|
INPATIENT MS-DRG 511: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC
|
Facility
IP
|
$52,474.82
|
|
|
Service Code
|
MS-DRG 511
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,474.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,474.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,644.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,327.46
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,693.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,578.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,835.76
|
| Rate for Payer: IEHP Medicare Advantage |
$27,835.76
|
| Rate for Payer: Innovage PACE Commercial |
$41,753.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,835.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,299.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,299.92
|
| Rate for Payer: Multiplan WC |
$41,693.68
|
| Rate for Payer: Preferred Health Network WC |
$42,544.57
|
| Rate for Payer: Prime Health Services Medicare |
$29,505.91
|
| Rate for Payer: Prime Health Services WC |
$40,226.98
|
| 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 512: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$42,473.60
|
|
|
Service Code
|
MS-DRG 512
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,473.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,473.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,312.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,548.54
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,845.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,660.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,711.74
|
| Rate for Payer: IEHP Medicare Advantage |
$22,711.74
|
| Rate for Payer: Innovage PACE Commercial |
$34,067.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,711.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,433.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,433.73
|
| Rate for Payer: Multiplan WC |
$33,845.83
|
| Rate for Payer: Preferred Health Network WC |
$34,536.56
|
| Rate for Payer: Prime Health Services Medicare |
$24,074.44
|
| Rate for Payer: Prime Health Services WC |
$32,655.20
|
| 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 513: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
|
Facility
IP
|
$42,663.10
|
|
|
Service Code
|
MS-DRG 513
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,663.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,663.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,099.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,287.50
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,582.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,791.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,808.81
|
| Rate for Payer: IEHP Medicare Advantage |
$22,808.81
|
| Rate for Payer: Innovage PACE Commercial |
$34,213.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,808.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,563.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,563.81
|
| Rate for Payer: Multiplan WC |
$33,582.47
|
| Rate for Payer: Preferred Health Network WC |
$34,267.83
|
| Rate for Payer: Prime Health Services Medicare |
$24,177.34
|
| Rate for Payer: Prime Health Services WC |
$32,401.11
|
| 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 514: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$27,411.24
|
|
|
Service Code
|
MS-DRG 514
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$27,411.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,411.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,556.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,565.87
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,756.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,242.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,994.62
|
| Rate for Payer: IEHP Medicare Advantage |
$14,994.62
|
| Rate for Payer: Innovage PACE Commercial |
$22,491.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,994.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,092.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,092.79
|
| Rate for Payer: Multiplan WC |
$21,756.98
|
| Rate for Payer: Preferred Health Network WC |
$22,201.00
|
| Rate for Payer: Prime Health Services Medicare |
$15,894.30
|
| Rate for Payer: Prime Health Services WC |
$20,991.61
|
| 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 515: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC
|
Facility
IP
|
$83,207.52
|
|
|
Service Code
|
MS-DRG 515
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$83,207.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$83,207.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53,005.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65,109.02
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$65,685.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,834.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,581.43
|
| Rate for Payer: IEHP Medicare Advantage |
$43,581.43
|
| Rate for Payer: Innovage PACE Commercial |
$65,372.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,581.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,399.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,399.12
|
| Rate for Payer: Multiplan WC |
$65,685.97
|
| Rate for Payer: Preferred Health Network WC |
$67,026.50
|
| Rate for Payer: Prime Health Services Medicare |
$46,196.32
|
| Rate for Payer: Prime Health Services WC |
$63,375.27
|
| 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 516: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC
|
Facility
IP
|
$53,711.82
|
|
|
Service Code
|
MS-DRG 516
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$53,711.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,711.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,576.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,471.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,848.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,433.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,469.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,258.00
|
| Rate for Payer: IEHP Medicare Advantage |
$28,469.55
|
| Rate for Payer: Innovage PACE Commercial |
$42,704.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,469.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,149.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,149.20
|
| Rate for Payer: Multiplan WC |
$42,848.21
|
| Rate for Payer: Preferred Health Network WC |
$43,722.66
|
| Rate for Payer: Prime Health Services Medicare |
$30,177.72
|
| Rate for Payer: Prime Health Services WC |
$41,340.89
|
| 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 517: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$39,331.11
|
|
|
Service Code
|
MS-DRG 517
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$39,331.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,331.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,669.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,531.24
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,810.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,487.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,101.69
