INPATIENT MS-DRG 458: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC
|
Facility
IP
|
$119,251.39
|
|
Service Code
|
MS-DRG 458
|
Min. Negotiated Rate |
$29,434.00 |
Max. Negotiated Rate |
$119,251.39 |
Rate for Payer: Aetna of CA HMO/PPO |
$119,251.39
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$81,827.51
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100,511.97
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$101,402.64
|
Rate for Payer: EPIC Health Plan Commercial |
$83,765.12
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$62,048.24
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$29,434.00
|
Rate for Payer: IEHP Medicare Advantage |
$62,048.24
|
Rate for Payer: Innovage PACE Commercial |
$93,072.36
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62,048.24
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$83,144.64
|
Rate for Payer: Molina Healthcare of CA Medicare |
$83,144.64
|
Rate for Payer: Multiplan WC |
$101,402.64
|
Rate for Payer: Preferred Health Network WC |
$103,472.08
|
Rate for Payer: Prime Health Services Medicare |
$65,771.13
|
Rate for Payer: Prime Health Services WC |
$97,835.50
|
Rate for Payer: United Healthcare All Other Commercial |
$77,772.00
|
Rate for Payer: United Healthcare All Other HMO |
$67,663.00
|
Rate for Payer: United Healthcare HMO Rider |
$51,399.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$53,693.00
|
|
INPATIENT MS-DRG 459: SPINAL FUSION EXCEPT CERVICAL WITH MCC
|
Facility
IP
|
$174,555.50
|
|
Service Code
|
MS-DRG 459
|
Min. Negotiated Rate |
$29,434.00 |
Max. Negotiated Rate |
$174,555.50 |
Rate for Payer: Aetna of CA HMO/PPO |
$174,555.50
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$112,767.63
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$138,516.94
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$139,744.38
|
Rate for Payer: EPIC Health Plan Commercial |
$122,016.93
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$90,382.91
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$29,434.00
|
Rate for Payer: IEHP Medicare Advantage |
$90,382.91
|
Rate for Payer: Innovage PACE Commercial |
$135,574.36
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90,382.91
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$121,113.10
|
Rate for Payer: Molina Healthcare of CA Medicare |
$121,113.10
|
Rate for Payer: Multiplan WC |
$139,744.38
|
Rate for Payer: Preferred Health Network WC |
$142,596.31
|
Rate for Payer: Prime Health Services Medicare |
$95,805.88
|
Rate for Payer: Prime Health Services WC |
$134,828.47
|
Rate for Payer: United Healthcare All Other Commercial |
$72,883.00
|
Rate for Payer: United Healthcare All Other HMO |
$65,316.00
|
Rate for Payer: United Healthcare HMO Rider |
$49,615.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$45,367.00
|
|
INPATIENT MS-DRG 460: SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
IP
|
$96,272.27
|
|
Service Code
|
MS-DRG 460
|
Min. Negotiated Rate |
$28,489.00 |
Max. Negotiated Rate |
$96,272.27 |
Rate for Payer: Aetna of CA HMO/PPO |
$96,272.27
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$64,025.77
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78,645.38
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$79,342.28
|
Rate for Payer: EPIC Health Plan Commercial |
$67,871.34
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,275.07
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$29,434.00
|
Rate for Payer: IEHP Medicare Advantage |
$50,275.07
|
Rate for Payer: Innovage PACE Commercial |
$75,412.60
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,275.07
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67,368.59
|
Rate for Payer: Molina Healthcare of CA Medicare |
$67,368.59
|
Rate for Payer: Multiplan WC |
$79,342.28
|
Rate for Payer: Preferred Health Network WC |
$80,961.51
|
Rate for Payer: Prime Health Services Medicare |
$53,291.57
|
Rate for Payer: Prime Health Services WC |
$76,551.18
|
Rate for Payer: United Healthcare All Other Commercial |
$77,654.00
|
Rate for Payer: United Healthcare All Other HMO |
$41,017.00
|
Rate for Payer: United Healthcare HMO Rider |
$31,155.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$28,489.00
|
|
INPATIENT MS-DRG 461: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC
|
Facility
IP
|
$179,456.10
|
|
Service Code
|
MS-DRG 461
|
Min. Negotiated Rate |
$43,041.00 |
Max. Negotiated Rate |
$179,456.10 |
Rate for Payer: Aetna of CA HMO/PPO |
$179,456.10
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$109,064.82
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133,968.62
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$135,155.77
