|
INPATIENT MS-DRG 273: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC
|
Facility
IP
|
$102,565.14
|
|
|
Service Code
|
MS-DRG 273
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$102,565.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,565.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68,225.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83,803.48
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$84,546.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,223.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$53,499.18
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$53,499.18
|
| Rate for Payer: Innovage PACE Commercial |
$80,248.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,499.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,688.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,688.90
|
| Rate for Payer: Multiplan WC |
$84,546.09
|
| Rate for Payer: Preferred Health Network WC |
$86,271.52
|
| Rate for Payer: Prime Health Services Medicare |
$56,709.13
|
| Rate for Payer: Prime Health Services WC |
$81,571.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$58,981.00
|
| Rate for Payer: United Healthcare All Other HMO |
$49,688.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,951.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,961.00
|
|
|
INPATIENT MS-DRG 274: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC
|
Facility
IP
|
$85,294.62
|
|
|
Service Code
|
MS-DRG 274
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$85,294.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,294.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57,114.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70,156.44
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$70,778.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,278.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,650.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,978.00
|
| Rate for Payer: IEHP Medicare Advantage |
$44,650.75
|
| Rate for Payer: Innovage PACE Commercial |
$66,976.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,650.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,832.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,832.00
|
| Rate for Payer: Multiplan WC |
$70,778.12
|
| Rate for Payer: Preferred Health Network WC |
$72,222.57
|
| Rate for Payer: Prime Health Services Medicare |
$47,329.80
|
| Rate for Payer: Prime Health Services WC |
$68,288.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$40,202.00
|
| Rate for Payer: United Healthcare All Other HMO |
$33,869.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,824.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,785.00
|
|
|
INPATIENT MS-DRG 275: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
IP
|
$185,175.22
|
|
|
Service Code
|
MS-DRG 275
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$185,175.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$185,175.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$129,362.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$95,823.81
|
| Rate for Payer: IEHP Medicare Advantage |
$95,823.81
|
| Rate for Payer: Innovage PACE Commercial |
$143,735.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95,823.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$128,403.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$128,403.91
|
| Rate for Payer: Prime Health Services Medicare |
$101,573.24
|
| 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 276: CARDIAC DEFIBRILLATOR IMPLANT WITH MCC
|
Facility
IP
|
$163,446.25
|
|
|
Service Code
|
MS-DRG 276
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$163,446.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$163,446.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$114,333.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$84,691.15
|
| Rate for Payer: IEHP Medicare Advantage |
$84,691.15
|
| Rate for Payer: Innovage PACE Commercial |
$127,036.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84,691.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$113,486.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$113,486.14
|
| Rate for Payer: Prime Health Services Medicare |
$89,772.62
|
| 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 277: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
IP
|
$125,867.99
|
|
|
Service Code
|
MS-DRG 277
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$125,867.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$125,867.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$88,341.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$65,438.20
|
| Rate for Payer: IEHP Medicare Advantage |
$65,438.20
|
| Rate for Payer: Innovage PACE Commercial |
$98,157.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65,438.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87,687.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87,687.19
|
| Rate for Payer: Prime Health Services Medicare |
$69,364.49
|
| 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 278: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC
|
Facility
IP
|
$117,393.27
|
|
|
Service Code
|
MS-DRG 278
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$117,393.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$117,393.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$82,479.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$61,096.26
|
| Rate for Payer: IEHP Medicare Advantage |
$61,096.26
|
| Rate for Payer: Innovage PACE Commercial |
$91,644.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61,096.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$81,868.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$81,868.99
|
| Rate for Payer: Prime Health Services Medicare |
$64,762.04
|
| 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 279: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC
|
Facility
IP
|
$84,236.59
|
|
|
Service Code
|
MS-DRG 279
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$84,236.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$84,236.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,546.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,108.67
|
| Rate for Payer: IEHP Medicare Advantage |
$44,108.67
|
| Rate for Payer: Innovage PACE Commercial |
$66,163.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,108.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,105.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,105.62
|
| Rate for Payer: Prime Health Services Medicare |
$46,755.19
|
| 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 280: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC
|
Facility
IP
|
$41,755.09
|
|
|
Service Code
|
MS-DRG 280
|
| Min. Negotiated Rate |
$19,520.00 |
| Max. Negotiated Rate |
$41,755.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,755.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,310.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,546.45
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,843.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,163.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,343.59
|
| Rate for Payer: IEHP Medicare Advantage |
