|
INPATIENT MS-DRG 076: VIRAL MENINGITIS WITHOUT CC/MCC
|
Facility
IP
|
$24,279.28
|
|
|
Service Code
|
MS-DRG 076
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$24,279.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,279.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,785.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,617.79
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,800.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,076.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,389.98
|
| Rate for Payer: IEHP Medicare Advantage |
$13,389.98
|
| Rate for Payer: Innovage PACE Commercial |
$20,084.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,389.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,942.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,942.57
|
| Rate for Payer: Multiplan WC |
$20,800.49
|
| Rate for Payer: Preferred Health Network WC |
$21,224.99
|
| Rate for Payer: Prime Health Services Medicare |
$14,193.38
|
| Rate for Payer: Prime Health Services WC |
$20,068.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 077: HYPERTENSIVE ENCEPHALOPATHY WITH MCC
|
Facility
IP
|
$39,765.38
|
|
|
Service Code
|
MS-DRG 077
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,765.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,765.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,592.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,665.19
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,954.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,787.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,324.18
|
| Rate for Payer: IEHP Medicare Advantage |
$21,324.18
|
| Rate for Payer: Innovage PACE Commercial |
$31,986.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,324.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,574.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,574.40
|
| Rate for Payer: Multiplan WC |
$32,954.65
|
| Rate for Payer: Preferred Health Network WC |
$33,627.19
|
| Rate for Payer: Prime Health Services Medicare |
$22,603.63
|
| Rate for Payer: Prime Health Services WC |
$31,795.37
|
| 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 078: HYPERTENSIVE ENCEPHALOPATHY WITH CC
|
Facility
IP
|
$26,763.79
|
|
|
Service Code
|
MS-DRG 078
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,763.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,763.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,878.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,732.64
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,916.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,794.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,662.92
|
| Rate for Payer: IEHP Medicare Advantage |
$14,662.92
|
| Rate for Payer: Innovage PACE Commercial |
$21,994.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,662.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,648.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,648.31
|
| Rate for Payer: Multiplan WC |
$20,916.37
|
| Rate for Payer: Preferred Health Network WC |
$21,343.23
|
| Rate for Payer: Prime Health Services Medicare |
$15,542.70
|
| Rate for Payer: Prime Health Services WC |
$20,180.57
|
| 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 079: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC
|
Facility
IP
|
$19,497.12
|
|
|
Service Code
|
MS-DRG 079
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,497.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,497.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,477.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,326.03
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,461.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,768.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,939.91
|
| Rate for Payer: IEHP Medicare Advantage |
$10,939.91
|
| Rate for Payer: Innovage PACE Commercial |
$16,409.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,939.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,659.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,659.48
|
| Rate for Payer: Multiplan WC |
$15,461.84
|
| Rate for Payer: Preferred Health Network WC |
$15,777.39
|
| Rate for Payer: Prime Health Services Medicare |
$11,596.30
|
| Rate for Payer: Prime Health Services WC |
$14,917.93
|
| 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 080: NONTRAUMATIC STUPOR AND COMA WITH MCC
|
Facility
IP
|
$58,130.78
|
|
|
Service Code
|
MS-DRG 080
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$58,130.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,130.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,678.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,597.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,974.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,490.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,733.56
|
| Rate for Payer: IEHP Medicare Advantage |
$30,733.56
|
| Rate for Payer: Innovage PACE Commercial |
$46,100.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,733.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,182.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,182.97
|
| Rate for Payer: Multiplan WC |
$42,974.61
|
| Rate for Payer: Preferred Health Network WC |
$43,851.64
|
| Rate for Payer: Prime Health Services Medicare |
$32,577.57
|
| Rate for Payer: Prime Health Services WC |
$41,462.85
|
| 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 081: NONTRAUMATIC STUPOR AND COMA WITHOUT MCC
|
Facility
IP
|
$23,937.13
|
|
|
Service Code
|
MS-DRG 081
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,937.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,937.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,275.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,763.38
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,929.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,839.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,214.69
|
| Rate for Payer: IEHP Medicare Advantage |
$13,214.69
|
| Rate for Payer: Innovage PACE Commercial |
$19,822.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,214.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,707.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,707.68
|
| Rate for Payer: Multiplan WC |
$18,929.64
|
| Rate for Payer: Preferred Health Network WC |
$19,315.96
|
| Rate for Payer: Prime Health Services Medicare |
$14,007.57
|
| Rate for Payer: Prime Health Services WC |
$18,263.74
|
| 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 082: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC
|
Facility
IP
|
$59,962.58
|
|
|
Service Code
|
MS-DRG 082
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$59,962.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,962.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38,512.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,306.26