|
Rate for Payer: EPIC Health Plan Commercial |
$125,406.48
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$92,893.69
|
Rate for Payer: IEHP Medicare Advantage |
$92,893.69
|
Rate for Payer: Innovage PACE Commercial |
$139,340.54
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92,893.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$124,477.54
|
Rate for Payer: Molina Healthcare of CA Medicare |
$124,477.54
|
Rate for Payer: Multiplan WC |
$135,155.77
|
Rate for Payer: Preferred Health Network WC |
$137,914.05
|
Rate for Payer: Prime Health Services Medicare |
$98,467.31
|
Rate for Payer: Prime Health Services WC |
$130,401.26
|
Rate for Payer: United Healthcare All Other Commercial |
$61,219.00
|
Rate for Payer: United Healthcare All Other HMO |
$61,965.00
|
Rate for Payer: United Healthcare HMO Rider |
$47,070.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$43,041.00
|
|
INPATIENT MS-DRG 462: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC
|
Facility
IP
|
$74,911.77
|
|
Service Code
|
MS-DRG 462
|
Min. Negotiated Rate |
$34,787.00 |
Max. Negotiated Rate |
$74,911.77 |
Rate for Payer: Aetna of CA HMO/PPO |
$74,911.77
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$50,758.19
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62,348.28
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$62,900.77
|
Rate for Payer: EPIC Health Plan Commercial |
$53,097.09
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$39,331.18
|
Rate for Payer: IEHP Medicare Advantage |
$39,331.18
|
Rate for Payer: Innovage PACE Commercial |
$58,996.77
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,331.18
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52,703.78
|
Rate for Payer: Molina Healthcare of CA Medicare |
$52,703.78
|
Rate for Payer: Multiplan WC |
$62,900.77
|
Rate for Payer: Preferred Health Network WC |
$64,184.46
|
Rate for Payer: Prime Health Services Medicare |
$41,691.05
|
Rate for Payer: Prime Health Services WC |
$60,688.05
|
Rate for Payer: United Healthcare All Other Commercial |
$49,480.00
|
Rate for Payer: United Healthcare All Other HMO |
$50,083.00
|
Rate for Payer: United Healthcare HMO Rider |
$38,042.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$34,787.00
|
|
INPATIENT MS-DRG 463: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
IP
|
$149,062.92
|
|
Service Code
|
MS-DRG 463
|
Min. Negotiated Rate |
$44,466.00 |
Max. Negotiated Rate |
$149,062.92 |
Rate for Payer: Aetna of CA HMO/PPO |
$149,062.92
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$89,112.44
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109,460.33
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$110,430.30
|
Rate for Payer: EPIC Health Plan Commercial |
$104,384.65
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$77,321.96
|
Rate for Payer: IEHP Medicare Advantage |
$77,321.96
|
Rate for Payer: Innovage PACE Commercial |
$115,982.94
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77,321.96
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$103,611.43
|
Rate for Payer: Molina Healthcare of CA Medicare |
$103,611.43
|
Rate for Payer: Multiplan WC |
$110,430.30
|
Rate for Payer: Preferred Health Network WC |
$112,683.98
|
Rate for Payer: Prime Health Services Medicare |
$81,961.28
|
Rate for Payer: Prime Health Services WC |
$106,545.59
|
Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
Rate for Payer: United Healthcare All Other HMO |
$64,022.00
|
Rate for Payer: United Healthcare HMO Rider |
$48,627.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$44,466.00
|
|
INPATIENT MS-DRG 464: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
IP
|
$106,647.00
|
|
Service Code
|
MS-DRG 464
|
Min. Negotiated Rate |
$32,351.00 |
Max. Negotiated Rate |
$106,647.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$78,993.85
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$50,785.39
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62,381.70
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$62,934.48
|
Rate for Payer: EPIC Health Plan Commercial |
$55,920.51
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,422.60
|
Rate for Payer: IEHP Medicare Advantage |
$41,422.60
|
Rate for Payer: Innovage PACE Commercial |
$62,133.90
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,422.60
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,506.28
|
Rate for Payer: Molina Healthcare of CA Medicare |
$55,506.28
|
Rate for Payer: Multiplan WC |
$62,934.48
|
Rate for Payer: Preferred Health Network WC |
$64,218.86
|
Rate for Payer: Prime Health Services Medicare |
$43,907.96
|
Rate for Payer: Prime Health Services WC |
$60,720.57