$22,343.59
|
| Rate for Payer: Innovage PACE Commercial |
$33,515.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,343.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,940.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,940.41
|
| Rate for Payer: Multiplan WC |
$33,843.72
|
| Rate for Payer: Preferred Health Network WC |
$34,534.41
|
| Rate for Payer: Prime Health Services Medicare |
$23,684.21
|
| Rate for Payer: Prime Health Services WC |
$32,653.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$25,665.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,106.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,346.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19,520.00
|
|
|
INPATIENT MS-DRG 281: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC
|
Facility
IP
|
$25,122.00
|
|
|
Service Code
|
MS-DRG 281
|
| Min. Negotiated Rate |
$13,261.90 |
| Max. Negotiated Rate |
$25,122.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,029.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,617.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,183.12
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,353.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,903.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,261.90
|
| Rate for Payer: IEHP Medicare Advantage |
$13,261.90
|
| Rate for Payer: Innovage PACE Commercial |
$19,892.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,261.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,770.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,770.95
|
| Rate for Payer: Multiplan WC |
$19,353.11
|
| Rate for Payer: Preferred Health Network WC |
$19,748.07
|
| Rate for Payer: Prime Health Services Medicare |
$14,057.61
|
| Rate for Payer: Prime Health Services WC |
$18,672.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$25,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,212.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,114.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,736.00
|
|
|
INPATIENT MS-DRG 282: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC
|
Facility
IP
|
$26,661.00
|
|
|
Service Code
|
MS-DRG 282
|
| Min. Negotiated Rate |
$10,633.81 |
| Max. Negotiated Rate |
$26,661.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,899.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,184.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,966.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,099.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,355.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,633.81
|
| Rate for Payer: IEHP Medicare Advantage |
$10,633.81
|
| Rate for Payer: Innovage PACE Commercial |
$15,950.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,633.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,249.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,249.31
|
| Rate for Payer: Multiplan WC |
$15,099.48
|
| Rate for Payer: Preferred Health Network WC |
$15,407.63
|
| Rate for Payer: Prime Health Services Medicare |
$11,271.84
|
| Rate for Payer: Prime Health Services WC |
$14,568.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$26,661.00
|
| Rate for Payer: United Healthcare All Other HMO |
$17,160.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,033.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,917.00
|
|
|
INPATIENT MS-DRG 283: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC
|
Facility
IP
|
$51,885.28
|
|
|
Service Code
|
MS-DRG 283
|
| Min. Negotiated Rate |
$17,720.00 |
| Max. Negotiated Rate |
$51,885.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,885.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,618.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,066.12
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,421.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,170.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,533.73
|
| Rate for Payer: IEHP Medicare Advantage |
$27,533.73
|
| Rate for Payer: Innovage PACE Commercial |
$41,300.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,533.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,895.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,895.20
|
| Rate for Payer: Multiplan WC |
$40,421.17
|
| Rate for Payer: Preferred Health Network WC |
$41,246.09
|
| Rate for Payer: Prime Health Services Medicare |
$29,185.75
|
| Rate for Payer: Prime Health Services WC |
$38,999.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,534.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,511.00
|
| Rate for Payer: United Healthcare HMO Rider |
$19,377.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,720.00
|
|
|
INPATIENT MS-DRG 284: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC
|
Facility
IP
|
$26,839.00
|
|
|
Service Code
|
MS-DRG 284
|
| Min. Negotiated Rate |
$10,925.05 |
| Max. Negotiated Rate |
$26,839.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,468.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,502.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,357.36
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,493.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,748.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,925.05
|
| Rate for Payer: IEHP Medicare Advantage |
$10,925.05
|
| Rate for Payer: Innovage PACE Commercial |
$16,387.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,925.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,639.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,639.57
|
| Rate for Payer: Multiplan WC |
$15,493.45
|
| Rate for Payer: Preferred Health Network WC |
$15,809.64
|
| Rate for Payer: Prime Health Services Medicare |
$11,580.55
|
| Rate for Payer: Prime Health Services WC |
$14,948.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$26,839.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,513.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,817.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,549.00
|
|
|
INPATIENT MS-DRG 285: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC
|
Facility
IP
|
$26,450.00
|
|
|
Service Code
|
MS-DRG 285
|
| Min. Negotiated Rate |
$7,540.49 |
| Max. Negotiated Rate |
$26,450.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,862.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,211.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,314.41
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,414.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,179.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,540.49
|
| Rate for Payer: IEHP Medicare Advantage |
$7,540.49
|
| Rate for Payer: Innovage PACE Commercial |
$11,310.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,540.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,104.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,104.26
|
| Rate for Payer: Multiplan WC |
$11,414.67
|
| Rate for Payer: Preferred Health Network WC |
$11,647.62
|
| Rate for Payer: Prime Health Services Medicare |
$7,992.92
|
| Rate for Payer: Prime Health Services WC |
$11,013.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$26,450.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,841.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,697.00