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$47,725.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,757.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,672.07
|
| Rate for Payer: IEHP Medicare Advantage |
$31,672.07
|
| Rate for Payer: Innovage PACE Commercial |
$47,508.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,672.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,440.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,440.57
|
| Rate for Payer: Multiplan WC |
$47,725.46
|
| Rate for Payer: Preferred Health Network WC |
$48,699.45
|
| Rate for Payer: Prime Health Services Medicare |
$33,572.39
|
| Rate for Payer: Prime Health Services WC |
$46,046.57
|
| 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 083: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC
|
Facility
IP
|
$35,699.09
|
|
|
Service Code
|
MS-DRG 083
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,699.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,699.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,920.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,154.46
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,403.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,975.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,240.85
|
| Rate for Payer: IEHP Medicare Advantage |
$19,240.85
|
| Rate for Payer: Innovage PACE Commercial |
$28,861.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,240.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,782.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,782.74
|
| Rate for Payer: Multiplan WC |
$28,403.95
|
| Rate for Payer: Preferred Health Network WC |
$28,983.62
|
| Rate for Payer: Prime Health Services Medicare |
$20,395.30
|
| Rate for Payer: Prime Health Services WC |
$27,404.75
|
| 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 084: TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC
|
Facility
IP
|
$24,205.58
|
|
|
Service Code
|
MS-DRG 084
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$24,205.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,205.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,581.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,139.27
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,308.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,025.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,352.24
|
| Rate for Payer: IEHP Medicare Advantage |
$13,352.24
|
| Rate for Payer: Innovage PACE Commercial |
$20,028.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,352.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,892.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,892.00
|
| Rate for Payer: Multiplan WC |
$19,308.87
|
| Rate for Payer: Preferred Health Network WC |
$19,702.93
|
| Rate for Payer: Prime Health Services Medicare |
$14,153.37
|
| Rate for Payer: Prime Health Services WC |
$18,629.63
|
| 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 085: TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC
|
Facility
IP
|
$59,817.82
|
|
|
Service Code
|
MS-DRG 085
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$59,817.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,817.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39,709.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48,776.42
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$49,208.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,657.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,597.90
|
| Rate for Payer: IEHP Medicare Advantage |
$31,597.90
|
| Rate for Payer: Innovage PACE Commercial |
$47,396.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,597.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,341.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,341.19
|
| Rate for Payer: Multiplan WC |
$49,208.65
|
| Rate for Payer: Preferred Health Network WC |
$50,212.91
|
| Rate for Payer: Prime Health Services Medicare |
$33,493.77
|
| Rate for Payer: Prime Health Services WC |
$47,477.59
|
| 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 086: TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC
|
Facility
IP
|
$34,664.75
|
|
|
Service Code
|
MS-DRG 086
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,664.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,664.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,096.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,141.64
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,382.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,259.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,710.90
|
| Rate for Payer: IEHP Medicare Advantage |
$18,710.90
|
| Rate for Payer: Innovage PACE Commercial |
$28,066.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,710.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,072.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,072.61
|
| Rate for Payer: Multiplan WC |
$27,382.15
|
| Rate for Payer: Preferred Health Network WC |
$27,940.97
|
| Rate for Payer: Prime Health Services Medicare |
$19,833.55
|
| Rate for Payer: Prime Health Services WC |
$26,418.90
|
| 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 087: TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC
|
Facility
IP
|
$23,323.90
|
|
|
Service Code
|
MS-DRG 087
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,323.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,323.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,831.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,218.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,379.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,415.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,900.52
|
| Rate for Payer: IEHP Medicare Advantage |
$12,900.52
|
| Rate for Payer: Innovage PACE Commercial |
$19,350.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,900.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,286.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,286.70
|
| Rate for Payer: Multiplan WC |
$18,379.77
|
| Rate for Payer: Preferred Health Network WC |
$18,754.87
|
| Rate for Payer: Prime Health Services Medicare |
$13,674.55
|
| Rate for Payer: Prime Health Services WC |
$17,733.20
|
| 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 088: CONCUSSION WITH MCC
|
Facility
IP
|
$40,368.08
|
|
|
Service Code
|
MS-DRG 088
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$40,368.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,368.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,798.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,917.87
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,209.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,204.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,632.96
|
| Rate for Payer: IEHP Medicare Advantage |