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,258.00
|
| Rate for Payer: IEHP Medicare Advantage |
$21,101.69
|
| Rate for Payer: Innovage PACE Commercial |
$31,652.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,101.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,276.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,276.26
|
| Rate for Payer: Multiplan WC |
$31,810.65
|
| Rate for Payer: Preferred Health Network WC |
$32,459.85
|
| Rate for Payer: Prime Health Services Medicare |
$22,367.79
|
| Rate for Payer: Prime Health Services WC |
$30,691.61
|
| 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 518: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR
|
Facility
IP
|
$96,111.72
|
|
|
Service Code
|
MS-DRG 518
|
| Min. Negotiated Rate |
$14,171.00 |
| Max. Negotiated Rate |
$96,111.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$96,111.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$63,374.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77,845.56
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$78,535.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$67,760.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,192.81
|
| Rate for Payer: IEHP Medicare Advantage |
$50,192.81
|
| Rate for Payer: Innovage PACE Commercial |
$75,289.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,192.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67,258.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67,258.37
|
| Rate for Payer: Multiplan WC |
$78,535.38
|
| Rate for Payer: Preferred Health Network WC |
$80,138.14
|
| Rate for Payer: Prime Health Services Medicare |
$53,204.38
|
| Rate for Payer: Prime Health Services WC |
$75,772.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,330.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,102.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,498.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,171.00
|
|
|
INPATIENT MS-DRG 519: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC
|
Facility
IP
|
$51,811.58
|
|
|
Service Code
|
MS-DRG 519
|
| Min. Negotiated Rate |
$14,171.00 |
| Max. Negotiated Rate |
$51,811.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,811.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,990.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,751.38
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,121.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,119.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,495.97
|
| Rate for Payer: IEHP Medicare Advantage |
$27,495.97
|
| Rate for Payer: Innovage PACE Commercial |
$41,243.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,495.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,844.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,844.60
|
| Rate for Payer: Multiplan WC |
$42,121.36
|
| Rate for Payer: Preferred Health Network WC |
$42,980.98
|
| Rate for Payer: Prime Health Services Medicare |
$29,145.73
|
| Rate for Payer: Prime Health Services WC |
$40,639.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,330.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,102.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,498.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,171.00
|
|
|
INPATIENT MS-DRG 520: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC
|
Facility
IP
|
$37,675.65
|
|
|
Service Code
|
MS-DRG 520
|
| Min. Negotiated Rate |
$10,755.00 |
| Max. Negotiated Rate |
$37,675.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,675.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,158.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,902.66
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,176.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,342.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,253.52
|
| Rate for Payer: IEHP Medicare Advantage |
$20,253.52
|
| Rate for Payer: Innovage PACE Commercial |
$30,380.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,253.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,139.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,139.72
|
| Rate for Payer: Multiplan WC |
$31,176.50
|
| Rate for Payer: Preferred Health Network WC |
$31,812.76
|
| Rate for Payer: Prime Health Services Medicare |
$21,468.73
|
| Rate for Payer: Prime Health Services WC |
$30,079.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$20,246.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,486.00
|
| Rate for Payer: United Healthcare HMO Rider |
$11,761.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10,755.00
|
|
|
INPATIENT MS-DRG 521: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
IP
|
$78,804.35
|
|
|
Service Code
|
MS-DRG 521
|
| Min. Negotiated Rate |
$41,325.50 |
| Max. Negotiated Rate |
$78,804.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78,804.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51,329.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63,049.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$63,608.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,789.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,325.50
|
| Rate for Payer: IEHP Medicare Advantage |
$41,325.50
|
| Rate for Payer: Innovage PACE Commercial |
$61,988.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,325.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,376.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,376.17
|
| Rate for Payer: Multiplan WC |
$63,608.66
|
| Rate for Payer: Preferred Health Network WC |
$64,906.80
|
| Rate for Payer: Prime Health Services Medicare |
$43,805.03
|
| Rate for Payer: Prime Health Services WC |
$61,371.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,948.00
|
| Rate for Payer: United Healthcare All Other HMO |
$54,808.00
|
| Rate for Payer: United Healthcare HMO Rider |
$51,849.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,943.00
|
|
|
INPATIENT MS-DRG 522: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
IP
|
$71,343.00
|
|
|
Service Code
|
MS-DRG 522
|
| Min. Negotiated Rate |
$29,432.32 |
| Max. Negotiated Rate |
$71,343.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,590.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,941.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,376.67
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,778.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,733.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,432.32
|
| Rate for Payer: IEHP Medicare Advantage |
$29,432.32
|
| Rate for Payer: Innovage PACE Commercial |
$44,148.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,432.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,439.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,439.31
|
| Rate for Payer: Multiplan WC |
$45,778.77
|
| Rate for Payer: Preferred Health Network WC |
$46,713.03
|
| Rate for Payer: Prime Health Services Medicare |
$31,198.26
|
| Rate for Payer: Prime Health Services WC |
$44,168.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$71,343.00
|
| Rate for Payer: United Healthcare All Other HMO |
