|
INPATIENT MS-DRG 180: RESPIRATORY NEOPLASMS WITH MCC
|
Facility
IP
|
$45,747.69
|
|
|
Service Code
|
MS-DRG 180
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,747.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,747.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,797.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,373.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,687.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,925.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,389.17
|
| Rate for Payer: IEHP Medicare Advantage |
$24,389.17
|
| Rate for Payer: Innovage PACE Commercial |
$36,583.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,389.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,681.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,681.49
|
| Rate for Payer: Multiplan WC |
$35,687.17
|
| Rate for Payer: Preferred Health Network WC |
$36,415.48
|
| Rate for Payer: Prime Health Services Medicare |
$25,852.52
|
| Rate for Payer: Prime Health Services WC |
$34,431.77
|
| 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 181: RESPIRATORY NEOPLASMS WITH CC
|
Facility
IP
|
$28,979.85
|
|
|
Service Code
|
MS-DRG 181
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,979.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,979.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,274.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,675.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,884.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,327.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,798.31
|
| Rate for Payer: IEHP Medicare Advantage |
$15,798.31
|
| Rate for Payer: Innovage PACE Commercial |
$23,697.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,798.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,169.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,169.74
|
| Rate for Payer: Multiplan WC |
$23,884.85
|
| Rate for Payer: Preferred Health Network WC |
$24,372.30
|
| Rate for Payer: Prime Health Services Medicare |
$16,746.21
|
| Rate for Payer: Prime Health Services WC |
$23,044.63
|
| 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 182: RESPIRATORY NEOPLASMS WITHOUT CC/MCC
|
Facility
IP
|
$19,976.12
|
|
|
Service Code
|
MS-DRG 182
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,976.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,976.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,088.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,533.66
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,697.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,824.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,721.98
|
| Rate for Payer: IEHP Medicare Advantage |
$11,721.98
|
| Rate for Payer: Innovage PACE Commercial |
$17,582.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,721.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,707.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,707.45
|
| Rate for Payer: Multiplan WC |
$18,697.90
|
| Rate for Payer: Preferred Health Network WC |
$19,079.49
|
| Rate for Payer: Prime Health Services Medicare |
$12,425.30
|
| Rate for Payer: Prime Health Services WC |
$18,040.14
|
| 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 183: MAJOR CHEST TRAUMA WITH MCC
|
Facility
IP
|
$41,439.27
|
|
|
Service Code
|
MS-DRG 183
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$41,439.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,439.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,538.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,370.44
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,648.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,945.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,181.79
|
| Rate for Payer: IEHP Medicare Advantage |
$22,181.79
|
| Rate for Payer: Innovage PACE Commercial |
$33,272.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,181.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,723.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,723.60
|
| Rate for Payer: Multiplan WC |
$31,648.42
|
| Rate for Payer: Preferred Health Network WC |
$32,294.31
|
| Rate for Payer: Prime Health Services Medicare |
$23,512.70
|
| Rate for Payer: Prime Health Services WC |
$30,535.10
|
| 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 184: MAJOR CHEST TRAUMA WITH CC
|
Facility
IP
|
$27,684.96
|
|
|
Service Code
|
MS-DRG 184
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,684.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,684.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,769.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,826.91
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,020.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,432.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,134.85
|
| Rate for Payer: IEHP Medicare Advantage |
$15,134.85
|
| Rate for Payer: Innovage PACE Commercial |
$22,702.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,134.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,280.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,280.70
|
| Rate for Payer: Multiplan WC |
$22,020.33
|
| Rate for Payer: Preferred Health Network WC |
$22,469.72
|
| Rate for Payer: Prime Health Services Medicare |
$16,042.94
|
| Rate for Payer: Prime Health Services WC |
$21,245.70
|
| 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 185: MAJOR CHEST TRAUMA WITHOUT CC/MCC
|
Facility
IP
|
$19,889.27
|
|
|
Service Code
|
MS-DRG 185
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,889.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,889.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,835.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,766.66
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,906.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,040.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,140.79
|
| Rate for Payer: IEHP Medicare Advantage |
$11,140.79
|
| Rate for Payer: Innovage PACE Commercial |
$16,711.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,140.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,928.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,928.66
|
| Rate for Payer: Multiplan WC |
$15,906.38
|
| Rate for Payer: Preferred Health Network WC |
$16,231.00
|
| Rate for Payer: Prime Health Services Medicare |
$11,809.24
|
| Rate for Payer: Prime Health Services WC |
$15,346.83
|
| 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 186: PLEURAL EFFUSION WITH MCC
|
Facility
IP
|
$40,849.72
|
|
|
Service Code
|
MS-DRG 186
