|
INPATIENT MS-DRG 390: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC
|
Facility
IP
|
$14,712.32
|
|
|
Service Code
|
MS-DRG 390
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$14,712.32 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,712.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,614.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,809.34
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,913.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,459.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,488.44
|
| Rate for Payer: IEHP Medicare Advantage |
$8,488.44
|
| Rate for Payer: Innovage PACE Commercial |
$12,732.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,488.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,374.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,374.51
|
| Rate for Payer: Multiplan WC |
$11,913.99
|
| Rate for Payer: Preferred Health Network WC |
$12,157.13
|
| Rate for Payer: Prime Health Services Medicare |
$8,997.75
|
| Rate for Payer: Prime Health Services WC |
$11,494.88
|
| 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 391: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC
|
Facility
IP
|
$33,575.15
|
|
|
Service Code
|
MS-DRG 391
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$33,575.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,575.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,829.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,813.77
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,051.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,506.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,152.67
|
| Rate for Payer: IEHP Medicare Advantage |
$18,152.67
|
| Rate for Payer: Innovage PACE Commercial |
$27,229.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,152.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,324.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,324.58
|
| Rate for Payer: Multiplan WC |
$27,051.38
|
| Rate for Payer: Preferred Health Network WC |
$27,603.45
|
| Rate for Payer: Prime Health Services Medicare |
$19,241.83
|
| Rate for Payer: Prime Health Services WC |
$26,099.76
|
| 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 392: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC
|
Facility
IP
|
$20,676.21
|
|
|
Service Code
|
MS-DRG 392
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,676.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,676.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,389.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,447.45
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,593.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,584.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,544.00
|
| Rate for Payer: IEHP Medicare Advantage |
$11,544.00
|
| Rate for Payer: Innovage PACE Commercial |
$17,316.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,544.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,468.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,468.96
|
| Rate for Payer: Multiplan WC |
$16,593.19
|
| Rate for Payer: Preferred Health Network WC |
$16,931.83
|
| Rate for Payer: Prime Health Services Medicare |
$12,236.64
|
| Rate for Payer: Prime Health Services WC |
$16,009.48
|
| 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 393: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC
|
Facility
IP
|
$42,626.25
|
|
|
Service Code
|
MS-DRG 393
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,626.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,626.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,393.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,648.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,946.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,766.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,789.93
|
| Rate for Payer: IEHP Medicare Advantage |
$22,789.93
|
| Rate for Payer: Innovage PACE Commercial |
$34,184.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,789.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,538.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,538.51
|
| Rate for Payer: Multiplan WC |
$33,946.96
|
| Rate for Payer: Preferred Health Network WC |
$34,639.75
|
| Rate for Payer: Prime Health Services Medicare |
$24,157.33
|
| Rate for Payer: Prime Health Services WC |
$32,752.77
|
| 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 394: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC
|
Facility
IP
|
$24,658.27
|
|
|
Service Code
|
MS-DRG 394
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$24,658.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,658.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,031.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,692.67
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,867.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,338.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,584.17
|
| Rate for Payer: IEHP Medicare Advantage |
$13,584.17
|
| Rate for Payer: Innovage PACE Commercial |
$20,376.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,584.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,202.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,202.79
|
| Rate for Payer: Multiplan WC |
$19,867.18
|
| Rate for Payer: Preferred Health Network WC |
$20,272.63
|
| Rate for Payer: Prime Health Services Medicare |
$14,399.22
|
| Rate for Payer: Prime Health Services WC |
$19,168.29
|
| 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 395: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
IP
|
$17,041.55
|
|
|
Service Code
|
MS-DRG 395
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$17,041.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,041.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,963.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,467.45
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,586.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,070.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,681.80
|
| Rate for Payer: IEHP Medicare Advantage |
$9,681.80
|
| Rate for Payer: Innovage PACE Commercial |
$14,522.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,681.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,973.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,973.61
|
| Rate for Payer: Multiplan WC |
$13,586.79
|
| Rate for Payer: Preferred Health Network WC |
$13,864.07
|
| Rate for Payer: Prime Health Services Medicare |
$10,262.71
|
| Rate for Payer: Prime Health Services WC |
$13,108.83
|
| 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 397: APPENDIX PROCEDURES WITH MCC
