|
INPATIENT MS-DRG 546: CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
IP
|
$31,564.38
|
|
|
Service Code
|
MS-DRG 546
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,564.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,564.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,496.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,176.54
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,399.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,115.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,122.46
|
| Rate for Payer: IEHP Medicare Advantage |
$17,122.46
|
| Rate for Payer: Innovage PACE Commercial |
$25,683.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,122.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,944.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,944.10
|
| Rate for Payer: Multiplan WC |
$25,399.64
|
| Rate for Payer: Preferred Health Network WC |
$25,918.00
|
| Rate for Payer: Prime Health Services Medicare |
$18,149.81
|
| Rate for Payer: Prime Health Services WC |
$24,506.14
|
| 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 547: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$21,407.87
|
|
|
Service Code
|
MS-DRG 547
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$21,407.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,407.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,552.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,103.77
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,273.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,270.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,052.35
|
| Rate for Payer: IEHP Medicare Advantage |
$12,052.35
|
| Rate for Payer: Innovage PACE Commercial |
$18,078.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,052.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,150.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,150.15
|
| Rate for Payer: Multiplan WC |
$19,273.05
|
| Rate for Payer: Preferred Health Network WC |
$19,666.38
|
| Rate for Payer: Prime Health Services Medicare |
$12,775.49
|
| Rate for Payer: Prime Health Services WC |
$18,595.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 548: SEPTIC ARTHRITIS WITH MCC
|
Facility
IP
|
$51,316.79
|
|
|
Service Code
|
MS-DRG 548
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$51,316.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,316.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,980.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,510.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,869.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,777.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,242.47
|
| Rate for Payer: IEHP Medicare Advantage |
$27,242.47
|
| Rate for Payer: Innovage PACE Commercial |
$40,863.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,242.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,504.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,504.91
|
| Rate for Payer: Multiplan WC |
$40,869.91
|
| Rate for Payer: Preferred Health Network WC |
$41,703.99
|
| Rate for Payer: Prime Health Services Medicare |
$28,877.02
|
| Rate for Payer: Prime Health Services WC |
$39,432.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 549: SEPTIC ARTHRITIS WITH CC
|
Facility
IP
|
$31,745.98
|
|
|
Service Code
|
MS-DRG 549
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,745.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,745.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,600.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,303.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,528.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,240.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,215.50
|
| Rate for Payer: IEHP Medicare Advantage |
$17,215.50
|
| Rate for Payer: Innovage PACE Commercial |
$25,823.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,215.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,068.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,068.77
|
| Rate for Payer: Multiplan WC |
$25,528.16
|
| Rate for Payer: Preferred Health Network WC |
$26,049.14
|
| Rate for Payer: Prime Health Services Medicare |
$18,248.43
|
| Rate for Payer: Prime Health Services WC |
$24,630.13
|
| 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 550: SEPTIC ARTHRITIS WITHOUT CC/MCC
|
Facility
IP
|
$24,234.54
|
|
|
Service Code
|
MS-DRG 550
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$24,234.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,234.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,822.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,891.65
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,085.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,458.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,673.16
|
| Rate for Payer: IEHP Medicare Advantage |
$13,673.16
|
| Rate for Payer: Innovage PACE Commercial |
$20,509.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,673.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,322.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,322.03
|
| Rate for Payer: Multiplan WC |
$22,085.64
|
| Rate for Payer: Preferred Health Network WC |
$22,536.37
|
| Rate for Payer: Prime Health Services Medicare |
$14,493.55
|
| Rate for Payer: Prime Health Services WC |
$21,308.71
|
| 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 551: MEDICAL BACK PROBLEMS WITH MCC
|
Facility
IP
|
$56,843.00
|
|
|
Service Code
|
MS-DRG 551
|
| Min. Negotiated Rate |
$13,055.00 |
| Max. Negotiated Rate |
$56,843.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,792.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,449.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,945.61
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,255.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,264.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,899.68
|
| Rate for Payer: IEHP Medicare Advantage |
$23,899.68
|
| Rate for Payer: Innovage PACE Commercial |
$35,849.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,899.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,025.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,025.57
|
| Rate for Payer: Multiplan WC |
$35,255.27
|
| Rate for Payer: Preferred Health Network WC |
$35,974.77
|
| Rate for Payer: Prime Health Services Medicare |
$25,333.66
|
| Rate for Payer: Prime Health Services WC |
$34,015.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,843.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,276.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,055.00
|
|
|
INPATIENT MS-DRG 552: MEDICAL BACK PROBLEMS WITHOUT MCC
|
Facility
IP
|
$56,843.00
|
|
|
Service Code
|
MS-DRG 552
|
| Min. Negotiated Rate |
$13,097.00 |
| Max. Negotiated Rate |
$56,843.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,432.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,329.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,058.12