|
|
|
INPATIENT MS-DRG 286: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
IP
|
$56,733.24
|
|
|
Service Code
|
MS-DRG 286
|
| Min. Negotiated Rate |
$4,504.00 |
| Max. Negotiated Rate |
$56,733.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,733.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,059.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,292.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$44,685.33
|
| 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 |
$40,523.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,017.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,504.00
|
| Rate for Payer: IEHP Medicare Advantage |
$30,017.55
|
| Rate for Payer: Innovage PACE Commercial |
$45,026.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,017.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,223.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,223.52
|
| Rate for Payer: Multiplan WC |
$44,685.33
|
| Rate for Payer: Preferred Health Network WC |
$45,597.28
|
| Rate for Payer: Prime Health Services Medicare |
$31,818.60
|
| Rate for Payer: Prime Health Services WC |
$43,113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$19,771.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,058.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,478.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,239.00
|
|
|
INPATIENT MS-DRG 287: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
IP
|
$28,466.63
|
|
|
Service Code
|
MS-DRG 287
|
| Min. Negotiated Rate |
$4,504.00 |
| Max. Negotiated Rate |
$28,466.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,466.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,704.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,975.48
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,179.07
|
| 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 |
$20,972.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,535.37
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,504.00
|
| Rate for Payer: IEHP Medicare Advantage |
$15,535.37
|
| Rate for Payer: Innovage PACE Commercial |
$23,303.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,535.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,817.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,817.40
|
| Rate for Payer: Multiplan WC |
$23,179.07
|
| Rate for Payer: Preferred Health Network WC |
$23,652.11
|
| Rate for Payer: Prime Health Services Medicare |
$16,467.49
|
| Rate for Payer: Prime Health Services WC |
$22,363.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$25,632.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,442.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,007.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,809.00
|
|
|
INPATIENT MS-DRG 288: ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC
|
Facility
IP
|
$68,245.17
|
|
|
Service Code
|
MS-DRG 288
|
| Min. Negotiated Rate |
$32,712.00 |
| Max. Negotiated Rate |
$68,245.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,245.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45,843.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56,311.01
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,810.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,486.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,915.59
|
| Rate for Payer: IEHP Medicare Advantage |
$35,915.59
|
| Rate for Payer: Innovage PACE Commercial |
$53,873.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,915.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,126.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,126.89
|
| Rate for Payer: Multiplan WC |
$56,810.00
|
| Rate for Payer: Preferred Health Network WC |
$57,969.39
|
| Rate for Payer: Prime Health Services Medicare |
$38,070.53
|
| Rate for Payer: Prime Health Services WC |
$54,811.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$35,642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$47,097.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,774.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,712.00
|
|
|
INPATIENT MS-DRG 289: ACUTE AND SUBACUTE ENDOCARDITIS WITH CC
|
Facility
IP
|
$38,891.59
|
|
|
Service Code
|
MS-DRG 289
|
| Min. Negotiated Rate |
$20,876.50 |
| Max. Negotiated Rate |
$38,891.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,891.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,322.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,561.07
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,858.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,183.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,876.50
|
| Rate for Payer: IEHP Medicare Advantage |
$20,876.50
|
| Rate for Payer: Innovage PACE Commercial |
$31,314.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,876.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,974.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,974.51
|
| Rate for Payer: Multiplan WC |
$33,858.47
|
| Rate for Payer: Preferred Health Network WC |
$34,549.46
|
| Rate for Payer: Prime Health Services Medicare |
$22,129.09
|
| Rate for Payer: Prime Health Services WC |
$32,667.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,362.00
|
| Rate for Payer: United Healthcare All Other HMO |
$37,290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28,325.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,901.00
|
|
|
INPATIENT MS-DRG 290: ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC
|
Facility
IP
|
$31,886.00
|
|
|
Service Code
|
MS-DRG 290
|
| Min. Negotiated Rate |
$15,582.56 |
| Max. Negotiated Rate |
$31,886.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,982.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,498.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,178.63
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,401.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,036.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,582.56
|
| Rate for Payer: IEHP Medicare Advantage |
$15,582.56
|
| Rate for Payer: Innovage PACE Commercial |
$23,373.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,582.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,880.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,880.63
|
| Rate for Payer: Multiplan WC |
$25,401.75
|
| Rate for Payer: Preferred Health Network WC |
$25,920.15
|
| Rate for Payer: Prime Health Services Medicare |
$16,517.51
|
| Rate for Payer: Prime Health Services WC |
$24,508.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,362.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31,886.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,225.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,150.00
|
|
|
INPATIENT MS-DRG 291: HEART FAILURE AND SHOCK WITH MCC
|
Facility
IP
|
$33,790.96
|
|
|
Service Code
|
MS-DRG 291
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,790.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,790.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,757.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,726.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$26,962.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,655.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,263.23
