|
INPATIENT MS-DRG 356: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
IP
|
$112,611.11
|
|
|
Service Code
|
MS-DRG 356
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$112,611.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$112,611.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$71,786.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88,178.47
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$88,959.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$79,172.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$58,646.14
|
| Rate for Payer: IEHP Medicare Advantage |
$58,646.14
|
| Rate for Payer: Innovage PACE Commercial |
$87,969.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,646.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78,585.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,585.83
|
| Rate for Payer: Multiplan WC |
$88,959.85
|
| Rate for Payer: Preferred Health Network WC |
$90,775.36
|
| Rate for Payer: Prime Health Services Medicare |
$62,164.91
|
| Rate for Payer: Prime Health Services WC |
$85,830.42
|
| 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 357: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC
|
Facility
IP
|
$57,817.58
|
|
|
Service Code
|
MS-DRG 357
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$57,817.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,817.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38,187.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46,907.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$47,323.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,273.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,573.10
|
| Rate for Payer: IEHP Medicare Advantage |
$30,573.10
|
| Rate for Payer: Innovage PACE Commercial |
$45,859.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,573.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,967.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,967.95
|
| Rate for Payer: Multiplan WC |
$47,323.05
|
| Rate for Payer: Preferred Health Network WC |
$48,288.83
|
| Rate for Payer: Prime Health Services Medicare |
$32,407.49
|
| Rate for Payer: Prime Health Services WC |
$45,658.33
|
| 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 358: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$33,717.27
|
|
|
Service Code
|
MS-DRG 358
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$33,717.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,717.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,583.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,968.90
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,225.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,604.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,225.48
|
| Rate for Payer: IEHP Medicare Advantage |
$18,225.48
|
| Rate for Payer: Innovage PACE Commercial |
$27,338.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,225.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,422.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,422.14
|
| Rate for Payer: Multiplan WC |
$29,225.60
|
| Rate for Payer: Preferred Health Network WC |
$29,822.04
|
| Rate for Payer: Prime Health Services Medicare |
$19,319.01
|
| Rate for Payer: Prime Health Services WC |
$28,197.50
|
| 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 368: MAJOR ESOPHAGEAL DISORDERS WITH MCC
|
Facility
IP
|
$43,478.99
|
|
|
Service Code
|
MS-DRG 368
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$43,478.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,478.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,823.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,632.96
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,957.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,356.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,226.82
|
| Rate for Payer: IEHP Medicare Advantage |
$23,226.82
|
| Rate for Payer: Innovage PACE Commercial |
$34,840.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,226.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,123.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,123.94
|
| Rate for Payer: Multiplan WC |
$36,957.57
|
| Rate for Payer: Preferred Health Network WC |
$37,711.81
|
| Rate for Payer: Prime Health Services Medicare |
$24,620.43
|
| Rate for Payer: Prime Health Services WC |
$35,657.48
|
| 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 369: MAJOR ESOPHAGEAL DISORDERS WITH CC
|
Facility
IP
|
$26,011.07
|
|
|
Service Code
|
MS-DRG 369
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,011.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,011.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,376.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,344.51
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,533.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,274.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,277.26
|
| Rate for Payer: IEHP Medicare Advantage |
$14,277.26
|
| Rate for Payer: Innovage PACE Commercial |
$21,415.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,277.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,131.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,131.53
|
| Rate for Payer: Multiplan WC |
$21,533.66
|
| Rate for Payer: Preferred Health Network WC |
$21,973.12
|
| Rate for Payer: Prime Health Services Medicare |
$15,133.90
|
| Rate for Payer: Prime Health Services WC |
$20,776.15
|
| 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 370: MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$19,573.44
|
|
|
Service Code
|
MS-DRG 370
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,573.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,573.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,728.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,635.10
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,773.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,821.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,978.99
|
| Rate for Payer: IEHP Medicare Advantage |
$10,978.99
|
| Rate for Payer: Innovage PACE Commercial |
$16,468.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,978.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,711.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,711.85
|
| Rate for Payer: Multiplan WC |
$15,773.65
|
| Rate for Payer: Preferred Health Network WC |
$16,095.56
|
| Rate for Payer: Prime Health Services Medicare |
$11,637.73
|
| Rate for Payer: Prime Health Services WC |
$15,218.77
|
| 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 371: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC
|
Facility
IP
|
$45,997.72
|
|
|
Service Code
|
MS-DRG 371
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,997.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,997.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,762.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,329.86