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,235.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,873.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,980.60
|
| Rate for Payer: IEHP Medicare Advantage |
$13,980.60
|
| Rate for Payer: Innovage PACE Commercial |
$20,970.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,980.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,734.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,734.00
|
| Rate for Payer: Multiplan WC |
$20,235.86
|
| Rate for Payer: Preferred Health Network WC |
$20,648.84
|
| Rate for Payer: Prime Health Services Medicare |
$14,819.44
|
| Rate for Payer: Prime Health Services WC |
$19,524.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,843.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,854.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,322.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,097.00
|
|
|
INPATIENT MS-DRG 553: BONE DISEASES AND ARTHROPATHIES WITH MCC
|
Facility
IP
|
$35,570.13
|
|
|
Service Code
|
MS-DRG 553
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,570.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,570.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,541.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,688.77
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,934.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,885.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,174.78
|
| Rate for Payer: IEHP Medicare Advantage |
$19,174.78
|
| Rate for Payer: Innovage PACE Commercial |
$28,762.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,174.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,694.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,694.21
|
| Rate for Payer: Multiplan WC |
$27,934.13
|
| Rate for Payer: Preferred Health Network WC |
$28,504.21
|
| Rate for Payer: Prime Health Services Medicare |
$20,325.27
|
| Rate for Payer: Prime Health Services WC |
$26,951.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 554: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC
|
Facility
IP
|
$21,628.95
|
|
|
Service Code
|
MS-DRG 554
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$21,628.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,628.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,944.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,128.24
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,280.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,243.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,032.13
|
| Rate for Payer: IEHP Medicare Advantage |
$12,032.13
|
| Rate for Payer: Innovage PACE Commercial |
$18,048.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,032.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,123.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,123.05
|
| Rate for Payer: Multiplan WC |
$17,280.02
|
| Rate for Payer: Preferred Health Network WC |
$17,632.67
|
| Rate for Payer: Prime Health Services Medicare |
$12,754.06
|
| Rate for Payer: Prime Health Services WC |
$16,672.14
|
| 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 555: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
IP
|
$36,820.28
|
|
|
Service Code
|
MS-DRG 555
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$36,820.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,820.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,631.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,799.45
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,045.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,750.64
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,815.29
|
| Rate for Payer: IEHP Medicare Advantage |
$19,815.29
|
| Rate for Payer: Innovage PACE Commercial |
$29,722.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,815.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,552.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,552.49
|
| Rate for Payer: Multiplan WC |
$28,045.79
|
| Rate for Payer: Preferred Health Network WC |
$28,618.15
|
| Rate for Payer: Prime Health Services Medicare |
$21,004.21
|
| Rate for Payer: Prime Health Services WC |
$27,059.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 556: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC
|
Facility
IP
|
$21,697.38
|
|
|
Service Code
|
MS-DRG 556
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$21,697.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,697.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,736.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,873.46
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,022.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,290.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,067.19
|
| Rate for Payer: IEHP Medicare Advantage |
$12,067.19
|
| Rate for Payer: Innovage PACE Commercial |
$18,100.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,067.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,170.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,170.03
|
| Rate for Payer: Multiplan WC |
$17,022.98
|
| Rate for Payer: Preferred Health Network WC |
$17,370.39
|
| Rate for Payer: Prime Health Services Medicare |
$12,791.22
|
| Rate for Payer: Prime Health Services WC |
$16,424.16
|
| 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 557: TENDONITIS, MYOSITIS AND BURSITIS WITH MCC
|
Facility
IP
|
$40,973.42
|
|
|
Service Code
|
MS-DRG 557
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$40,973.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,973.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,343.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,902.37
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,167.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,623.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,943.12
|
| Rate for Payer: IEHP Medicare Advantage |
$21,943.12
|
| Rate for Payer: Innovage PACE Commercial |
$32,914.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,943.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,403.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,403.78
|
| Rate for Payer: Multiplan WC |
$30,167.34
|
| Rate for Payer: Preferred Health Network WC |
$30,783.00
|
| Rate for Payer: Prime Health Services Medicare |
$23,259.71
|
| Rate for Payer: Prime Health Services WC |
$29,106.12
|
| 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 558: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC
|
Facility
IP
|
$23,118.61
|
|
|
Service Code
|
MS-DRG 558
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,118.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,118.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,773.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,147.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,308.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,273.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,795.34