|
Facility
IP
|
$59,128.27
|
|
|
Service Code
|
MS-DRG 397
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$59,128.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,128.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,180.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$31,244.61
|
| Rate for Payer: IEHP Medicare Advantage |
$31,244.61
|
| Rate for Payer: Innovage PACE Commercial |
$46,866.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,244.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,867.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,867.78
|
| Rate for Payer: Prime Health Services Medicare |
$33,119.29
|
| 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 398: APPENDIX PROCEDURES WITH CC
|
Facility
IP
|
$39,828.54
|
|
|
Service Code
|
MS-DRG 398
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$39,828.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,828.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,831.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,356.54
|
| Rate for Payer: IEHP Medicare Advantage |
$21,356.54
|
| Rate for Payer: Innovage PACE Commercial |
$32,034.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,356.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,617.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,617.76
|
| Rate for Payer: Prime Health Services Medicare |
$22,637.93
|
| 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 399: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$29,295.68
|
|
|
Service Code
|
MS-DRG 399
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$29,295.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,295.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,546.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,960.11
|
| Rate for Payer: IEHP Medicare Advantage |
$15,960.11
|
| Rate for Payer: Innovage PACE Commercial |
$23,940.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,960.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,386.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,386.55
|
| Rate for Payer: Prime Health Services Medicare |
$16,917.72
|
| 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 405: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC
|
Facility
IP
|
$144,891.36
|
|
|
Service Code
|
MS-DRG 405
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$144,891.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$144,891.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94,217.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115,731.50
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$116,757.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$101,499.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$75,184.70
|
| Rate for Payer: IEHP Medicare Advantage |
$75,184.70
|
| Rate for Payer: Innovage PACE Commercial |
$112,777.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75,184.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$100,747.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$100,747.50
|
| Rate for Payer: Multiplan WC |
$116,757.03
|
| Rate for Payer: Preferred Health Network WC |
$119,139.83
|
| Rate for Payer: Prime Health Services Medicare |
$79,695.78
|
| Rate for Payer: Prime Health Services WC |
$112,649.76
|
| 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 406: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC
|
Facility
IP
|
$75,993.48
|
|
|
Service Code
|
MS-DRG 406
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$75,993.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$75,993.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49,807.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61,180.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$61,723.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,845.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,885.40
|
| Rate for Payer: IEHP Medicare Advantage |
$39,885.40
|
| Rate for Payer: Innovage PACE Commercial |
$59,828.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,885.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,446.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,446.44
|
| Rate for Payer: Multiplan WC |
$61,723.08
|
| Rate for Payer: Preferred Health Network WC |
$62,982.73
|
| Rate for Payer: Prime Health Services Medicare |
$42,278.52
|
| Rate for Payer: Prime Health Services WC |
$59,551.78
|
| 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 407: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$56,612.17
|
|
|
Service Code
|
MS-DRG 407
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$56,612.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,612.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37,839.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46,479.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$46,891.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,439.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,955.51
|
| Rate for Payer: IEHP Medicare Advantage |
$29,955.51
|
| Rate for Payer: Innovage PACE Commercial |
$44,933.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,955.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,140.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,140.38
|
| Rate for Payer: Multiplan WC |
$46,891.17
|
| Rate for Payer: Preferred Health Network WC |
$47,848.13
|
| Rate for Payer: Prime Health Services Medicare |
$31,752.84
|
| Rate for Payer: Prime Health Services WC |
$45,241.62
|
| 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 408: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC
|
Facility
IP
|
$97,964.58
|
|
|
Service Code
|
MS-DRG 408
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$97,964.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97,964.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62,385.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76,630.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$77,309.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,041.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,142.10
|
| Rate for Payer: IEHP Medicare Advantage |
$51,142.10
|
| Rate for Payer: Innovage PACE Commercial |
$76,713.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,142.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,530.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,530.41
|
| Rate for Payer: Multiplan WC |
$77,309.22
|
| Rate for Payer: Preferred Health Network WC |
$78,886.96
|
| Rate for Payer: Prime Health Services Medicare |
$54,210.63
|
| Rate for Payer: Prime Health Services WC |
$74,589.63