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,642.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,098.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,517.29
|
| Rate for Payer: IEHP Medicare Advantage |
$24,517.29
|
| Rate for Payer: Innovage PACE Commercial |
$36,775.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,517.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,853.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,853.17
|
| Rate for Payer: Multiplan WC |
$35,642.93
|
| Rate for Payer: Preferred Health Network WC |
$36,370.34
|
| Rate for Payer: Prime Health Services Medicare |
$25,988.33
|
| Rate for Payer: Prime Health Services WC |
$34,389.08
|
| 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 372: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC
|
Facility
IP
|
$27,432.29
|
|
|
Service Code
|
MS-DRG 372
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,432.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,432.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,307.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,258.89
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,447.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,257.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,005.42
|
| Rate for Payer: IEHP Medicare Advantage |
$15,005.42
|
| Rate for Payer: Innovage PACE Commercial |
$22,508.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,005.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,107.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,107.26
|
| Rate for Payer: Multiplan WC |
$21,447.28
|
| Rate for Payer: Preferred Health Network WC |
$21,884.98
|
| Rate for Payer: Prime Health Services Medicare |
$15,905.75
|
| Rate for Payer: Prime Health Services WC |
$20,692.81
|
| 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 373: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC
|
Facility
IP
|
$18,857.56
|
|
|
Service Code
|
MS-DRG 373
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,857.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,857.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,342.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,161.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,295.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,326.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,612.21
|
| Rate for Payer: IEHP Medicare Advantage |
$10,612.21
|
| Rate for Payer: Innovage PACE Commercial |
$15,918.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,612.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,220.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,220.36
|
| Rate for Payer: Multiplan WC |
$15,295.41
|
| Rate for Payer: Preferred Health Network WC |
$15,607.56
|
| Rate for Payer: Prime Health Services Medicare |
$11,248.94
|
| Rate for Payer: Prime Health Services WC |
$14,757.35
|
| 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 374: DIGESTIVE MALIGNANCY WITH MCC
|
Facility
IP
|
$55,243.58
|
|
|
Service Code
|
MS-DRG 374
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,243.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,243.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,888.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,626.08
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,994.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,493.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,254.33
|
| Rate for Payer: IEHP Medicare Advantage |
$29,254.33
|
| Rate for Payer: Innovage PACE Commercial |
$43,881.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,254.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,200.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,200.80
|
| Rate for Payer: Multiplan WC |
$41,994.95
|
| Rate for Payer: Preferred Health Network WC |
$42,851.99
|
| Rate for Payer: Prime Health Services Medicare |
$31,009.59
|
| Rate for Payer: Prime Health Services WC |
$40,517.65
|
| 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 375: DIGESTIVE MALIGNANCY WITH CC
|
Facility
IP
|
$31,538.06
|
|
|
Service Code
|
MS-DRG 375
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,538.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,538.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,479.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,155.66
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,378.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,097.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,108.98
|
| Rate for Payer: IEHP Medicare Advantage |
$17,108.98
|
| Rate for Payer: Innovage PACE Commercial |
$25,663.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,108.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,926.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,926.03
|
| Rate for Payer: Multiplan WC |
$25,378.58
|
| Rate for Payer: Preferred Health Network WC |
$25,896.51
|
| Rate for Payer: Prime Health Services Medicare |
$18,135.52
|
| Rate for Payer: Prime Health Services WC |
$24,485.81
|
| 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 376: DIGESTIVE MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$23,460.76
|
|
|
Service Code
|
MS-DRG 376
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,460.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,460.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,923.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,331.10
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,493.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,510.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,970.63
|
| Rate for Payer: IEHP Medicare Advantage |
$12,970.63
|
| Rate for Payer: Innovage PACE Commercial |
$19,455.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,970.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,380.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,380.64
|
| Rate for Payer: Multiplan WC |
$18,493.53
|
| Rate for Payer: Preferred Health Network WC |
$18,870.95
|
| Rate for Payer: Prime Health Services Medicare |
$13,748.87
|
| Rate for Payer: Prime Health Services WC |
$17,842.98
|
| 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 377: GASTROINTESTINAL HEMORRHAGE WITH MCC
|
Facility
IP
|
$47,118.91
|
|
|
Service Code
|
MS-DRG 377
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,118.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,118.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,227.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,129.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,459.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,873.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,091.70
|
