|
INPATIENT MS-DRG 574: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
IP
|
$89,637.25
|
|
|
Service Code
|
MS-DRG 574
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$89,637.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,637.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61,281.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75,274.86
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$75,941.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,282.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,875.66
|
| Rate for Payer: IEHP Medicare Advantage |
$46,875.66
|
| Rate for Payer: Innovage PACE Commercial |
$70,313.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,875.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,813.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,813.38
|
| Rate for Payer: Multiplan WC |
$75,941.90
|
| Rate for Payer: Preferred Health Network WC |
$77,491.73
|
| Rate for Payer: Prime Health Services Medicare |
$49,688.20
|
| Rate for Payer: Prime Health Services WC |
$73,270.41
|
| 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 575: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
IP
|
$53,848.67
|
|
|
Service Code
|
MS-DRG 575
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$53,848.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,848.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,845.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,801.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$43,181.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,528.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,539.66
|
| Rate for Payer: IEHP Medicare Advantage |
$28,539.66
|
| Rate for Payer: Innovage PACE Commercial |
$42,809.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,539.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,243.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,243.14
|
| Rate for Payer: Multiplan WC |
$43,181.08
|
| Rate for Payer: Preferred Health Network WC |
$44,062.33
|
| Rate for Payer: Prime Health Services Medicare |
$30,252.04
|
| Rate for Payer: Prime Health Services WC |
$41,662.05
|
| 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 576: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
IP
|
$149,573.51
|
|
|
Service Code
|
MS-DRG 576
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$149,573.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$149,573.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$96,038.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117,968.07
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$119,013.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$104,737.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$77,583.56
|
| Rate for Payer: IEHP Medicare Advantage |
$77,583.56
|
| Rate for Payer: Innovage PACE Commercial |
$116,375.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77,583.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$103,961.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$103,961.97
|
| Rate for Payer: Multiplan WC |
$119,013.42
|
| Rate for Payer: Preferred Health Network WC |
$121,442.27
|
| Rate for Payer: Prime Health Services Medicare |
$82,238.57
|
| Rate for Payer: Prime Health Services WC |
$114,826.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 577: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
IP
|
$69,721.66
|
|
|
Service Code
|
MS-DRG 577
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$69,721.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,721.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$44,520.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54,686.31
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$55,170.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,507.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$36,672.06
|
| Rate for Payer: IEHP Medicare Advantage |
$36,672.06
|
| Rate for Payer: Innovage PACE Commercial |
$55,008.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,672.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,140.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,140.56
|
| Rate for Payer: Multiplan WC |
$55,170.90
|
| Rate for Payer: Preferred Health Network WC |
$56,296.84
|
| Rate for Payer: Prime Health Services Medicare |
$38,872.38
|
| Rate for Payer: Prime Health Services WC |
$53,230.11
|
| 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 578: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
IP
|
$42,386.75
|
|
|
Service Code
|
MS-DRG 578
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$42,386.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,386.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,114.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,762.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,079.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,600.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,667.21
|
| Rate for Payer: IEHP Medicare Advantage |
$22,667.21
|
| Rate for Payer: Innovage PACE Commercial |
$34,000.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,667.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,374.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,374.06
|
| Rate for Payer: Multiplan WC |
$36,079.04
|
| Rate for Payer: Preferred Health Network WC |
$36,815.35
|
| Rate for Payer: Prime Health Services Medicare |
$24,027.24
|
| Rate for Payer: Prime Health Services WC |
$34,809.85
|
| 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 579: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC
|
Facility
IP
|
$87,963.36
|
|
|
Service Code
|
MS-DRG 579
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$87,963.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87,963.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53,582.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65,816.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$66,400.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$62,124.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$46,018.06
|
| Rate for Payer: IEHP Medicare Advantage |
$46,018.06
|
| Rate for Payer: Innovage PACE Commercial |
$69,027.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$46,018.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$61,664.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$61,664.20
|
| Rate for Payer: Multiplan WC |
$66,400.17
|
| Rate for Payer: Preferred Health Network WC |
$67,755.28
|
| Rate for Payer: Prime Health Services Medicare |
$48,779.14
|
| Rate for Payer: Prime Health Services WC |
$64,064.36
|
| 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 580: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
|
Facility
IP
|
$45,968.77
|
|
|
Service Code
|
MS-DRG 580
