28
|
| Rate for Payer: Multiplan WC |
$91,825.11
|
| Rate for Payer: Preferred Health Network WC |
$93,699.09
|
| Rate for Payer: Prime Health Services Medicare |
$57,076.47
|
| Rate for Payer: Prime Health Services WC |
$88,594.88
|
| 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 023: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
IP
|
$149,197.15
|
|
|
Service Code
|
MS-DRG 023
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$149,197.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$149,197.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97,439.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119,688.83
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$120,749.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$104,477.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$77,390.73
|
| Rate for Payer: IEHP Medicare Advantage |
$77,390.73
|
| Rate for Payer: Innovage PACE Commercial |
$116,086.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77,390.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$103,703.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$103,703.58
|
| Rate for Payer: Multiplan WC |
$120,749.44
|
| Rate for Payer: Preferred Health Network WC |
$123,213.71
|
| Rate for Payer: Prime Health Services Medicare |
$82,034.17
|
| Rate for Payer: Prime Health Services WC |
$116,501.71
|
| 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 024: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
IP
|
$99,717.43
|
|
|
Service Code
|
MS-DRG 024
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$99,717.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$99,717.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$67,133.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82,462.79
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$83,193.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$70,254.23
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,040.17
|
| Rate for Payer: IEHP Medicare Advantage |
$52,040.17
|
| Rate for Payer: Innovage PACE Commercial |
$78,060.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,040.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69,733.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,733.83
|
| Rate for Payer: Multiplan WC |
$83,193.52
|
| Rate for Payer: Preferred Health Network WC |
$84,891.35
|
| Rate for Payer: Prime Health Services Medicare |
$55,162.58
|
| Rate for Payer: Prime Health Services WC |
$80,266.95
|
| 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 025: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
IP
|
$116,224.70
|
|
|
Service Code
|
MS-DRG 025
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$116,224.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$116,224.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$77,193.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$94,819.26
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$95,659.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$81,671.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$60,497.53
|
| Rate for Payer: IEHP Medicare Advantage |
$60,497.53
|
| Rate for Payer: Innovage PACE Commercial |
$90,746.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60,497.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$81,066.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$81,066.69
|
| Rate for Payer: Multiplan WC |
$95,659.49
|
| Rate for Payer: Preferred Health Network WC |
$97,611.72
|
| Rate for Payer: Prime Health Services Medicare |
$64,127.38
|
| Rate for Payer: Prime Health Services WC |
$92,294.38
|
| 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 026: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
IP
|
$77,722.64
|
|
|
Service Code
|
MS-DRG 026
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$77,722.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77,722.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51,402.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63,139.75
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$63,699.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,041.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,771.31
|
| Rate for Payer: IEHP Medicare Advantage |
$40,771.31
|
| Rate for Payer: Innovage PACE Commercial |
$61,156.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,771.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,633.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,633.56
|
| Rate for Payer: Multiplan WC |
$63,699.26
|
| Rate for Payer: Preferred Health Network WC |
$64,999.24
|
| Rate for Payer: Prime Health Services Medicare |
$43,217.59
|
| Rate for Payer: Prime Health Services WC |
$61,458.44
|
| 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 027: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$64,031.50
|
|
|
Service Code
|
MS-DRG 027
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$64,031.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,031.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42,424.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52,111.44
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$52,573.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,571.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,756.74
|
| Rate for Payer: IEHP Medicare Advantage |
$33,756.74
|
| Rate for Payer: Innovage PACE Commercial |
$50,635.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,756.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,234.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,234.03
|
| Rate for Payer: Multiplan WC |
$52,573.22
|
| Rate for Payer: Preferred Health Network WC |
$53,646.14
|
| Rate for Payer: Prime Health Services Medicare |
$35,782.14
|
| Rate for Payer: Prime Health Services WC |
$50,723.79
|
| 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 028: SPINAL PROCEDURES WITH MCC
|
Facility
IP
|
$158,600.93
|
|
|
Service Code
|
MS-DRG 028
|
| Min. Negotiated Rate |
$25,604.00 |
| Max. Negotiated Rate |
$158,600.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$158,600.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99,923.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122,739.83
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$123,827.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$110,981.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$82,208.69
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25,604.00
|
| Rate for Payer: IEHP Medicare Advantage |
$82,208.69
|
| Rate for Payer: Innovage PACE Commercial |
$123,313.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82,208.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$110,159.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$110,159.64
|
| Rate for Payer: Multiplan WC |
$123,827.48
|
| Rate for Payer: Preferred Health Network WC |
$126,354.57
|
| Rate for Payer: Prime Health Services Medicare |
$87,141.21
|
| Rate for Payer: Prime Health Services WC |
$119,471.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$55,964.00
|
| Rate for Payer: United Healthcare All Other HMO |
$68,420.00
|
| Rate for Payer: United Healthcare HMO Rider |
$51,970.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47,523.00
|
|
|
INPATIENT MS-DRG 029: SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS
|
Facility
IP
|
$90,226.80
|
|
|
Service Code
|
MS-DRG 029
|