|
Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
Rate for Payer: United Healthcare All Other HMO |
$46,576.00
|
Rate for Payer: United Healthcare HMO Rider |
$35,378.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$32,351.00
|
|
INPATIENT MS-DRG 465: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$106,647.00
|
|
Service Code
|
MS-DRG 465
|
Min. Negotiated Rate |
$26,177.19 |
Max. Negotiated Rate |
$106,647.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$49,237.59
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,877.89
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,613.55
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,982.31
|
Rate for Payer: EPIC Health Plan Commercial |
$35,339.21
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,177.19
|
Rate for Payer: IEHP Medicare Advantage |
$26,177.19
|
Rate for Payer: Innovage PACE Commercial |
$39,265.78
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,177.19
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,077.43
|
Rate for Payer: Molina Healthcare of CA Medicare |
$35,077.43
|
Rate for Payer: Multiplan WC |
$41,982.31
|
Rate for Payer: Preferred Health Network WC |
$42,839.09
|
Rate for Payer: Prime Health Services Medicare |
$27,747.82
|
Rate for Payer: Prime Health Services WC |
$40,505.45
|
Rate for Payer: United Healthcare All Other Commercial |
$106,647.00
|
Rate for Payer: United Healthcare All Other HMO |
$37,843.00
|
Rate for Payer: United Healthcare HMO Rider |
$28,743.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$26,283.00
|
|
INPATIENT MS-DRG 466: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
|
Facility
IP
|
$136,506.13
|
|
Service Code
|
MS-DRG 466
|
Min. Negotiated Rate |
$37,472.00 |
Max. Negotiated Rate |
$136,506.13 |
Rate for Payer: Aetna of CA HMO/PPO |
$136,506.13
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$89,171.95
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109,533.42
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$110,504.04
|
Rate for Payer: EPIC Health Plan Commercial |
$95,699.58
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$70,888.58
|
Rate for Payer: IEHP Medicare Advantage |
$70,888.58
|
Rate for Payer: Innovage PACE Commercial |
$106,332.87
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$70,888.58
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$94,990.70
|
Rate for Payer: Molina Healthcare of CA Medicare |
$94,990.70
|
Rate for Payer: Multiplan WC |
$110,504.04
|
Rate for Payer: Preferred Health Network WC |
$112,759.22
|
Rate for Payer: Prime Health Services Medicare |
$75,141.89
|
Rate for Payer: Prime Health Services WC |
$106,616.73
|
Rate for Payer: United Healthcare All Other Commercial |
$37,472.00
|
Rate for Payer: United Healthcare All Other HMO |
$41,372.00
|
Rate for Payer: United Healthcare HMO Rider |
$43,467.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$39,746.00
|
|
INPATIENT MS-DRG 467: REVISION OF HIP OR KNEE REPLACEMENT WITH CC
|
Facility
IP
|
$91,755.93
|
|
Service Code
|
MS-DRG 467
|
Min. Negotiated Rate |
$30,893.00 |
Max. Negotiated Rate |
$91,755.93 |
Rate for Payer: Aetna of CA HMO/PPO |
$91,755.93
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$61,643.93
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75,719.67
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$76,390.65
|
Rate for Payer: EPIC Health Plan Commercial |
$64,747.57
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,961.16
|
Rate for Payer: IEHP Medicare Advantage |
$47,961.16
|
Rate for Payer: Innovage PACE Commercial |
$71,941.74
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,961.16
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,267.95
|
Rate for Payer: Molina Healthcare of CA Medicare |
$64,267.95
|
Rate for Payer: Multiplan WC |
$76,390.65
|
Rate for Payer: Preferred Health Network WC |
$77,949.64
|
Rate for Payer: Prime Health Services Medicare |
$50,838.83
|
Rate for Payer: Prime Health Services WC |
$73,703.38
|
Rate for Payer: United Healthcare All Other Commercial |
$34,616.00
|
Rate for Payer: United Healthcare All Other HMO |
$32,162.00
|
Rate for Payer: United Healthcare HMO Rider |
$33,785.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$30,893.00
|
|
INPATIENT MS-DRG 468: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
|
Facility
IP
|
$70,261.20
|
|
Service Code
|
MS-DRG 468
|
Min. Negotiated Rate |
$27,553.00 |
Max. Negotiated Rate |
$70,261.20 |
Rate for Payer: Aetna of CA HMO/PPO |
$70,261.20
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$47,420.89
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58,248.95
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$58,765.11