|
| 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 409: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC
|
Facility
IP
|
$51,514.18
|
|
|
Service Code
|
MS-DRG 409
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,514.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,514.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,235.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,510.03
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$44,904.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,913.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,343.59
|
| Rate for Payer: IEHP Medicare Advantage |
$27,343.59
|
| Rate for Payer: Innovage PACE Commercial |
$41,015.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,343.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,640.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,640.41
|
| Rate for Payer: Multiplan WC |
$44,904.44
|
| Rate for Payer: Preferred Health Network WC |
$45,820.86
|
| Rate for Payer: Prime Health Services Medicare |
$28,984.21
|
| Rate for Payer: Prime Health Services WC |
$43,324.80
|
| 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 410: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
IP
|
$41,194.50
|
|
|
Service Code
|
MS-DRG 410
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$41,194.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,194.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,862.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,453.07
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,767.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,776.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,056.38
|
| Rate for Payer: IEHP Medicare Advantage |
$22,056.38
|
| Rate for Payer: Innovage PACE Commercial |
$33,084.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,056.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,555.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,555.55
|
| Rate for Payer: Multiplan WC |
$35,767.23
|
| Rate for Payer: Preferred Health Network WC |
$36,497.17
|
| Rate for Payer: Prime Health Services Medicare |
$23,379.76
|
| Rate for Payer: Prime Health Services WC |
$34,509.01
|
| 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 411: CHOLECYSTECTOMY WITH C.D.E. WITH MCC
|
Facility
IP
|
$75,811.88
|
|
|
Service Code
|
MS-DRG 411
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$75,811.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$75,811.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57,432.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70,546.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$71,172.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,630.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,948.49
|
| Rate for Payer: IEHP Medicare Advantage |
$41,948.49
|
| Rate for Payer: Innovage PACE Commercial |
$62,922.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,948.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,210.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,210.98
|
| Rate for Payer: Multiplan WC |
$71,172.09
|
| Rate for Payer: Preferred Health Network WC |
$72,624.58
|
| Rate for Payer: Prime Health Services Medicare |
$44,465.40
|
| Rate for Payer: Prime Health Services WC |
$68,668.40
|
| 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 412: CHOLECYSTECTOMY WITH C.D.E. WITH CC
|
Facility
IP
|
$53,835.51
|
|
|
Service Code
|
MS-DRG 412
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$53,835.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,835.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39,029.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,941.10
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$48,365.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,894.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,810.68
|
| Rate for Payer: IEHP Medicare Advantage |
$28,810.68
|
| Rate for Payer: Innovage PACE Commercial |
$43,216.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,810.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,606.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,606.31
|
| Rate for Payer: Multiplan WC |
$48,365.93
|
| Rate for Payer: Preferred Health Network WC |
$49,352.99
|
| Rate for Payer: Prime Health Services Medicare |
$30,539.32
|
| Rate for Payer: Prime Health Services WC |
$46,664.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 413: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC
|
Facility
IP
|
$39,731.16
|
|
|
Service Code
|
MS-DRG 413
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$39,731.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,731.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,548.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,838.81
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,138.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,763.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,306.66
|
| Rate for Payer: IEHP Medicare Advantage |
$21,306.66
|
| Rate for Payer: Innovage PACE Commercial |
$31,959.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,306.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,550.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,550.92
|
| Rate for Payer: Multiplan WC |
$34,138.67
|
| Rate for Payer: Preferred Health Network WC |
$34,835.38
|
| Rate for Payer: Prime Health Services Medicare |
$22,585.06
|
| Rate for Payer: Prime Health Services WC |
$32,937.74
|
| 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 414: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC
|
Facility
IP
|
$92,779.74
|
|
|
Service Code
|
MS-DRG 414
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$92,779.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92,779.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60,093.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73,815.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$74,469.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,455.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$48,485.70
|
| Rate for Payer: IEHP Medicare Advantage |
$48,485.70
|
| Rate for Payer: Innovage PACE Commercial |
$72,728.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,485.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,970.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,970.84
|
| Rate for Payer: Multiplan WC |
$74,469.24
|
| Rate for Payer: Preferred Health Network WC |
$75,989.02
|
| Rate for Payer: Prime Health Services Medicare |
$51,394.84
|
| Rate for Payer: Prime Health Services WC |
$71,849.57
|