| Min. Negotiated Rate |
$25,604.00 |
| Max. Negotiated Rate |
$90,226.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,226.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58,102.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71,369.74
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$72,002.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,689.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,177.71
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25,604.00
|
| Rate for Payer: IEHP Medicare Advantage |
$47,177.71
|
| Rate for Payer: Innovage PACE Commercial |
$70,766.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,177.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,218.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,218.13
|
| Rate for Payer: Multiplan WC |
$72,002.18
|
| Rate for Payer: Preferred Health Network WC |
$73,471.61
|
| Rate for Payer: Prime Health Services Medicare |
$50,008.37
|
| Rate for Payer: Prime Health Services WC |
$69,469.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$72,752.00
|
| Rate for Payer: United Healthcare All Other HMO |
$45,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,810.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,830.00
|
|
|
INPATIENT MS-DRG 030: SPINAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$61,033.76
|
|
|
Service Code
|
MS-DRG 030
|
| Min. Negotiated Rate |
$19,770.00 |
| Max. Negotiated Rate |
$61,033.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61,033.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39,802.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48,891.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$49,324.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,498.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,220.89
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25,604.00
|
| Rate for Payer: IEHP Medicare Advantage |
$32,220.89
|
| Rate for Payer: Innovage PACE Commercial |
$48,331.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,220.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,175.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,175.99
|
| Rate for Payer: Multiplan WC |
$49,324.53
|
| Rate for Payer: Preferred Health Network WC |
$50,331.15
|
| Rate for Payer: Prime Health Services Medicare |
$34,154.14
|
| Rate for Payer: Prime Health Services WC |
$47,589.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$55,964.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,467.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,620.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,770.00
|
|
|
INPATIENT MS-DRG 031: VENTRICULAR SHUNT PROCEDURES WITH MCC
|
Facility
IP
|
$108,344.80
|
|
|
Service Code
|
MS-DRG 031
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$108,344.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$108,344.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70,061.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86,058.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$86,821.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$76,221.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$56,460.34
|
| Rate for Payer: IEHP Medicare Advantage |
$56,460.34
|
| Rate for Payer: Innovage PACE Commercial |
$84,690.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,460.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75,656.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75,656.86
|
| Rate for Payer: Multiplan WC |
$86,821.44
|
| Rate for Payer: Preferred Health Network WC |
$88,593.31
|
| Rate for Payer: Prime Health Services Medicare |
$59,847.96
|
| Rate for Payer: Prime Health Services WC |
$83,767.24
|
| 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 032: VENTRICULAR SHUNT PROCEDURES WITH CC
|
Facility
IP
|
$56,685.86
|
|
|
Service Code
|
MS-DRG 032
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$56,685.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,685.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,928.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,904.12
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$43,284.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,490.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,993.27
|
| Rate for Payer: IEHP Medicare Advantage |
$29,993.27
|
| Rate for Payer: Innovage PACE Commercial |
$44,989.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,993.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,190.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,190.98
|
| Rate for Payer: Multiplan WC |
$43,284.32
|
| Rate for Payer: Preferred Health Network WC |
$44,167.67
|
| Rate for Payer: Prime Health Services Medicare |
$31,792.87
|
| Rate for Payer: Prime Health Services WC |
$41,761.66
|
| 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 033: VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$42,713.11
|
|
|
Service Code
|
MS-DRG 033
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,713.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,713.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,876.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,469.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,784.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,826.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,834.43
|
| Rate for Payer: IEHP Medicare Advantage |
$22,834.43
|
| Rate for Payer: Innovage PACE Commercial |
$34,251.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,834.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,598.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,598.14
|
| Rate for Payer: Multiplan WC |
$35,784.08
|
| Rate for Payer: Preferred Health Network WC |
$36,514.37
|
| Rate for Payer: Prime Health Services Medicare |
$24,204.50
|
| Rate for Payer: Prime Health Services WC |
$34,525.28
|
| 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 034: CAROTID ARTERY STENT PROCEDURES WITH MCC
|
Facility
IP
|
$102,680.95
|
|
|
Service Code
|
MS-DRG 034
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$102,680.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,680.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$67,993.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83,519.47
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$84,259.57
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,303.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$53,558.50
|
| Rate for Payer: IEHP Medicare Advantage |
$53,558.50
|
| Rate for Payer: Innovage PACE Commercial |
$80,337.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,558.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,768.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,768.39
|
| Rate for Payer: Multiplan WC |
$84,259.57
|
| Rate for Payer: Preferred Health Network WC |
$85,979.15
|
| Rate for Payer: Prime Health Services Medicare |
$56,772.01
|
| Rate for Payer: Prime Health Services WC |
$81,295.49
|
| 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 035: CAROTID ARTERY STENT PROCEDURES WITH CC
|
Facility
IP
|
$60,520.54
|
|
|
Service Code
|
MS-DRG 035
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$60,520.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$60,520.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38,826.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,692.60