$21,632.96
|
| Rate for Payer: Innovage PACE Commercial |
$32,449.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,632.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,988.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,988.17
|
| Rate for Payer: Multiplan WC |
$33,209.57
|
| Rate for Payer: Preferred Health Network WC |
$33,887.32
|
| Rate for Payer: Prime Health Services Medicare |
$22,930.94
|
| Rate for Payer: Prime Health Services WC |
$32,041.32
|
| 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 089: CONCUSSION WITH CC
|
Facility
IP
|
$30,264.22
|
|
|
Service Code
|
MS-DRG 089
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,264.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,264.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,852.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,385.08
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,601.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,216.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16,456.33
|
| Rate for Payer: IEHP Medicare Advantage |
$16,456.33
|
| Rate for Payer: Innovage PACE Commercial |
$24,684.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,456.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,051.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,051.48
|
| Rate for Payer: Multiplan WC |
$24,601.17
|
| Rate for Payer: Preferred Health Network WC |
$25,103.23
|
| Rate for Payer: Prime Health Services Medicare |
$17,443.71
|
| Rate for Payer: Prime Health Services WC |
$23,735.74
|
| 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 090: CONCUSSION WITHOUT CC/MCC
|
Facility
IP
|
$24,603.00
|
|
|
Service Code
|
MS-DRG 090
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$24,603.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,603.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,993.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,188.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,341.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,300.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,555.85
|
| Rate for Payer: IEHP Medicare Advantage |
$13,555.85
|
| Rate for Payer: Innovage PACE Commercial |
$20,333.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,555.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,164.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,164.84
|
| Rate for Payer: Multiplan WC |
$17,341.11
|
| Rate for Payer: Preferred Health Network WC |
$17,695.01
|
| Rate for Payer: Prime Health Services Medicare |
$14,369.20
|
| Rate for Payer: Prime Health Services WC |
$16,731.08
|
| 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 091: OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC
|
Facility
IP
|
$47,089.95
|
|
|
Service Code
|
MS-DRG 091
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,089.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,089.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,367.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,073.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,392.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,853.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,076.89
|
| Rate for Payer: IEHP Medicare Advantage |
$25,076.89
|
| Rate for Payer: Innovage PACE Commercial |
$37,615.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,076.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,603.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,603.03
|
| Rate for Payer: Multiplan WC |
$36,392.96
|
| Rate for Payer: Preferred Health Network WC |
$37,135.67
|
| Rate for Payer: Prime Health Services Medicare |
$26,581.50
|
| Rate for Payer: Prime Health Services WC |
$35,112.72
|
| 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 092: OTHER DISORDERS OF NERVOUS SYSTEM WITH CC
|
Facility
IP
|
$27,005.93
|
|
|
Service Code
|
MS-DRG 092
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,005.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,005.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,904.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,763.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,947.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,962.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,786.96
|
| Rate for Payer: IEHP Medicare Advantage |
$14,786.96
|
| Rate for Payer: Innovage PACE Commercial |
$22,180.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,786.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,814.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,814.53
|
| Rate for Payer: Multiplan WC |
$20,947.96
|
| Rate for Payer: Preferred Health Network WC |
$21,375.47
|
| Rate for Payer: Prime Health Services Medicare |
$15,674.18
|
| Rate for Payer: Prime Health Services WC |
$20,211.06
|
| 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 093: OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
IP
|
$20,381.43
|
|
|
Service Code
|
MS-DRG 093
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,381.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,381.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,002.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,971.32
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,112.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,380.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,392.96
|
| Rate for Payer: IEHP Medicare Advantage |
$11,392.96
|
| Rate for Payer: Innovage PACE Commercial |
$17,089.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,392.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,266.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,266.57
|
| Rate for Payer: Multiplan WC |
$16,112.85
|
| Rate for Payer: Preferred Health Network WC |
$16,441.68
|
| Rate for Payer: Prime Health Services Medicare |
$12,076.54
|
| Rate for Payer: Prime Health Services WC |
$15,546.03
|
| 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 094: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC
|
Facility
IP
|
$95,345.84
|
|
|
Service Code
|
MS-DRG 094
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$95,345.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95,345.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60,753.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74,625.40
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$75,286.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,230.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,800.42
|
| Rate for Payer: IEHP Medicare Advantage |
$49,800.42
|
| Rate for Payer: Innovage PACE Commercial |
$74,700.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,800.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,732.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,732.56
|
| Rate for Payer: Multiplan WC |
$75,286.69
|