|
Rate for Payer: EPIC Health Plan Commercial |
$49,880.46
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,948.49
|
Rate for Payer: IEHP Medicare Advantage |
$36,948.49
|
Rate for Payer: Innovage PACE Commercial |
$55,422.74
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,948.49
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,510.98
|
Rate for Payer: Molina Healthcare of CA Medicare |
$49,510.98
|
Rate for Payer: Multiplan WC |
$58,765.11
|
Rate for Payer: Preferred Health Network WC |
$59,964.40
|
Rate for Payer: Prime Health Services Medicare |
$39,165.40
|
Rate for Payer: Prime Health Services WC |
$56,697.88
|
Rate for Payer: United Healthcare All Other Commercial |
$37,472.00
|
Rate for Payer: United Healthcare All Other HMO |
$28,682.00
|
Rate for Payer: United Healthcare HMO Rider |
$30,132.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$27,553.00
|
|
INPATIENT MS-DRG 469: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
IP
|
$87,637.01
|
|
Service Code
|
MS-DRG 469
|
Min. Negotiated Rate |
$23,506.00 |
Max. Negotiated Rate |
$87,637.01 |
Rate for Payer: Aetna of CA HMO/PPO |
$87,637.01
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$54,937.03
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67,481.33
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$68,079.31
|
Rate for Payer: EPIC Health Plan Commercial |
$61,898.65
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$45,850.85
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$23,506.00
|
Rate for Payer: IEHP Medicare Advantage |
$45,850.85
|
Rate for Payer: Innovage PACE Commercial |
$68,776.28
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,850.85
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61,440.14
|
Rate for Payer: Molina Healthcare of CA Medicare |
$61,440.14
|
Rate for Payer: Multiplan WC |
$68,079.31
|
Rate for Payer: Preferred Health Network WC |
$69,468.68
|
Rate for Payer: Prime Health Services Medicare |
$48,601.90
|
Rate for Payer: Prime Health Services WC |
$65,684.41
|
Rate for Payer: United Healthcare All Other Commercial |
$39,776.00
|
Rate for Payer: United Healthcare All Other HMO |
$36,955.00
|
Rate for Payer: United Healthcare HMO Rider |
$32,727.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$29,927.00
|
|
INPATIENT MS-DRG 470: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
IP
|
$50,959.00
|
|
Service Code
|
MS-DRG 470
|
Min. Negotiated Rate |
$22,307.00 |
Max. Negotiated Rate |
$50,959.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$49,524.46
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,504.21
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,926.21
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,280.01
|
Rate for Payer: EPIC Health Plan Commercial |
$35,537.63
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,324.17
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$23,506.00
|
Rate for Payer: IEHP Medicare Advantage |
$26,324.17
|
Rate for Payer: Innovage PACE Commercial |
$39,486.26
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,324.17
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,274.39
|
Rate for Payer: Molina Healthcare of CA Medicare |
$35,274.39
|
Rate for Payer: Multiplan WC |
$40,280.01
|
Rate for Payer: Preferred Health Network WC |
$41,102.05
|
Rate for Payer: Prime Health Services Medicare |
$27,903.62
|
Rate for Payer: Prime Health Services WC |
$38,863.04
|
Rate for Payer: United Healthcare All Other Commercial |
$50,959.00
|
Rate for Payer: United Healthcare All Other HMO |
$32,115.00
|
Rate for Payer: United Healthcare HMO Rider |
$24,395.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$22,307.00
|
|
INPATIENT MS-DRG 471: CERVICAL SPINAL FUSION WITH MCC
|
Facility
IP
|
$129,463.16
|
|
Service Code
|
MS-DRG 471
|
Min. Negotiated Rate |
$24,564.00 |
Max. Negotiated Rate |
$129,463.16 |
Rate for Payer: Aetna of CA HMO/PPO |
$129,463.16
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$85,634.04
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105,187.67
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$106,119.78
|
Rate for Payer: EPIC Health Plan Commercial |
$90,828.26
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$67,280.19
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,564.00
|
Rate for Payer: IEHP Medicare Advantage |
$67,280.19
|
Rate for Payer: Innovage PACE Commercial |
$100,920.28
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,280.19
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90,155.45
|
Rate for Payer: Molina Healthcare of CA Medicare |
$90,155.45
|
Rate for Payer: Multiplan WC |
$106,119.78
|