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$48,115.22
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,143.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,957.93
|
| Rate for Payer: IEHP Medicare Advantage |
$31,957.93
|
| Rate for Payer: Innovage PACE Commercial |
$47,936.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,957.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,823.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,823.63
|
| Rate for Payer: Multiplan WC |
$48,115.22
|
| Rate for Payer: Preferred Health Network WC |
$49,097.16
|
| Rate for Payer: Prime Health Services Medicare |
$33,875.41
|
| Rate for Payer: Prime Health Services WC |
$46,422.62
|
| 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 036: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$47,590.02
|
|
|
Service Code
|
MS-DRG 036
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$47,590.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,590.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,973.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,274.66
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,622.68
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,199.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,333.07
|
| Rate for Payer: IEHP Medicare Advantage |
$25,333.07
|
| Rate for Payer: Innovage PACE Commercial |
$37,999.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,333.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,946.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,946.31
|
| Rate for Payer: Multiplan WC |
$39,622.68
|
| Rate for Payer: Preferred Health Network WC |
$40,431.31
|
| Rate for Payer: Prime Health Services Medicare |
$26,853.05
|
| Rate for Payer: Prime Health Services WC |
$38,228.83
|
| 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 037: EXTRACRANIAL PROCEDURES WITH MCC
|
Facility
IP
|
$88,842.42
|
|
|
Service Code
|
MS-DRG 037
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$88,842.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$88,842.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57,344.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70,438.36
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$71,062.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,732.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,468.43
|
| Rate for Payer: IEHP Medicare Advantage |
$46,468.43
|
| Rate for Payer: Innovage PACE Commercial |
$69,702.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,468.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,267.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,267.70
|
| Rate for Payer: Multiplan WC |
$71,062.53
|
| Rate for Payer: Preferred Health Network WC |
$72,512.79
|
| Rate for Payer: Prime Health Services Medicare |
$49,256.54
|
| Rate for Payer: Prime Health Services WC |
$68,562.70
|
| 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 038: EXTRACRANIAL PROCEDURES WITH CC
|
Facility
IP
|
$42,107.77
|
|
|
Service Code
|
MS-DRG 038
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,107.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,107.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,805.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,154.15
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,456.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,407.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,524.29
|
| Rate for Payer: IEHP Medicare Advantage |
$22,524.29
|
| Rate for Payer: Innovage PACE Commercial |
$33,786.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,524.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,182.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,182.55
|
| Rate for Payer: Multiplan WC |
$34,456.80
|
| Rate for Payer: Preferred Health Network WC |
$35,160.00
|
| Rate for Payer: Prime Health Services Medicare |
$23,875.75
|
| Rate for Payer: Prime Health Services WC |
$33,244.67
|
| 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 039: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$30,029.98
|
|
|
Service Code
|
MS-DRG 039
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$30,029.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,029.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,597.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,071.83
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,285.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,054.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16,336.31
|
| Rate for Payer: IEHP Medicare Advantage |
$16,336.31
|
| Rate for Payer: Innovage PACE Commercial |
$24,504.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,336.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,890.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,890.66
|
| Rate for Payer: Multiplan WC |
$24,285.14
|
| Rate for Payer: Preferred Health Network WC |
$24,780.76
|
| Rate for Payer: Prime Health Services Medicare |
$17,316.49
|
| Rate for Payer: Prime Health Services WC |
$23,430.84
|
| 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
|
|
|
INPATIENT MS-DRG 040: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC
|
Facility
IP
|
$101,341.31
|
|
|
Service Code
|
MS-DRG 040
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$101,341.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101,341.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64,406.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79,113.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$79,814.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$71,377.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$52,872.16
|
| Rate for Payer: IEHP Medicare Advantage |
$52,872.16
|
| Rate for Payer: Innovage PACE Commercial |
$79,308.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52,872.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$70,848.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$70,848.69
|
| Rate for Payer: Multiplan WC |
$79,814.21
|
| Rate for Payer: Preferred Health Network WC |
$81,443.07
|
| Rate for Payer: Prime Health Services Medicare |
$56,044.49
|
| Rate for Payer: Prime Health Services WC |
$77,006.51
|
| 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 041: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR
|
Facility
IP
|
$58,709.79
|
|
|
Service Code
|
MS-DRG 041
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$58,709.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,709.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39,750.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48,826.54
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$49,259.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,890.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,030.20
|
| Rate for Payer: IEHP Medicare Advantage |
$31,030.20
|
| Rate for Payer: Innovage PACE Commercial |
$46,545.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,030.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,580.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,580.47
|
| Rate for Payer: Multiplan WC |
$49,259.21
|
| Rate for Payer: Preferred Health Network WC |
$50,264.50
|
| Rate for Payer: Prime Health Services Medicare |
$32,892.01
|
| Rate for Payer: Prime Health Services WC |
$47,526.37
|
| 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
|
|