| Rate for Payer: Preferred Health Network WC |
$76,823.15
|
| Rate for Payer: Prime Health Services Medicare |
$52,788.45
|
| Rate for Payer: Prime Health Services WC |
$72,638.25
|
| 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 095: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC
|
Facility
IP
|
$62,749.76
|
|
|
Service Code
|
MS-DRG 095
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$62,749.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,749.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43,468.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53,393.65
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$53,866.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,685.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,100.05
|
| Rate for Payer: IEHP Medicare Advantage |
$33,100.05
|
| Rate for Payer: Innovage PACE Commercial |
$49,650.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,100.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,354.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,354.07
|
| Rate for Payer: Multiplan WC |
$53,866.80
|
| Rate for Payer: Preferred Health Network WC |
$54,966.12
|
| Rate for Payer: Prime Health Services Medicare |
$35,086.05
|
| Rate for Payer: Prime Health Services WC |
$51,971.87
|
| 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 096: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC
|
Facility
IP
|
$57,367.52
|
|
|
Service Code
|
MS-DRG 096
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$57,367.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,367.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38,835.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,703.04
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$48,125.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,962.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,342.51
|
| Rate for Payer: IEHP Medicare Advantage |
$30,342.51
|
| Rate for Payer: Innovage PACE Commercial |
$45,513.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,342.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,658.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,658.96
|
| Rate for Payer: Multiplan WC |
$48,125.75
|
| Rate for Payer: Preferred Health Network WC |
$49,107.91
|
| Rate for Payer: Prime Health Services Medicare |
$32,163.06
|
| Rate for Payer: Prime Health Services WC |
$46,432.78
|
| 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 097: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC
|
Facility
IP
|
$95,719.57
|
|
|
Service Code
|
MS-DRG 097
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$95,719.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95,719.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66,103.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81,197.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$81,916.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,489.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$49,991.89
|
| Rate for Payer: IEHP Medicare Advantage |
$49,991.89
|
| Rate for Payer: Innovage PACE Commercial |
$74,987.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,991.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,989.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,989.13
|
| Rate for Payer: Multiplan WC |
$81,916.80
|
| Rate for Payer: Preferred Health Network WC |
$83,588.57
|
| Rate for Payer: Prime Health Services Medicare |
$52,991.40
|
| Rate for Payer: Prime Health Services WC |
$79,035.13
|
| 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 098: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC
|
Facility
IP
|
$56,704.29
|
|
|
Service Code
|
MS-DRG 098
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$56,704.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,704.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35,433.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43,524.35
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$43,910.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,503.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,002.72
|
| Rate for Payer: IEHP Medicare Advantage |
$30,002.72
|
| Rate for Payer: Innovage PACE Commercial |
$45,004.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,002.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,203.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,203.64
|
| Rate for Payer: Multiplan WC |
$43,910.04
|
| Rate for Payer: Preferred Health Network WC |
$44,806.16
|
| Rate for Payer: Prime Health Services Medicare |
$31,802.88
|
| Rate for Payer: Prime Health Services WC |
$42,365.37
|
| 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 099: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC
|
Facility
IP
|
$34,746.34
|
|
|
Service Code
|
MS-DRG 099
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,746.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,746.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,775.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,204.88
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,463.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,316.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,752.71
|
| Rate for Payer: IEHP Medicare Advantage |
$18,752.71
|
| Rate for Payer: Innovage PACE Commercial |
$28,129.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,752.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,128.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,128.63
|
| Rate for Payer: Multiplan WC |
$29,463.67
|
| Rate for Payer: Preferred Health Network WC |
$30,064.97
|
| Rate for Payer: Prime Health Services Medicare |
$19,877.87
|
| Rate for Payer: Prime Health Services WC |
$28,427.20
|
| 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 100: SEIZURES WITH MCC
|
Facility
IP
|
$52,177.42
|
|
|
Service Code
|
MS-DRG 100
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$52,177.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,177.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,658.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,116.24
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,471.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,372.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,683.40
|
| Rate for Payer: IEHP Medicare Advantage |
$27,683.40
|
| Rate for Payer: Innovage PACE Commercial |
$41,525.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,683.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,095.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,095.76
|
| Rate for Payer: Multiplan WC |
$40,471.73
|
| Rate for Payer: Preferred Health Network WC |
$41,297.68
|
| Rate for Payer: Prime Health Services Medicare |
$29,344.40
|
| Rate for Payer: Prime Health Services WC |
$39,048.01
|
| 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
|
|