Rate for Payer: Preferred Health Network WC |
$108,285.49
|
Rate for Payer: Prime Health Services Medicare |
$71,317.00
|
Rate for Payer: Prime Health Services WC |
$102,386.70
|
Rate for Payer: United Healthcare All Other Commercial |
$39,970.00
|
Rate for Payer: United Healthcare All Other HMO |
$37,136.00
|
Rate for Payer: United Healthcare HMO Rider |
$32,944.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$30,125.00
|
|
INPATIENT MS-DRG 472: CERVICAL SPINAL FUSION WITH CC
|
Facility
IP
|
$77,783.17
|
|
Service Code
|
MS-DRG 472
|
Min. Negotiated Rate |
$21,530.00 |
Max. Negotiated Rate |
$77,783.17 |
Rate for Payer: Aetna of CA HMO/PPO |
$77,783.17
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$52,210.07
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64,131.69
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,699.98
|
Rate for Payer: EPIC Health Plan Commercial |
$55,083.13
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,802.32
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,564.00
|
Rate for Payer: IEHP Medicare Advantage |
$40,802.32
|
Rate for Payer: Innovage PACE Commercial |
$61,203.48
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,802.32
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,675.11
|
Rate for Payer: Molina Healthcare of CA Medicare |
$54,675.11
|
Rate for Payer: Multiplan WC |
$64,699.98
|
Rate for Payer: Preferred Health Network WC |
$66,020.39
|
Rate for Payer: Prime Health Services Medicare |
$43,250.46
|
Rate for Payer: Prime Health Services WC |
$62,423.97
|
Rate for Payer: United Healthcare All Other Commercial |
$28,568.00
|
Rate for Payer: United Healthcare All Other HMO |
$40,108.00
|
Rate for Payer: United Healthcare HMO Rider |
$23,544.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$21,530.00
|
|
INPATIENT MS-DRG 473: CERVICAL SPINAL FUSION WITHOUT CC/MCC
|
Facility
IP
|
$64,760.53
|
|
Service Code
|
MS-DRG 473
|
Min. Negotiated Rate |
$21,828.00 |
Max. Negotiated Rate |
$64,760.53 |
Rate for Payer: Aetna of CA HMO/PPO |
$64,760.53
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$43,099.24
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52,940.49
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$53,409.62
|
Rate for Payer: EPIC Health Plan Commercial |
$46,075.86
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,130.27
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,564.00
|
Rate for Payer: IEHP Medicare Advantage |
$34,130.27
|
Rate for Payer: Innovage PACE Commercial |
$51,195.40
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,130.27
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,734.56
|
Rate for Payer: Molina Healthcare of CA Medicare |
$45,734.56
|
Rate for Payer: Multiplan WC |
$53,409.62
|
Rate for Payer: Preferred Health Network WC |
$54,499.61
|
Rate for Payer: Prime Health Services Medicare |
$36,178.09
|
Rate for Payer: Prime Health Services WC |
$51,530.77
|
Rate for Payer: United Healthcare All Other Commercial |
$40,144.00
|
Rate for Payer: United Healthcare All Other HMO |
$31,425.00
|
Rate for Payer: United Healthcare HMO Rider |
$23,871.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$21,828.00
|
|
INPATIENT MS-DRG 474: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
IP
|
$113,245.39
|
|
Service Code
|
MS-DRG 474
|
Min. Negotiated Rate |
$7,235.00 |
Max. Negotiated Rate |
$113,245.39 |
Rate for Payer: Aetna of CA HMO/PPO |
$113,245.39
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$69,651.40
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85,555.56
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$86,313.71
|
Rate for Payer: EPIC Health Plan Commercial |
$79,611.04
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$58,971.14
|
Rate for Payer: IEHP Medicare Advantage |
$58,971.14
|
Rate for Payer: Innovage PACE Commercial |
$88,456.71
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,971.14
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79,021.33
|
Rate for Payer: Molina Healthcare of CA Medicare |
$79,021.33
|
Rate for Payer: Multiplan WC |
$86,313.71
|
Rate for Payer: Preferred Health Network WC |
$88,075.21
|
Rate for Payer: Prime Health Services Medicare |
$62,509.41
|
Rate for Payer: Prime Health Services WC |
$83,277.36
|
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 475: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
IP
|
$56,446.36
|
|
Service Code
|
MS-DRG 475
|
Min. Negotiated Rate |
$7,235.00 |
Max. Negotiated Rate |
$56,446.36 |
Rate for Payer: Aetna of CA HMO/PPO |
$56,446.36
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$37,762.62
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46,385.32