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,968.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,968.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,517.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,257.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,578.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,078.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,502.45
|
| Rate for Payer: IEHP Medicare Advantage |
$24,502.45
|
| Rate for Payer: Innovage PACE Commercial |
$36,753.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,502.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,833.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,833.28
|
| Rate for Payer: Multiplan WC |
$36,578.35
|
| Rate for Payer: Preferred Health Network WC |
$37,324.85
|
| Rate for Payer: Prime Health Services Medicare |
$25,972.60
|
| Rate for Payer: Prime Health Services WC |
$35,291.60
|
| 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 581: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$35,443.80
|
|
|
Service Code
|
MS-DRG 581
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,443.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,443.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,996.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,476.35
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,737.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,798.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,110.07
|
| Rate for Payer: IEHP Medicare Advantage |
$19,110.07
|
| Rate for Payer: Innovage PACE Commercial |
$28,665.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,110.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,607.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,607.49
|
| Rate for Payer: Multiplan WC |
$29,737.55
|
| Rate for Payer: Preferred Health Network WC |
$30,344.44
|
| Rate for Payer: Prime Health Services Medicare |
$20,256.67
|
| Rate for Payer: Prime Health Services WC |
$28,691.45
|
| 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 582: MASTECTOMY FOR MALIGNANCY WITH CC/MCC
|
Facility
IP
|
$43,876.40
|
|
|
Service Code
|
MS-DRG 582
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$43,876.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,876.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,893.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,404.43
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,762.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,981.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,430.98
|
| Rate for Payer: IEHP Medicare Advantage |
$24,430.98
|
| Rate for Payer: Innovage PACE Commercial |
$36,646.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,430.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,737.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,737.51
|
| Rate for Payer: Multiplan WC |
$40,762.46
|
| Rate for Payer: Preferred Health Network WC |
$41,594.35
|
| Rate for Payer: Prime Health Services Medicare |
$25,896.84
|
| Rate for Payer: Prime Health Services WC |
$39,328.52
|
| 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 583: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$40,054.89
|
|
|
Service Code
|
MS-DRG 583
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,054.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,054.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,685.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,550.04
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,829.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,987.89
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,472.51
|
| Rate for Payer: IEHP Medicare Advantage |
$21,472.51
|
| Rate for Payer: Innovage PACE Commercial |
$32,208.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,472.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,773.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,773.16
|
| Rate for Payer: Multiplan WC |
$31,829.62
|
| Rate for Payer: Preferred Health Network WC |
$32,479.20
|
| Rate for Payer: Prime Health Services Medicare |
$22,760.86
|
| Rate for Payer: Prime Health Services WC |
$30,709.91
|
| 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 584: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC
|
Facility
IP
|
$51,548.39
|
|
|
Service Code
|
MS-DRG 584
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$51,548.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,548.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,310.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,601.91
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$44,997.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,937.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,361.12
|
| Rate for Payer: IEHP Medicare Advantage |
$27,361.12
|
| Rate for Payer: Innovage PACE Commercial |
$41,041.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,361.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,663.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,663.90
|
| Rate for Payer: Multiplan WC |
$44,997.14
|
| Rate for Payer: Preferred Health Network WC |
$45,915.45
|
| Rate for Payer: Prime Health Services Medicare |
$29,002.79
|
| Rate for Payer: Prime Health Services WC |
$43,414.23
|
| 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 585: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$44,321.20
|
|
|
Service Code
|
MS-DRG 585
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,321.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,321.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,300.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,447.69
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,788.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,938.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,658.33
|
| Rate for Payer: IEHP Medicare Advantage |
$23,658.33
|
| Rate for Payer: Innovage PACE Commercial |
$35,487.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,658.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,702.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,702.16
|
| Rate for Payer: Multiplan WC |
$38,788.39
|
| Rate for Payer: Preferred Health Network WC |
$39,579.99
|
| Rate for Payer: Prime Health Services Medicare |
$25,077.83
|
| Rate for Payer: Prime Health Services WC |
$37,423.89
|
| 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 592: SKIN ULCERS WITH MCC
|
Facility
IP
|
$55,009.34
|
|
|
Service Code
|
MS-DRG 592
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,009.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,009.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,329.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,255.27