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$40,849.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,849.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,957.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,884.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,166.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,537.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,879.73
|
| Rate for Payer: IEHP Medicare Advantage |
$21,879.73
|
| Rate for Payer: Innovage PACE Commercial |
$32,819.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,879.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,318.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,318.84
|
| Rate for Payer: Multiplan WC |
$32,166.70
|
| Rate for Payer: Preferred Health Network WC |
$32,823.16
|
| Rate for Payer: Prime Health Services Medicare |
$23,192.51
|
| Rate for Payer: Prime Health Services WC |
$31,035.14
|
| 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 187: PLEURAL EFFUSION WITH CC
|
Facility
IP
|
$26,221.62
|
|
|
Service Code
|
MS-DRG 187
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,221.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,221.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,781.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,841.53
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,035.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,419.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,385.16
|
| Rate for Payer: IEHP Medicare Advantage |
$14,385.16
|
| Rate for Payer: Innovage PACE Commercial |
$21,577.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,385.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,276.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,276.11
|
| Rate for Payer: Multiplan WC |
$22,035.07
|
| Rate for Payer: Preferred Health Network WC |
$22,484.77
|
| Rate for Payer: Prime Health Services Medicare |
$15,248.27
|
| Rate for Payer: Prime Health Services WC |
$21,259.93
|
| 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 188: PLEURAL EFFUSION WITHOUT CC/MCC
|
Facility
IP
|
$19,647.13
|
|
|
Service Code
|
MS-DRG 188
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,647.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,647.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,308.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,119.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,253.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,872.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,016.75
|
| Rate for Payer: IEHP Medicare Advantage |
$11,016.75
|
| Rate for Payer: Innovage PACE Commercial |
$16,525.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,016.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,762.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,762.44
|
| Rate for Payer: Multiplan WC |
$15,253.27
|
| Rate for Payer: Preferred Health Network WC |
$15,564.56
|
| Rate for Payer: Prime Health Services Medicare |
$11,677.76
|
| Rate for Payer: Prime Health Services WC |
$14,716.69
|
| 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 189: PULMONARY EDEMA AND RESPIRATORY FAILURE
|
Facility
IP
|
$32,425.01
|
|
|
Service Code
|
MS-DRG 189
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$32,425.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,425.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,520.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,205.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,429.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,710.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,563.40
|
| Rate for Payer: IEHP Medicare Advantage |
$17,563.40
|
| Rate for Payer: Innovage PACE Commercial |
$26,345.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,563.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,534.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,534.96
|
| Rate for Payer: Multiplan WC |
$25,429.14
|
| Rate for Payer: Preferred Health Network WC |
$25,948.10
|
| Rate for Payer: Prime Health Services Medicare |
$18,617.20
|
| Rate for Payer: Prime Health Services WC |
$24,534.59
|
| 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 190: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC
|
Facility
IP
|
$29,003.54
|
|
|
Service Code
|
MS-DRG 190
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,003.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,003.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,454.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,668.50
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,869.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,344.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,810.43
|
| Rate for Payer: IEHP Medicare Advantage |
$15,810.43
|
| Rate for Payer: Innovage PACE Commercial |
$23,715.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,810.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,185.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,185.98
|
| Rate for Payer: Multiplan WC |
$22,869.37
|
| Rate for Payer: Preferred Health Network WC |
$23,336.09
|
| Rate for Payer: Prime Health Services Medicare |
$16,759.06
|
| Rate for Payer: Prime Health Services WC |
$22,064.87
|
| 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 191: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC
|
Facility
IP
|
$22,344.83
|
|
|
Service Code
|
MS-DRG 191
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$22,344.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,344.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,692.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,047.09
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,207.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,738.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,398.89
|
| Rate for Payer: IEHP Medicare Advantage |
$12,398.89
|
| Rate for Payer: Innovage PACE Commercial |
$18,598.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,398.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,614.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,614.51
|
| Rate for Payer: Multiplan WC |
$18,207.01
|
| Rate for Payer: Preferred Health Network WC |
$18,578.58
|
| Rate for Payer: Prime Health Services Medicare |
$13,142.82
|
| Rate for Payer: Prime Health Services WC |
$17,566.53
|
| 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 192: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC
|
Facility
IP
|
$16,891.53
|
|
|
Service Code
|
MS-DRG 192
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$16,891.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,891.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,086.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,617.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,738.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,966.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,604.94