$44,961.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,152.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,230.00
|
|
|
INPATIENT MS-DRG 533: FRACTURES OF FEMUR WITH MCC
|
Facility
IP
|
$42,936.82
|
|
|
Service Code
|
MS-DRG 533
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,936.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,936.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,248.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,785.42
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,049.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,981.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,949.03
|
| Rate for Payer: IEHP Medicare Advantage |
$22,949.03
|
| Rate for Payer: Innovage PACE Commercial |
$34,423.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,949.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,751.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,751.70
|
| Rate for Payer: Multiplan WC |
$30,049.36
|
| Rate for Payer: Preferred Health Network WC |
$30,662.61
|
| Rate for Payer: Prime Health Services Medicare |
$24,325.97
|
| Rate for Payer: Prime Health Services WC |
$28,992.29
|
| 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 534: FRACTURES OF FEMUR WITHOUT MCC
|
Facility
IP
|
$21,318.39
|
|
|
Service Code
|
MS-DRG 534
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$21,318.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,318.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,531.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,620.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,768.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,028.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,873.02
|
| Rate for Payer: IEHP Medicare Advantage |
$11,873.02
|
| Rate for Payer: Innovage PACE Commercial |
$17,809.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,873.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,909.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,909.85
|
| Rate for Payer: Multiplan WC |
$16,768.06
|
| Rate for Payer: Preferred Health Network WC |
$17,110.27
|
| Rate for Payer: Prime Health Services Medicare |
$12,585.40
|
| Rate for Payer: Prime Health Services WC |
$16,178.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 535: FRACTURES OF HIP AND PELVIS WITH MCC
|
Facility
IP
|
$34,127.85
|
|
|
Service Code
|
MS-DRG 535
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,127.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,127.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,922.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,928.63
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,167.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,888.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,435.85
|
| Rate for Payer: IEHP Medicare Advantage |
$18,435.85
|
| Rate for Payer: Innovage PACE Commercial |
$27,653.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,435.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,704.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,704.04
|
| Rate for Payer: Multiplan WC |
$27,167.26
|
| Rate for Payer: Preferred Health Network WC |
$27,721.69
|
| Rate for Payer: Prime Health Services Medicare |
$19,542.00
|
| Rate for Payer: Prime Health Services WC |
$26,211.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 536: FRACTURES OF HIP AND PELVIS WITHOUT MCC
|
Facility
IP
|
$20,715.68
|
|
|
Service Code
|
MS-DRG 536
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,715.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,715.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,211.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,228.18
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,371.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,611.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,564.22
|
| Rate for Payer: IEHP Medicare Advantage |
$11,564.22
|
| Rate for Payer: Innovage PACE Commercial |
$17,346.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,564.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,496.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,496.05
|
| Rate for Payer: Multiplan WC |
$16,371.99
|
| Rate for Payer: Preferred Health Network WC |
$16,706.11
|
| Rate for Payer: Prime Health Services Medicare |
$12,258.07
|
| Rate for Payer: Prime Health Services WC |
$15,796.05
|
| 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 537: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC
|
Facility
IP
|
$25,450.47
|
|
|
Service Code
|
MS-DRG 537
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$25,450.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,450.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,888.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,745.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,929.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,886.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,990.04
|
| Rate for Payer: IEHP Medicare Advantage |
$13,990.04
|
| Rate for Payer: Innovage PACE Commercial |
$20,985.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,990.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,746.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,746.65
|
| Rate for Payer: Multiplan WC |
$20,929.01
|
| Rate for Payer: Preferred Health Network WC |
$21,356.13
|
| Rate for Payer: Prime Health Services Medicare |
$14,829.44
|
| Rate for Payer: Prime Health Services WC |
$20,192.76
|
| 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 538: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC
|
Facility
IP
|
$18,662.80
|
|
|
Service Code
|
MS-DRG 538
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,662.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,662.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,836.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,538.74
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,667.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,191.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,512.43
|
| Rate for Payer: IEHP Medicare Advantage |
$10,512.43
|
| Rate for Payer: Innovage PACE Commercial |
$15,768.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,512.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,086.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,086.66
|
| Rate for Payer: Multiplan WC |
$14,667.58
|
| Rate for Payer: Preferred Health Network WC |
$14,966.92
|
| Rate for Payer: Prime Health Services Medicare |
$11,143.18
|
| Rate for Payer: Prime Health Services WC |
$14,151.60
|
| 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 539: OSTEOMYELITIS WITH MCC
|
Facility
IP
|
$52,227.42
|
|
|
Service Code
|
MS-DRG 539
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$52,227.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,227.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,932.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,680.38
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,049.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,407.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,709.02
|