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,585.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,331.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,134.31
|
| Rate for Payer: IEHP Medicare Advantage |
$29,134.31
|
| Rate for Payer: Innovage PACE Commercial |
$43,701.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,134.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,039.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,039.98
|
| Rate for Payer: Multiplan WC |
$37,585.40
|
| Rate for Payer: Preferred Health Network WC |
$38,352.45
|
| Rate for Payer: Prime Health Services Medicare |
$30,882.37
|
| Rate for Payer: Prime Health Services WC |
$36,263.23
|
| 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 593: SKIN ULCERS WITH CC
|
Facility
IP
|
$31,843.36
|
|
|
Service Code
|
MS-DRG 593
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,843.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,843.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,583.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,055.13
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,268.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,308.29
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,265.40
|
| Rate for Payer: IEHP Medicare Advantage |
$17,265.40
|
| Rate for Payer: Innovage PACE Commercial |
$25,898.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,265.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,135.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,135.64
|
| Rate for Payer: Multiplan WC |
$24,268.29
|
| Rate for Payer: Preferred Health Network WC |
$24,763.56
|
| Rate for Payer: Prime Health Services Medicare |
$18,301.32
|
| Rate for Payer: Prime Health Services WC |
$23,414.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 594: SKIN ULCERS WITHOUT CC/MCC
|
Facility
IP
|
$20,723.58
|
|
|
Service Code
|
MS-DRG 594
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,723.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,723.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,157.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,161.35
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,304.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,617.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,568.26
|
| Rate for Payer: IEHP Medicare Advantage |
$11,568.26
|
| Rate for Payer: Innovage PACE Commercial |
$17,352.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,568.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,501.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,501.47
|
| Rate for Payer: Multiplan WC |
$16,304.56
|
| Rate for Payer: Preferred Health Network WC |
$16,637.31
|
| Rate for Payer: Prime Health Services Medicare |
$12,262.36
|
| Rate for Payer: Prime Health Services WC |
$15,731.00
|
| 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 595: MAJOR SKIN DISORDERS WITH MCC
|
Facility
IP
|
$57,243.82
|
|
|
Service Code
|
MS-DRG 595
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$57,243.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,243.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,405.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,718.86
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,115.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,279.13
|
| Rate for Payer: IEHP Medicare Advantage |
$30,279.13
|
| Rate for Payer: Innovage PACE Commercial |
$45,418.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,279.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,574.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,574.03
|
| Rate for Payer: Multiplan WC |
$45,115.12
|
| Rate for Payer: Preferred Health Network WC |
$46,035.84
|
| Rate for Payer: Prime Health Services Medicare |
$32,095.88
|
| Rate for Payer: Prime Health Services WC |
$43,528.07
|
| 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 596: MAJOR SKIN DISORDERS WITHOUT MCC
|
Facility
IP
|
$26,555.87
|
|
|
Service Code
|
MS-DRG 596
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,555.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,555.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,561.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,800.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,002.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,651.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,556.40
|
| Rate for Payer: IEHP Medicare Advantage |
$14,556.40
|
| Rate for Payer: Innovage PACE Commercial |
$21,834.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,556.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,505.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,505.58
|
| Rate for Payer: Multiplan WC |
$23,002.10
|
| Rate for Payer: Preferred Health Network WC |
$23,471.53
|
| Rate for Payer: Prime Health Services Medicare |
$15,429.78
|
| Rate for Payer: Prime Health Services WC |
$22,192.93
|
| 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 597: MALIGNANT BREAST DISORDERS WITH MCC
|
Facility
IP
|
$42,123.56
|
|
|
Service Code
|
MS-DRG 597
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,123.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,123.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,629.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,166.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,478.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,418.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,532.38
|
| Rate for Payer: IEHP Medicare Advantage |
$22,532.38
|
| Rate for Payer: Innovage PACE Commercial |
$33,798.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,532.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,193.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,193.39
|
| Rate for Payer: Multiplan WC |
$35,478.60
|
| Rate for Payer: Preferred Health Network WC |
$36,202.65
|
| Rate for Payer: Prime Health Services Medicare |
$23,884.32
|
| Rate for Payer: Prime Health Services WC |
$34,230.53
|
| 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 598: MALIGNANT BREAST DISORDERS WITH CC
|
Facility
IP
|
$31,551.22
|
|
|
Service Code
|
MS-DRG 598
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,551.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,551.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,158.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,305.13
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,502.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,106.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,115.73
|
| Rate for Payer: IEHP Medicare Advantage |
$17,115.73
|
| Rate for Payer: Innovage PACE Commercial |
$25,673.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,115.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,935.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,935.08