| Rate for Payer: IEHP Medicare Advantage |
$25,091.70
|
| Rate for Payer: Innovage PACE Commercial |
$37,637.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,091.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,622.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,622.88
|
| Rate for Payer: Multiplan WC |
$37,459.00
|
| Rate for Payer: Preferred Health Network WC |
$38,223.47
|
| Rate for Payer: Prime Health Services Medicare |
$26,597.20
|
| Rate for Payer: Prime Health Services WC |
$36,141.27
|
| 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 378: GASTROINTESTINAL HEMORRHAGE WITH CC
|
Facility
IP
|
$25,892.63
|
|
|
Service Code
|
MS-DRG 378
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$25,892.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,892.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,745.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,569.76
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,752.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,192.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,216.59
|
| Rate for Payer: IEHP Medicare Advantage |
$14,216.59
|
| Rate for Payer: Innovage PACE Commercial |
$21,324.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,216.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,050.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,050.23
|
| Rate for Payer: Multiplan WC |
$20,752.03
|
| Rate for Payer: Preferred Health Network WC |
$21,175.54
|
| Rate for Payer: Prime Health Services Medicare |
$15,069.59
|
| Rate for Payer: Prime Health Services WC |
$20,022.01
|
| 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
|
|
|
INPATIENT MS-DRG 379: GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC
|
Facility
IP
|
$16,665.19
|
|
|
Service Code
|
MS-DRG 379
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$16,665.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,665.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,775.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,235.65
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,352.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,810.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,488.99
|
| Rate for Payer: IEHP Medicare Advantage |
$9,488.99
|
| Rate for Payer: Innovage PACE Commercial |
$14,233.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,488.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,715.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,715.25
|
| Rate for Payer: Multiplan WC |
$13,352.93
|
| Rate for Payer: Preferred Health Network WC |
$13,625.44
|
| Rate for Payer: Prime Health Services Medicare |
$10,058.33
|
| Rate for Payer: Prime Health Services WC |
$12,883.20
|
| 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 380: COMPLICATED PEPTIC ULCER WITH MCC
|
Facility
IP
|
$51,282.57
|
|
|
Service Code
|
MS-DRG 380
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$51,282.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,282.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,371.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,763.32
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,115.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,753.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,224.93
|
| Rate for Payer: IEHP Medicare Advantage |
$27,224.93
|
| Rate for Payer: Innovage PACE Commercial |
$40,837.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,224.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,481.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,481.41
|
| Rate for Payer: Multiplan WC |
$40,115.67
|
| Rate for Payer: Preferred Health Network WC |
$40,934.36
|
| Rate for Payer: Prime Health Services Medicare |
$28,858.43
|
| Rate for Payer: Prime Health Services WC |
$38,704.49
|
| 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 381: COMPLICATED PEPTIC ULCER WITH CC
|
Facility
IP
|
$28,240.29
|
|
|
Service Code
|
MS-DRG 381
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,240.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,240.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,944.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,042.01
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,237.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,816.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,419.40
|
| Rate for Payer: IEHP Medicare Advantage |
$15,419.40
|
| Rate for Payer: Innovage PACE Commercial |
$23,129.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,419.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,662.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,662.00
|
| Rate for Payer: Multiplan WC |
$22,237.33
|
| Rate for Payer: Preferred Health Network WC |
$22,691.15
|
| Rate for Payer: Prime Health Services Medicare |
$16,344.56
|
| Rate for Payer: Prime Health Services WC |
$21,455.06
|
| 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 382: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC
|
Facility
IP
|
$19,926.11
|
|
|
Service Code
|
MS-DRG 382
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,926.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,926.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,087.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,075.73
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,218.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,065.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,159.68
|
| Rate for Payer: IEHP Medicare Advantage |
$11,159.68
|
| Rate for Payer: Innovage PACE Commercial |
$16,739.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,159.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,953.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,953.97
|
| Rate for Payer: Multiplan WC |
$16,218.19
|
| Rate for Payer: Preferred Health Network WC |
$16,549.17
|
| Rate for Payer: Prime Health Services Medicare |
$11,829.26
|
| Rate for Payer: Prime Health Services WC |
$15,647.66
|
| 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 383: UNCOMPLICATED PEPTIC ULCER WITH MCC
|
Facility
IP
|
$36,799.23
|
|
|
Service Code
|
MS-DRG 383
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,799.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,799.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,121.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,400.88
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,652.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,736.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,804.50
|
| Rate for Payer: IEHP Medicare Advantage |
$19,804.50
|
| Rate for Payer: Innovage PACE Commercial |
$29,706.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,804.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,538.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,538.03
|