| Rate for Payer: IEHP Medicare Advantage |
$27,709.02
|
| Rate for Payer: Innovage PACE Commercial |
$41,563.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,709.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,130.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,130.09
|
| Rate for Payer: Multiplan WC |
$42,049.72
|
| Rate for Payer: Preferred Health Network WC |
$42,907.88
|
| Rate for Payer: Prime Health Services Medicare |
$29,371.56
|
| Rate for Payer: Prime Health Services WC |
$40,570.50
|
| 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 540: OSTEOMYELITIS WITH CC
|
Facility
IP
|
$34,167.33
|
|
|
Service Code
|
MS-DRG 540
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,167.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,167.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,893.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,121.05
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,370.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,915.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,456.05
|
| Rate for Payer: IEHP Medicare Advantage |
$18,456.05
|
| Rate for Payer: Innovage PACE Commercial |
$27,684.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,456.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,731.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,731.11
|
| Rate for Payer: Multiplan WC |
$28,370.24
|
| Rate for Payer: Preferred Health Network WC |
$28,949.22
|
| Rate for Payer: Prime Health Services Medicare |
$19,563.41
|
| Rate for Payer: Prime Health Services WC |
$27,372.23
|
| 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 541: OSTEOMYELITIS WITHOUT CC/MCC
|
Facility
IP
|
$22,579.07
|
|
|
Service Code
|
MS-DRG 541
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$22,579.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,579.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,906.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,082.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,233.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,900.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,518.91
|
| Rate for Payer: IEHP Medicare Advantage |
$12,518.91
|
| Rate for Payer: Innovage PACE Commercial |
$18,778.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,518.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,775.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,775.34
|
| Rate for Payer: Multiplan WC |
$17,233.66
|
| Rate for Payer: Preferred Health Network WC |
$17,585.37
|
| Rate for Payer: Prime Health Services Medicare |
$13,270.04
|
| Rate for Payer: Prime Health Services WC |
$16,627.42
|
| 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 542: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC
|
Facility
IP
|
$47,997.96
|
|
|
Service Code
|
MS-DRG 542
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,997.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,997.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,077.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,174.12
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,512.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,481.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,542.09
|
| Rate for Payer: IEHP Medicare Advantage |
$25,542.09
|
| Rate for Payer: Innovage PACE Commercial |
$38,313.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,542.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,226.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,226.40
|
| Rate for Payer: Multiplan WC |
$38,512.40
|
| Rate for Payer: Preferred Health Network WC |
$39,298.37
|
| Rate for Payer: Prime Health Services Medicare |
$27,074.62
|
| Rate for Payer: Prime Health Services WC |
$37,157.61
|
| 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 543: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC
|
Facility
IP
|
$28,706.13
|
|
|
Service Code
|
MS-DRG 543
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,706.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,706.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,514.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,741.59
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,943.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,138.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,658.06
|
| Rate for Payer: IEHP Medicare Advantage |
$15,658.06
|
| Rate for Payer: Innovage PACE Commercial |
$23,487.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,658.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,981.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,981.80
|
| Rate for Payer: Multiplan WC |
$22,943.11
|
| Rate for Payer: Preferred Health Network WC |
$23,411.34
|
| Rate for Payer: Prime Health Services Medicare |
$16,597.54
|
| Rate for Payer: Prime Health Services WC |
$22,136.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 544: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$20,199.83
|
|
|
Service Code
|
MS-DRG 544
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,199.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,199.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,228.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,249.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,393.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,254.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,299.92
|
| Rate for Payer: IEHP Medicare Advantage |
$11,299.92
|
| Rate for Payer: Innovage PACE Commercial |
$16,949.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,299.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,141.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,141.89
|
| Rate for Payer: Multiplan WC |
$16,393.05
|
| Rate for Payer: Preferred Health Network WC |
$16,727.60
|
| Rate for Payer: Prime Health Services Medicare |
$11,977.92
|
| Rate for Payer: Prime Health Services WC |
$15,816.37
|
| 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 545: CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
IP
|
$65,618.53
|
|
|
Service Code
|
MS-DRG 545
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$65,618.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,618.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42,648.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52,387.09
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$52,851.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,669.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,569.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,258.00
|
| Rate for Payer: IEHP Medicare Advantage |
$34,569.87
|
| Rate for Payer: Innovage PACE Commercial |
$51,854.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,569.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,323.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,323.63
|
| Rate for Payer: Multiplan WC |
$52,851.31
|
| Rate for Payer: Preferred Health Network WC |
$53,929.91
|
| Rate for Payer: Prime Health Services Medicare |
$36,644.06
|
| Rate for Payer: Prime Health Services WC |
$50,992.11
|
| 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
|
|