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$46,796.35
|
Rate for Payer: EPIC Health Plan Commercial |
$40,325.24
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,870.55
|
Rate for Payer: IEHP Medicare Advantage |
$29,870.55
|
Rate for Payer: Innovage PACE Commercial |
$44,805.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,870.55
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,026.54
|
Rate for Payer: Molina Healthcare of CA Medicare |
$40,026.54
|
Rate for Payer: Multiplan WC |
$46,796.35
|
Rate for Payer: Preferred Health Network WC |
$47,751.38
|
Rate for Payer: Prime Health Services Medicare |
$31,662.78
|
Rate for Payer: Prime Health Services WC |
$45,150.15
|
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
|
|
INPATIENT MS-DRG 476: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$30,974.83
|
|
Service Code
|
MS-DRG 476
|
Min. Negotiated Rate |
$7,235.00 |
Max. Negotiated Rate |
$30,974.83 |
Rate for Payer: Aetna of CA HMO/PPO |
$30,974.83
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,868.73
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,633.88
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,861.03
|
Rate for Payer: EPIC Health Plan Commercial |
$22,707.55
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$16,820.41
|
Rate for Payer: IEHP Medicare Advantage |
$16,820.41
|
Rate for Payer: Innovage PACE Commercial |
$25,230.62
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,820.41
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,539.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$22,539.35
|
Rate for Payer: Multiplan WC |
$25,861.03
|
Rate for Payer: Preferred Health Network WC |
$26,388.81
|
Rate for Payer: Prime Health Services Medicare |
$17,829.63
|
Rate for Payer: Prime Health Services WC |
$24,951.29
|
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 477: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
IP
|
$88,668.71
|
|
Service Code
|
MS-DRG 477
|
Min. Negotiated Rate |
$7,235.00 |
Max. Negotiated Rate |
$88,668.71 |
Rate for Payer: Aetna of CA HMO/PPO |
$88,668.71
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$57,851.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71,060.67
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$71,690.37
|
Rate for Payer: EPIC Health Plan Commercial |
$62,612.23
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,379.43
|
Rate for Payer: IEHP Medicare Advantage |
$46,379.43
|
Rate for Payer: Innovage PACE Commercial |
$69,569.14
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,379.43
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,148.44
|
Rate for Payer: Molina Healthcare of CA Medicare |
$62,148.44
|
Rate for Payer: Multiplan WC |
$71,690.37
|
Rate for Payer: Preferred Health Network WC |
$73,153.44
|
Rate for Payer: Prime Health Services Medicare |
$49,162.20
|
Rate for Payer: Prime Health Services WC |
$69,168.44
|
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 478: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
IP
|
$62,736.60
|
|
Service Code
|
MS-DRG 478
|
Min. Negotiated Rate |
$7,235.00 |
Max. Negotiated Rate |
$62,736.60 |
Rate for Payer: Aetna of CA HMO/PPO |
$62,736.60
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$39,933.65
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49,052.08
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$49,486.75
|
Rate for Payer: EPIC Health Plan Commercial |
$44,675.98
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,093.32
|
Rate for Payer: IEHP Medicare Advantage |
$33,093.32
|
Rate for Payer: Innovage PACE Commercial |
$49,639.98
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,093.32
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,345.05
|
Rate for Payer: Molina Healthcare of CA Medicare |
$44,345.05
|
Rate for Payer: Multiplan WC |
$49,486.75
|
Rate for Payer: Preferred Health Network WC |
$50,496.68
|
Rate for Payer: Prime Health Services Medicare |
$35,078.92
|
Rate for Payer: Prime Health Services WC |
$47,745.90
|
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 479: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
IP
|
$49,058.62
|
|
Service Code
|
MS-DRG 479
|
Min. Negotiated Rate |
$7,235.00 |
Max. Negotiated Rate |
$49,058.62 |
Rate for Payer: Aetna of CA HMO/PPO |
$49,058.62
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,064.57
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,929.50
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,256.74
|
Rate for Payer: EPIC Health Plan Commercial |
$35,215.42
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,085.50
|
Rate for Payer: IEHP Medicare Advantage |
$26,085.50