| 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 415: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
IP
|
$52,001.08
|
|
|
Service Code
|
MS-DRG 415
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,001.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,001.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,002.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,766.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,136.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,250.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,593.05
|
| Rate for Payer: IEHP Medicare Advantage |
$27,593.05
|
| Rate for Payer: Innovage PACE Commercial |
$41,389.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,593.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,974.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,974.69
|
| Rate for Payer: Multiplan WC |
$42,136.10
|
| Rate for Payer: Preferred Health Network WC |
$42,996.02
|
| Rate for Payer: Prime Health Services Medicare |
$29,248.63
|
| Rate for Payer: Prime Health Services WC |
$40,653.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 416: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
IP
|
$35,246.40
|
|
|
Service Code
|
MS-DRG 416
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,246.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,246.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,400.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,743.36
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,998.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,662.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,008.92
|
| Rate for Payer: IEHP Medicare Advantage |
$19,008.92
|
| Rate for Payer: Innovage PACE Commercial |
$28,513.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,008.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,471.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,471.95
|
| Rate for Payer: Multiplan WC |
$28,998.06
|
| Rate for Payer: Preferred Health Network WC |
$29,589.86
|
| Rate for Payer: Prime Health Services Medicare |
$20,149.46
|
| Rate for Payer: Prime Health Services WC |
$27,977.97
|
| 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 417: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC
|
Facility
IP
|
$61,002.18
|
|
|
Service Code
|
MS-DRG 417
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$61,002.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61,002.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40,423.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49,653.51
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$50,093.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,476.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$32,204.70
|
| Rate for Payer: IEHP Medicare Advantage |
$32,204.70
|
| Rate for Payer: Innovage PACE Commercial |
$48,307.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,204.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,154.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,154.30
|
| Rate for Payer: Multiplan WC |
$50,093.50
|
| Rate for Payer: Preferred Health Network WC |
$51,115.82
|
| Rate for Payer: Prime Health Services Medicare |
$34,136.98
|
| Rate for Payer: Prime Health Services WC |
$48,331.32
|
| 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 418: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC
|
Facility
IP
|
$43,023.67
|
|
|
Service Code
|
MS-DRG 418
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$43,023.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,023.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,238.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,686.66
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,994.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,041.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,993.57
|
| Rate for Payer: IEHP Medicare Advantage |
$22,993.57
|
| Rate for Payer: Innovage PACE Commercial |
$34,490.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,993.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,811.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,811.38
|
| Rate for Payer: Multiplan WC |
$34,994.04
|
| Rate for Payer: Preferred Health Network WC |
$35,708.20
|
| Rate for Payer: Prime Health Services Medicare |
$24,373.18
|
| Rate for Payer: Prime Health Services WC |
$33,763.01
|
| 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 419: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
IP
|
$34,562.11
|
|
|
Service Code
|
MS-DRG 419
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$34,562.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,562.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,186.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,252.32
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,493.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,188.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,658.32
|
| Rate for Payer: IEHP Medicare Advantage |
$18,658.32
|
| Rate for Payer: Innovage PACE Commercial |
$27,987.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,658.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,002.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,002.15
|
| Rate for Payer: Multiplan WC |
$27,493.81
|
| Rate for Payer: Preferred Health Network WC |
$28,054.91
|
| Rate for Payer: Prime Health Services Medicare |
$19,777.82
|
| Rate for Payer: Prime Health Services WC |
$26,526.63
|
| 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 420: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
IP
|
$84,241.86
|
|
|
Service Code
|
MS-DRG 420
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$84,241.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$84,241.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55,443.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68,103.64
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$68,707.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,550.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,111.39
|
| Rate for Payer: IEHP Medicare Advantage |
$44,111.39
|
| Rate for Payer: Innovage PACE Commercial |
$66,167.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,111.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,109.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,109.26
|
| Rate for Payer: Multiplan WC |
$68,707.13
|
| Rate for Payer: Preferred Health Network WC |
$70,109.32
|
| Rate for Payer: Prime Health Services Medicare |
$46,758.07
|
| Rate for Payer: Prime Health Services WC |
$66,290.15
|
| 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
|
|