| Rate for Payer: Multiplan WC |
$28,652.55
|
| Rate for Payer: Preferred Health Network WC |
$29,237.30
|
| Rate for Payer: Prime Health Services Medicare |
$20,992.77
|
| Rate for Payer: Prime Health Services WC |
$27,644.61
|
| 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
|
|
|
INPATIENT MS-DRG 384: UNCOMPLICATED PEPTIC ULCER WITHOUT MCC
|
Facility
IP
|
$23,047.55
|
|
|
Service Code
|
MS-DRG 384
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,047.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,047.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,328.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,828.11
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,994.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,224.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,758.93
|
| Rate for Payer: IEHP Medicare Advantage |
$12,758.93
|
| Rate for Payer: Innovage PACE Commercial |
$19,138.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,758.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,096.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,096.97
|
| Rate for Payer: Multiplan WC |
$18,994.96
|
| Rate for Payer: Preferred Health Network WC |
$19,382.61
|
| Rate for Payer: Prime Health Services Medicare |
$13,524.47
|
| Rate for Payer: Prime Health Services WC |
$18,326.75
|
| 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 385: INFLAMMATORY BOWEL DISEASE WITH MCC
|
Facility
IP
|
$41,239.24
|
|
|
Service Code
|
MS-DRG 385
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$41,239.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,239.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,689.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,012.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,313.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,807.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,079.29
|
| Rate for Payer: IEHP Medicare Advantage |
$22,079.29
|
| Rate for Payer: Innovage PACE Commercial |
$33,118.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,079.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,586.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,586.25
|
| Rate for Payer: Multiplan WC |
$34,313.53
|
| Rate for Payer: Preferred Health Network WC |
$35,013.81
|
| Rate for Payer: Prime Health Services Medicare |
$23,404.05
|
| Rate for Payer: Prime Health Services WC |
$33,106.46
|
| 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 386: INFLAMMATORY BOWEL DISEASE WITH CC
|
Facility
IP
|
$25,571.54
|
|
|
Service Code
|
MS-DRG 386
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$25,571.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,571.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,827.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,669.99
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,853.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,970.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,052.08
|
| Rate for Payer: IEHP Medicare Advantage |
$14,052.08
|
| Rate for Payer: Innovage PACE Commercial |
$21,078.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,052.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,829.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,829.79
|
| Rate for Payer: Multiplan WC |
$20,853.16
|
| Rate for Payer: Preferred Health Network WC |
$21,278.73
|
| Rate for Payer: Prime Health Services Medicare |
$14,895.20
|
| Rate for Payer: Prime Health Services WC |
$20,119.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 387: INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC
|
Facility
IP
|
$18,004.83
|
|
|
Service Code
|
MS-DRG 387
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,004.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,004.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,757.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,442.68
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,570.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,736.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,175.33
|
| Rate for Payer: IEHP Medicare Advantage |
$10,175.33
|
| Rate for Payer: Innovage PACE Commercial |
$15,263.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,175.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,634.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,634.94
|
| Rate for Payer: Multiplan WC |
$14,570.67
|
| Rate for Payer: Preferred Health Network WC |
$14,868.03
|
| Rate for Payer: Prime Health Services Medicare |
$10,785.85
|
| Rate for Payer: Prime Health Services WC |
$14,058.09
|
| 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 388: GASTROINTESTINAL OBSTRUCTION WITH MCC
|
Facility
IP
|
$38,254.67
|
|
|
Service Code
|
MS-DRG 388
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$38,254.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,254.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,947.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,643.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,915.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,742.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,550.19
|
| Rate for Payer: IEHP Medicare Advantage |
$20,550.19
|
| Rate for Payer: Innovage PACE Commercial |
$30,825.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,550.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,537.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,537.25
|
| Rate for Payer: Multiplan WC |
$30,915.26
|
| Rate for Payer: Preferred Health Network WC |
$31,546.18
|
| Rate for Payer: Prime Health Services Medicare |
$21,783.20
|
| Rate for Payer: Prime Health Services WC |
$29,827.72
|
| 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 389: GASTROINTESTINAL OBSTRUCTION WITH CC
|
Facility
IP
|
$20,960.45
|
|
|
Service Code
|
MS-DRG 389
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,960.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,960.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,721.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,854.67
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,004.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,781.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,689.63
|
| Rate for Payer: IEHP Medicare Advantage |
$11,689.63
|
| Rate for Payer: Innovage PACE Commercial |
$17,534.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,689.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,664.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,664.10
|
| Rate for Payer: Multiplan WC |
$17,004.03
|
| Rate for Payer: Preferred Health Network WC |
$17,351.05
|
| Rate for Payer: Prime Health Services Medicare |
$12,391.01
|
| Rate for Payer: Prime Health Services WC |
$16,405.86
|
| 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
|
|