|
| Rate for Payer: IEHP Medicare Advantage |
$12,795.34
|
| Rate for Payer: Innovage PACE Commercial |
$19,193.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,795.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,145.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,145.76
|
| Rate for Payer: Multiplan WC |
$18,308.13
|
| Rate for Payer: Preferred Health Network WC |
$18,681.77
|
| Rate for Payer: Prime Health Services Medicare |
$13,563.06
|
| Rate for Payer: Prime Health Services WC |
$17,664.10
|
| 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 559: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
IP
|
$48,703.31
|
|
|
Service Code
|
MS-DRG 559
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$48,703.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,703.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,346.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,276.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,606.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,969.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,903.47
|
| Rate for Payer: IEHP Medicare Advantage |
$25,903.47
|
| Rate for Payer: Innovage PACE Commercial |
$38,855.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,903.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,710.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,710.65
|
| Rate for Payer: Multiplan WC |
$37,606.47
|
| Rate for Payer: Preferred Health Network WC |
$38,373.95
|
| Rate for Payer: Prime Health Services Medicare |
$27,457.68
|
| Rate for Payer: Prime Health Services WC |
$36,283.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 560: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
IP
|
$29,795.74
|
|
|
Service Code
|
MS-DRG 560
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,795.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,795.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,626.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,879.41
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,082.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,892.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16,216.31
|
| Rate for Payer: IEHP Medicare Advantage |
$16,216.31
|
| Rate for Payer: Innovage PACE Commercial |
$24,324.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,216.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,729.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,729.86
|
| Rate for Payer: Multiplan WC |
$23,082.16
|
| Rate for Payer: Preferred Health Network WC |
$23,553.22
|
| Rate for Payer: Prime Health Services Medicare |
$17,189.29
|
| Rate for Payer: Prime Health Services WC |
$22,270.17
|
| 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 561: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
IP
|
$20,534.08
|
|
|
Service Code
|
MS-DRG 561
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,534.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,534.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,434.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,501.75
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,647.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,486.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,471.17
|
| Rate for Payer: IEHP Medicare Advantage |
$11,471.17
|
| Rate for Payer: Innovage PACE Commercial |
$17,206.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,471.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,371.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,371.37
|
| Rate for Payer: Multiplan WC |
$16,647.98
|
| Rate for Payer: Preferred Health Network WC |
$16,987.73
|
| Rate for Payer: Prime Health Services Medicare |
$12,159.44
|
| Rate for Payer: Prime Health Services WC |
$16,062.34
|
| 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 562: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC
|
Facility
IP
|
$40,023.30
|
|
|
Service Code
|
MS-DRG 562
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$40,023.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,023.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,869.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,547.65
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,818.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,966.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,456.34
|
| Rate for Payer: IEHP Medicare Advantage |
$21,456.34
|
| Rate for Payer: Innovage PACE Commercial |
$32,184.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,456.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,751.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,751.50
|
| Rate for Payer: Multiplan WC |
$30,818.34
|
| Rate for Payer: Preferred Health Network WC |
$31,447.29
|
| Rate for Payer: Prime Health Services Medicare |
$22,743.72
|
| Rate for Payer: Prime Health Services WC |
$29,734.22
|
| 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 563: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC
|
Facility
IP
|
$23,571.30
|
|
|
Service Code
|
MS-DRG 563
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,571.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,571.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,641.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,984.44
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,143.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,586.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,027.27
|
| Rate for Payer: IEHP Medicare Advantage |
$13,027.27
|
| Rate for Payer: Innovage PACE Commercial |
$19,540.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,027.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,456.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,456.54
|
| Rate for Payer: Multiplan WC |
$18,143.81
|
| Rate for Payer: Preferred Health Network WC |
$18,514.09
|
| Rate for Payer: Prime Health Services Medicare |
$13,808.91
|
| Rate for Payer: Prime Health Services WC |
$17,505.54
|
| 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 564: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC
|
Facility
IP
|
$41,107.65
|
|
|
Service Code
|
MS-DRG 564
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$41,107.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,107.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,407.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,437.56
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,725.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,716.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,011.89
|
| Rate for Payer: IEHP Medicare Advantage |
$22,011.89
|
| Rate for Payer: Innovage PACE Commercial |
$33,017.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,011.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,495.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,495.93