|
| Rate for Payer: IEHP Medicare Advantage |
$9,604.94
|
| Rate for Payer: Innovage PACE Commercial |
$14,407.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,604.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,870.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,870.62
|
| Rate for Payer: Multiplan WC |
$13,738.47
|
| Rate for Payer: Preferred Health Network WC |
$14,018.85
|
| Rate for Payer: Prime Health Services Medicare |
$10,181.24
|
| Rate for Payer: Prime Health Services WC |
$13,255.19
|
| 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 193: SIMPLE PNEUMONIA AND PLEURISY WITH MCC
|
Facility
IP
|
$34,914.79
|
|
|
Service Code
|
MS-DRG 193
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,914.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,914.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,079.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,120.75
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,361.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,432.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,839.01
|
| Rate for Payer: IEHP Medicare Advantage |
$18,839.01
|
| Rate for Payer: Innovage PACE Commercial |
$28,258.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,839.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,244.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,244.27
|
| Rate for Payer: Multiplan WC |
$27,361.08
|
| Rate for Payer: Preferred Health Network WC |
$27,919.47
|
| Rate for Payer: Prime Health Services Medicare |
$19,969.35
|
| Rate for Payer: Prime Health Services WC |
$26,398.57
|
| 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 194: SIMPLE PNEUMONIA AND PLEURISY WITH CC
|
Facility
IP
|
$21,639.48
|
|
|
Service Code
|
MS-DRG 194
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$21,639.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,639.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,284.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,545.90
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,701.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,250.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,037.52
|
| Rate for Payer: IEHP Medicare Advantage |
$12,037.52
|
| Rate for Payer: Innovage PACE Commercial |
$18,056.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,037.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,130.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,130.28
|
| Rate for Payer: Multiplan WC |
$17,701.38
|
| Rate for Payer: Preferred Health Network WC |
$18,062.63
|
| Rate for Payer: Prime Health Services Medicare |
$12,759.77
|
| Rate for Payer: Prime Health Services WC |
$17,078.68
|
| 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 195: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC
|
Facility
IP
|
$16,465.17
|
|
|
Service Code
|
MS-DRG 195
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$16,465.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,465.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,911.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,402.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,521.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,671.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,386.49
|
| Rate for Payer: IEHP Medicare Advantage |
$9,386.49
|
| Rate for Payer: Innovage PACE Commercial |
$14,079.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,386.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,577.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,577.90
|
| Rate for Payer: Multiplan WC |
$13,521.47
|
| Rate for Payer: Preferred Health Network WC |
$13,797.42
|
| Rate for Payer: Prime Health Services Medicare |
$9,949.68
|
| Rate for Payer: Prime Health Services WC |
$13,045.82
|
| 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 196: INTERSTITIAL LUNG DISEASE WITH MCC
|
Facility
IP
|
$49,885.03
|
|
|
Service Code
|
MS-DRG 196
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,885.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,885.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,542.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,288.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,609.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,787.03
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,508.91
|
| Rate for Payer: IEHP Medicare Advantage |
$26,508.91
|
| Rate for Payer: Innovage PACE Commercial |
$39,763.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,508.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,521.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,521.94
|
| Rate for Payer: Multiplan WC |
$36,609.96
|
| Rate for Payer: Preferred Health Network WC |
$37,357.10
|
| Rate for Payer: Prime Health Services Medicare |
$28,099.44
|
| Rate for Payer: Prime Health Services WC |
$35,322.09
|
| 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 197: INTERSTITIAL LUNG DISEASE WITH CC
|
Facility
IP
|
$26,253.20
|
|
|
Service Code
|
MS-DRG 197
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,253.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,253.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,722.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,540.52
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,722.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,441.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,401.33
|
| Rate for Payer: IEHP Medicare Advantage |
$14,401.33
|
| Rate for Payer: Innovage PACE Commercial |
$21,602.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,401.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,297.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,297.78
|
| Rate for Payer: Multiplan WC |
$20,722.53
|
| Rate for Payer: Preferred Health Network WC |
$21,145.44
|
| Rate for Payer: Prime Health Services Medicare |
$15,265.41
|
| Rate for Payer: Prime Health Services WC |
$19,993.56
|
| 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 198: INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC
|
Facility
IP
|
$20,481.45
|
|
|
Service Code
|
MS-DRG 198
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,481.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,481.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,086.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,845.72
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,977.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,444.23
|
| Rate for Payer: IEHP Medicare Advantage |
$11,444.23
|
| Rate for Payer: Innovage PACE Commercial |
$17,166.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,444.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,335.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,335.27