|
| Rate for Payer: Multiplan WC |
$22,502.79
|
| Rate for Payer: Preferred Health Network WC |
$22,962.03
|
| Rate for Payer: Prime Health Services Medicare |
$18,142.67
|
| Rate for Payer: Prime Health Services WC |
$21,711.18
|
| 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 599: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$16,354.63
|
|
|
Service Code
|
MS-DRG 599
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$16,354.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,354.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,709.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,612.13
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,750.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,530.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,022.95
|
| Rate for Payer: IEHP Medicare Advantage |
$10,022.95
|
| Rate for Payer: Innovage PACE Commercial |
$15,034.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,022.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,430.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,430.75
|
| Rate for Payer: Multiplan WC |
$15,750.47
|
| Rate for Payer: Preferred Health Network WC |
$16,071.91
|
| Rate for Payer: Prime Health Services Medicare |
$10,624.33
|
| Rate for Payer: Prime Health Services WC |
$15,196.41
|
| 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 600: NON-MALIGNANT BREAST DISORDERS WITH CC/MCC
|
Facility
IP
|
$26,990.13
|
|
|
Service Code
|
MS-DRG 600
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,990.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,990.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,699.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,741.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,933.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,951.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,778.90
|
| Rate for Payer: IEHP Medicare Advantage |
$14,778.90
|
| Rate for Payer: Innovage PACE Commercial |
$22,168.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,778.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,803.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,803.73
|
| Rate for Payer: Multiplan WC |
$21,933.95
|
| Rate for Payer: Preferred Health Network WC |
$22,381.58
|
| Rate for Payer: Prime Health Services Medicare |
$15,665.63
|
| Rate for Payer: Prime Health Services WC |
$21,162.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 601: NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$16,386.21
|
|
|
Service Code
|
MS-DRG 601
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$16,386.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,386.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,967.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,699.54
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,829.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,815.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,493.02
|
| Rate for Payer: IEHP Medicare Advantage |
$9,493.02
|
| Rate for Payer: Innovage PACE Commercial |
$14,239.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,493.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,720.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,720.65
|
| Rate for Payer: Multiplan WC |
$14,829.80
|
| Rate for Payer: Preferred Health Network WC |
$15,132.45
|
| Rate for Payer: Prime Health Services Medicare |
$10,062.60
|
| Rate for Payer: Prime Health Services WC |
$14,308.12
|
| 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 602: CELLULITIS WITH MCC
|
Facility
IP
|
$39,149.51
|
|
|
Service Code
|
MS-DRG 602
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,149.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,149.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,501.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,096.58
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,363.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,361.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,008.66
|
| Rate for Payer: IEHP Medicare Advantage |
$21,008.66
|
| Rate for Payer: Innovage PACE Commercial |
$31,512.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,008.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,151.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,151.60
|
| Rate for Payer: Multiplan WC |
$30,363.27
|
| Rate for Payer: Preferred Health Network WC |
$30,982.93
|
| Rate for Payer: Prime Health Services Medicare |
$22,269.18
|
| Rate for Payer: Prime Health Services WC |
$29,295.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 603: CELLULITIS WITHOUT MCC
|
Facility
IP
|
$23,284.42
|
|
|
Service Code
|
MS-DRG 603
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,284.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,284.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,991.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,414.63
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,577.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,388.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,880.29
|
| Rate for Payer: IEHP Medicare Advantage |
$12,880.29
|
| Rate for Payer: Innovage PACE Commercial |
$19,320.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,880.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,259.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,259.59
|
| Rate for Payer: Multiplan WC |
$18,577.81
|
| Rate for Payer: Preferred Health Network WC |
$18,956.95
|
| Rate for Payer: Prime Health Services Medicare |
$13,653.11
|
| Rate for Payer: Prime Health Services WC |
$17,924.28
|
| 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 604: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC
|
Facility
IP
|
$39,641.68
|
|
|
Service Code
|
MS-DRG 604
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,641.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,641.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,657.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,516.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,795.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,702.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,260.81
|
| Rate for Payer: IEHP Medicare Advantage |
$21,260.81
|
| Rate for Payer: Innovage PACE Commercial |
$31,891.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,260.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,489.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,489.49
|
| Rate for Payer: Multiplan WC |
$31,795.90
|
| Rate for Payer: Preferred Health Network WC |
$32,444.80
|
| Rate for Payer: Prime Health Services Medicare |
$22,536.46
|
| Rate for Payer: Prime Health Services WC |
$30,677.38
|
| 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
|
|