|
Rate for Payer: Innovage PACE Commercial |
$39,128.25
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,085.50
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,954.57
|
Rate for Payer: Molina Healthcare of CA Medicare |
$34,954.57
|
Rate for Payer: Multiplan WC |
$37,256.74
|
Rate for Payer: Preferred Health Network WC |
$38,017.08
|
Rate for Payer: Prime Health Services Medicare |
$27,650.63
|
Rate for Payer: Prime Health Services WC |
$35,946.12
|
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 480: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
IP
|
$77,612.10
|
|
Service Code
|
MS-DRG 480
|
Min. Negotiated Rate |
$24,564.00 |
Max. Negotiated Rate |
$77,612.10 |
Rate for Payer: Aetna of CA HMO/PPO |
$77,612.10
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$50,424.97
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61,938.98
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$62,487.84
|
Rate for Payer: EPIC Health Plan Commercial |
$54,964.79
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,714.66
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,564.00
|
Rate for Payer: IEHP Medicare Advantage |
$40,714.66
|
Rate for Payer: Innovage PACE Commercial |
$61,071.99
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,714.66
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,557.64
|
Rate for Payer: Molina Healthcare of CA Medicare |
$54,557.64
|
Rate for Payer: Multiplan WC |
$62,487.84
|
Rate for Payer: Preferred Health Network WC |
$63,763.10
|
Rate for Payer: Prime Health Services Medicare |
$43,157.54
|
Rate for Payer: Prime Health Services WC |
$60,289.64
|
Rate for Payer: United Healthcare All Other Commercial |
$53,801.00
|
Rate for Payer: United Healthcare All Other HMO |
$38,830.00
|
Rate for Payer: United Healthcare HMO Rider |
$29,495.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$26,969.00
|
|
INPATIENT MS-DRG 481: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
IP
|
$70,749.00
|
|
Service Code
|
MS-DRG 481
|
Min. Negotiated Rate |
$20,751.00 |
Max. Negotiated Rate |
$70,749.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$54,609.29
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$35,912.91
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,113.25
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$44,504.15
|
Rate for Payer: EPIC Health Plan Commercial |
$39,054.64
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,929.36
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,564.00
|
Rate for Payer: IEHP Medicare Advantage |
$28,929.36
|
Rate for Payer: Innovage PACE Commercial |
$43,394.04
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,929.36
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,765.34
|
Rate for Payer: Molina Healthcare of CA Medicare |
$38,765.34
|
Rate for Payer: Multiplan WC |
$44,504.15
|
Rate for Payer: Preferred Health Network WC |
$45,412.40
|
Rate for Payer: Prime Health Services Medicare |
$30,665.12
|
Rate for Payer: Prime Health Services WC |
$42,938.58
|
Rate for Payer: United Healthcare All Other Commercial |
$70,749.00
|
Rate for Payer: United Healthcare All Other HMO |
$29,870.00
|
Rate for Payer: United Healthcare HMO Rider |
$22,693.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$20,751.00
|
|
INPATIENT MS-DRG 482: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
IP
|
$57,674.00
|
|
Service Code
|
MS-DRG 482
|
Min. Negotiated Rate |
$17,559.00 |
Max. Negotiated Rate |
$57,674.00 |
Rate for Payer: Aetna of CA HMO/PPO |
$41,805.10
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,985.35
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,375.51
|
Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,680.12
|
Rate for Payer: EPIC Health Plan Commercial |
$30,198.45
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,369.22
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,564.00
|
Rate for Payer: IEHP Medicare Advantage |
$22,369.22
|
Rate for Payer: Innovage PACE Commercial |
$33,553.83
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,369.22
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,974.75
|
Rate for Payer: Molina Healthcare of CA Medicare |
$29,974.75
|
Rate for Payer: Multiplan WC |
$34,680.12
|
Rate for Payer: Preferred Health Network WC |
$35,387.88
|
Rate for Payer: Prime Health Services Medicare |
$23,711.37
|
Rate for Payer: Prime Health Services WC |
$33,460.14
|
Rate for Payer: United Healthcare All Other Commercial |
$57,674.00
|
Rate for Payer: United Healthcare All Other HMO |
$25,281.00
|
Rate for Payer: United Healthcare HMO Rider |
$19,203.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$17,559.00
|
|