|
| Rate for Payer: Multiplan WC |
$14,977.28
|
| Rate for Payer: Preferred Health Network WC |
$15,282.94
|
| Rate for Payer: Prime Health Services Medicare |
$12,130.88
|
| Rate for Payer: Prime Health Services WC |
$14,450.41
|
| 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 199: PNEUMOTHORAX WITH MCC
|
Facility
IP
|
$46,692.54
|
|
|
Service Code
|
MS-DRG 199
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$46,692.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,692.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,897.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,724.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,050.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,578.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,873.25
|
| Rate for Payer: IEHP Medicare Advantage |
$24,873.25
|
| Rate for Payer: Innovage PACE Commercial |
$37,309.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,873.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,330.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,330.16
|
| Rate for Payer: Multiplan WC |
$37,050.27
|
| Rate for Payer: Preferred Health Network WC |
$37,806.40
|
| Rate for Payer: Prime Health Services Medicare |
$26,365.64
|
| Rate for Payer: Prime Health Services WC |
$35,746.92
|
| 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 200: PNEUMOTHORAX WITH CC
|
Facility
IP
|
$28,345.56
|
|
|
Service Code
|
MS-DRG 200
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,345.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,345.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,225.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,386.58
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,584.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,888.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,473.32
|
| Rate for Payer: IEHP Medicare Advantage |
$15,473.32
|
| Rate for Payer: Innovage PACE Commercial |
$23,209.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,473.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,734.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,734.25
|
| Rate for Payer: Multiplan WC |
$22,584.95
|
| Rate for Payer: Preferred Health Network WC |
$23,045.87
|
| Rate for Payer: Prime Health Services Medicare |
$16,401.72
|
| Rate for Payer: Prime Health Services WC |
$21,790.46
|
| 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 201: PNEUMOTHORAX WITHOUT CC/MCC
|
Facility
IP
|
$18,583.85
|
|
|
Service Code
|
MS-DRG 201
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,583.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,583.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,375.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,200.74
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,335.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,137.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,471.97
|
| Rate for Payer: IEHP Medicare Advantage |
$10,471.97
|
| Rate for Payer: Innovage PACE Commercial |
$15,707.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,471.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,032.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,032.44
|
| Rate for Payer: Multiplan WC |
$15,335.43
|
| Rate for Payer: Preferred Health Network WC |
$15,648.40
|
| Rate for Payer: Prime Health Services Medicare |
$11,100.29
|
| Rate for Payer: Prime Health Services WC |
$14,795.96
|
| 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 202: BRONCHITIS AND ASTHMA WITH CC/MCC
|
Facility
IP
|
$25,200.44
|
|
|
Service Code
|
MS-DRG 202
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$25,200.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,200.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,739.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,333.48
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,504.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,713.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,861.95
|
| Rate for Payer: IEHP Medicare Advantage |
$13,861.95
|
| Rate for Payer: Innovage PACE Commercial |
$20,792.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,861.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,575.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,575.01
|
| Rate for Payer: Multiplan WC |
$19,504.80
|
| Rate for Payer: Preferred Health Network WC |
$19,902.86
|
| Rate for Payer: Prime Health Services Medicare |
$14,693.67
|
| Rate for Payer: Prime Health Services WC |
$18,818.66
|
| 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 203: BRONCHITIS AND ASTHMA WITHOUT CC/MCC
|
Facility
IP
|
$18,289.07
|
|
|
Service Code
|
MS-DRG 203
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,289.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,289.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,341.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,931.05
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,054.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,933.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,320.96
|
| Rate for Payer: IEHP Medicare Advantage |
$10,320.96
|
| Rate for Payer: Innovage PACE Commercial |
$15,481.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,320.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,830.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,830.09
|
| Rate for Payer: Multiplan WC |
$14,054.49
|
| Rate for Payer: Preferred Health Network WC |
$14,341.32
|
| Rate for Payer: Prime Health Services Medicare |
$10,940.22
|
| Rate for Payer: Prime Health Services WC |
$13,560.09
|
| 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 204: RESPIRATORY SIGNS AND SYMPTOMS
|
Facility
IP
|
$21,657.91
|
|
|
Service Code
|
MS-DRG 204
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$21,657.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,657.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,760.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,902.70
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,052.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,263.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,046.96
|
| Rate for Payer: IEHP Medicare Advantage |
$12,046.96
|
| Rate for Payer: Innovage PACE Commercial |
$18,070.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,046.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,142.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,142.93
|
| Rate for Payer: Multiplan WC |
$17,052.48
|
| Rate for Payer: Preferred Health Network WC |
$17,400.49
|
| Rate for Payer: Prime Health Services Medicare |
$12,769.78
|
| Rate for Payer: Prime Health Services WC |
$16,452.61
|
| 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
|
|