|
| Rate for Payer: Multiplan WC |
$32,725.00
|
| Rate for Payer: Preferred Health Network WC |
$33,392.86
|
| Rate for Payer: Prime Health Services Medicare |
$23,332.60
|
| Rate for Payer: Prime Health Services WC |
$31,573.80
|
| 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 565: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC
|
Facility
IP
|
$26,303.21
|
|
|
Service Code
|
MS-DRG 565
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,303.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,303.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,786.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,619.87
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,802.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,476.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,426.95
|
| Rate for Payer: IEHP Medicare Advantage |
$14,426.95
|
| Rate for Payer: Innovage PACE Commercial |
$21,640.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,426.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,332.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,332.11
|
| Rate for Payer: Multiplan WC |
$20,802.60
|
| Rate for Payer: Preferred Health Network WC |
$21,227.14
|
| Rate for Payer: Prime Health Services Medicare |
$15,292.57
|
| Rate for Payer: Prime Health Services WC |
$20,070.80
|
| 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 566: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC
|
Facility
IP
|
$19,752.41
|
|
|
Service Code
|
MS-DRG 566
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,752.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,752.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,626.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,509.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,647.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,945.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,070.68
|
| Rate for Payer: IEHP Medicare Advantage |
$11,070.68
|
| Rate for Payer: Innovage PACE Commercial |
$16,606.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,070.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,834.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,834.71
|
| Rate for Payer: Multiplan WC |
$15,647.24
|
| Rate for Payer: Preferred Health Network WC |
$15,966.57
|
| Rate for Payer: Prime Health Services Medicare |
$11,734.92
|
| Rate for Payer: Prime Health Services WC |
$15,096.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 570: SKIN DEBRIDEMENT WITH MCC
|
Facility
IP
|
$76,909.38
|
|
|
Service Code
|
MS-DRG 570
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$76,909.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$76,909.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49,593.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60,917.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$61,457.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,478.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$40,354.65
|
| Rate for Payer: IEHP Medicare Advantage |
$40,354.65
|
| Rate for Payer: Innovage PACE Commercial |
$60,531.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,354.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,075.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,075.23
|
| Rate for Payer: Multiplan WC |
$61,457.61
|
| Rate for Payer: Preferred Health Network WC |
$62,711.85
|
| Rate for Payer: Prime Health Services Medicare |
$42,775.93
|
| Rate for Payer: Prime Health Services WC |
$59,295.66
|
| 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 571: SKIN DEBRIDEMENT WITH CC
|
Facility
IP
|
$44,529.12
|
|
|
Service Code
|
MS-DRG 571
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,529.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,529.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,027.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,427.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,732.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,082.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,764.87
|
| Rate for Payer: IEHP Medicare Advantage |
$23,764.87
|
| Rate for Payer: Innovage PACE Commercial |
$35,647.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,764.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,844.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,844.93
|
| Rate for Payer: Multiplan WC |
$34,732.79
|
| Rate for Payer: Preferred Health Network WC |
$35,441.62
|
| Rate for Payer: Prime Health Services Medicare |
$25,190.76
|
| Rate for Payer: Prime Health Services WC |
$33,510.96
|
| 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 572: SKIN DEBRIDEMENT WITHOUT CC/MCC
|
Facility
IP
|
$29,993.13
|
|
|
Service Code
|
MS-DRG 572
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$29,993.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,993.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,462.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,134.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,357.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,028.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16,317.44
|
| Rate for Payer: IEHP Medicare Advantage |
$16,317.44
|
| Rate for Payer: Innovage PACE Commercial |
$24,476.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,317.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,865.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,865.37
|
| Rate for Payer: Multiplan WC |
$25,357.51
|
| Rate for Payer: Preferred Health Network WC |
$25,875.01
|
| Rate for Payer: Prime Health Services Medicare |
$17,296.49
|
| Rate for Payer: Prime Health Services WC |
$24,465.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 573: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
IP
|
$163,654.17
|
|
|
Service Code
|
MS-DRG 573
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$163,654.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$163,654.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99,804.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122,593.65
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$123,680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$114,476.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$84,797.67
|
| Rate for Payer: IEHP Medicare Advantage |
$84,797.67
|
| Rate for Payer: Innovage PACE Commercial |
$127,196.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84,797.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$113,628.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$113,628.88
|
| Rate for Payer: Multiplan WC |
$123,680.00
|
| Rate for Payer: Preferred Health Network WC |
$126,204.08
|
| Rate for Payer: Prime Health Services Medicare |
$89,885.53
|
| Rate for Payer: Prime Health Services WC |
$119,329.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