|
| Rate for Payer: IEHP Medicare Advantage |
$18,263.23
|
| Rate for Payer: Innovage PACE Commercial |
$27,394.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,263.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,472.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,472.73
|
| Rate for Payer: Multiplan WC |
$26,962.90
|
| Rate for Payer: Preferred Health Network WC |
$27,513.16
|
| Rate for Payer: Prime Health Services Medicare |
$19,359.02
|
| Rate for Payer: Prime Health Services WC |
$26,014.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 292: HEART FAILURE AND SHOCK WITH CC
|
Facility
IP
|
$22,542.22
|
|
|
Service Code
|
MS-DRG 292
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$22,542.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,542.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,668.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,017.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,177.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,875.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,500.03
|
| Rate for Payer: IEHP Medicare Advantage |
$12,500.03
|
| Rate for Payer: Innovage PACE Commercial |
$18,750.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,500.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,750.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,750.04
|
| Rate for Payer: Multiplan WC |
$18,177.51
|
| Rate for Payer: Preferred Health Network WC |
$18,548.48
|
| Rate for Payer: Prime Health Services Medicare |
$13,250.03
|
| Rate for Payer: Prime Health Services WC |
$17,538.07
|
| 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 293: HEART FAILURE AND SHOCK WITHOUT CC/MCC
|
Facility
IP
|
$14,778.12
|
|
|
Service Code
|
MS-DRG 293
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$14,778.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,778.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,525.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,700.74
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,804.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,504.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,522.14
|
| Rate for Payer: IEHP Medicare Advantage |
$8,522.14
|
| Rate for Payer: Innovage PACE Commercial |
$12,783.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,522.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,419.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,419.67
|
| Rate for Payer: Multiplan WC |
$11,804.43
|
| Rate for Payer: Preferred Health Network WC |
$12,045.34
|
| Rate for Payer: Prime Health Services Medicare |
$9,033.47
|
| Rate for Payer: Prime Health Services WC |
$11,389.18
|
| 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 294: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC
|
Facility
IP
|
$28,785.09
|
|
|
Service Code
|
MS-DRG 294
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,785.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,785.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,627.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,109.42
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,323.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,192.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,698.51
|
| Rate for Payer: IEHP Medicare Advantage |
$15,698.51
|
| Rate for Payer: Innovage PACE Commercial |
$23,547.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,698.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,036.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,036.00
|
| Rate for Payer: Multiplan WC |
$24,323.06
|
| Rate for Payer: Preferred Health Network WC |
$24,819.45
|
| Rate for Payer: Prime Health Services Medicare |
$16,640.42
|
| Rate for Payer: Prime Health Services WC |
$23,467.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 295: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC
|
Facility
IP
|
$19,040.79
|
|
|
Service Code
|
MS-DRG 295
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,040.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,620.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,057.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,496.07
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,659.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,793.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,699.05
|
| Rate for Payer: IEHP Medicare Advantage |
$11,699.05
|
| Rate for Payer: Innovage PACE Commercial |
$17,548.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,699.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,676.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,676.73
|
| Rate for Payer: Multiplan WC |
$18,659.97
|
| Rate for Payer: Preferred Health Network WC |
$19,040.79
|
| Rate for Payer: Prime Health Services Medicare |
$12,400.99
|
| Rate for Payer: Prime Health Services WC |
$18,003.55
|
| 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 296: CARDIAC ARREST, UNEXPLAINED WITH MCC
|
Facility
IP
|
$42,194.62
|
|
|
Service Code
|
MS-DRG 296
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,194.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,194.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,852.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,212.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,515.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,467.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,568.80
|
| Rate for Payer: IEHP Medicare Advantage |
$22,568.80
|
| Rate for Payer: Innovage PACE Commercial |
$33,853.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,568.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,242.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,242.19
|
| Rate for Payer: Multiplan WC |
$34,515.79
|
| Rate for Payer: Preferred Health Network WC |
$35,220.19
|
| Rate for Payer: Prime Health Services Medicare |
$23,922.93
|
| Rate for Payer: Prime Health Services WC |
$33,301.59
|
| 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 297: CARDIAC ARREST, UNEXPLAINED WITH CC
|
Facility
IP
|
$19,176.02
|
|
|
Service Code
|
MS-DRG 297
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,176.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,176.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,817.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,287.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,405.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,546.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,775.38
|
| Rate for Payer: IEHP Medicare Advantage |
$10,775.38
|
| Rate for Payer: Innovage PACE Commercial |
$16,163.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,775.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,439.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,439.01
|
| Rate for Payer: Multiplan WC |
$13,405.61
|
| Rate for Payer: Preferred Health Network WC |
$13,679.19
|
| Rate for Payer: Prime Health Services Medicare |
$11,421.90
|
| Rate for Payer: Prime Health Services WC |
$12,934.02
|
| 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
|
|
