|
INPATIENT MS-DRG 642: INBORN AND OTHER DISORDERS OF METABOLISM
|
Facility
IP
|
$34,301.55
|
|
|
Service Code
|
MS-DRG 642
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,301.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,301.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,857.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,305.11
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,564.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,008.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,524.84
|
| Rate for Payer: IEHP Medicare Advantage |
$18,524.84
|
| Rate for Payer: Innovage PACE Commercial |
$27,787.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,524.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,823.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,823.29
|
| Rate for Payer: Multiplan WC |
$29,564.80
|
| Rate for Payer: Preferred Health Network WC |
$30,168.16
|
| Rate for Payer: Prime Health Services Medicare |
$19,636.33
|
| Rate for Payer: Prime Health Services WC |
$28,524.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 643: ENDOCRINE DISORDERS WITH MCC
|
Facility
IP
|
$43,297.39
|
|
|
Service Code
|
MS-DRG 643
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$43,297.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,297.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,944.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,325.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,629.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,230.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,133.78
|
| Rate for Payer: IEHP Medicare Advantage |
$23,133.78
|
| Rate for Payer: Innovage PACE Commercial |
$34,700.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,133.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,999.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,999.27
|
| Rate for Payer: Multiplan WC |
$34,629.55
|
| Rate for Payer: Preferred Health Network WC |
$35,336.28
|
| Rate for Payer: Prime Health Services Medicare |
$24,521.81
|
| Rate for Payer: Prime Health Services WC |
$33,411.36
|
| 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 644: ENDOCRINE DISORDERS WITH CC
|
Facility
IP
|
$27,942.88
|
|
|
Service Code
|
MS-DRG 644
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,942.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,942.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,325.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,281.87
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,470.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,610.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,267.02
|
| Rate for Payer: IEHP Medicare Advantage |
$15,267.02
|
| Rate for Payer: Innovage PACE Commercial |
$22,900.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,267.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,457.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,457.81
|
| Rate for Payer: Multiplan WC |
$21,470.45
|
| Rate for Payer: Preferred Health Network WC |
$21,908.62
|
| Rate for Payer: Prime Health Services Medicare |
$16,183.04
|
| Rate for Payer: Prime Health Services WC |
$20,715.16
|
| 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 645: ENDOCRINE DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$20,026.13
|
|
|
Service Code
|
MS-DRG 645
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,026.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,026.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,624.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,507.72
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,645.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,134.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,210.91
|
| Rate for Payer: IEHP Medicare Advantage |
$11,210.91
|
| Rate for Payer: Innovage PACE Commercial |
$16,816.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,210.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,022.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,022.62
|
| Rate for Payer: Multiplan WC |
$15,645.13
|
| Rate for Payer: Preferred Health Network WC |
$15,964.42
|
| Rate for Payer: Prime Health Services Medicare |
$11,883.56
|
| Rate for Payer: Prime Health Services WC |
$15,094.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 650: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC
|
Facility
IP
|
$118,369.70
|
|
|
Service Code
|
MS-DRG 650
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$118,369.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,369.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78,950.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$96,978.56
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$97,837.93
|
| Rate for Payer: BCBS Transplant Transplant |
$113,455.00
|
| Rate for Payer: Caremore Medicare Advantage |
$61,596.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$83,155.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$61,596.52
|
| Rate for Payer: IEHP Medicare Advantage |
$61,596.52
|
| Rate for Payer: Innovage PACE Commercial |
$92,394.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61,596.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82,539.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82,539.34
|
| Rate for Payer: Multiplan WC |
$97,837.93
|
| Rate for Payer: OptumHealth/URN Transplant Commercial |
$77,000.00
|
| Rate for Payer: Preferred Health Network WC |
$99,834.62
|
| Rate for Payer: Prime Health Services Medicare |
$65,292.31
|
| Rate for Payer: Prime Health Services WC |
$94,396.19
|
| 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
|
|
|
INPATIENT MS-DRG 651: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC
|
Facility
IP
|
$113,455.00
|
|
|
Service Code
|
MS-DRG 651
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$113,455.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$91,021.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60,288.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74,055.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$74,711.52
|
| Rate for Payer: BCBS Transplant Transplant |
$113,455.00
|
| Rate for Payer: Caremore Medicare Advantage |
$47,584.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$64,239.67
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,584.94
|
| Rate for Payer: IEHP Medicare Advantage |
$47,584.94
|
| Rate for Payer: Innovage PACE Commercial |
$71,377.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,584.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,763.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,763.82
|
| Rate for Payer: Multiplan WC |
$74,711.52
|
| Rate for Payer: OptumHealth/URN Transplant Commercial |
$77,000.00
|
| Rate for Payer: Preferred Health Network WC |
$76,236.25
|
| Rate for Payer: Prime Health Services Medicare |
$50,440.04
|
| Rate for Payer: Prime Health Services WC |
$72,083.33
|
| 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 652: KIDNEY TRANSPLANT
|
Facility
IP
|
$113,455.00
|
|
|
Service Code
|
MS-DRG 652
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$113,455.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$79,072.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52,449.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64,426.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,997.05
|
| Rate for Payer: BCBS Transplant Transplant |
$113,455.00
|
| Rate for Payer: Caremore Medicare Advantage |
$41,463.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,975.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,463.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$105,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$63,280.00
|
| Rate for Payer: IEHP Medicare Advantage |
$41,463.05
|
| Rate for Payer: Innovage PACE Commercial |
$62,194.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,463.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,560.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,560.49
|
| Rate for Payer: Multiplan WC |
$64,997.05
|
| Rate for Payer: Networks By Design Commercial |
$75,000.00
|
| Rate for Payer: OptumHealth/URN Transplant Commercial |
$77,000.00
|
| Rate for Payer: Preferred Health Network WC |
$66,323.52
|
| Rate for Payer: Prime Health Services Medicare |
$43,950.83
|
| Rate for Payer: Prime Health Services WC |
$62,710.58
|
| 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 653: MAJOR BLADDER PROCEDURES WITH MCC
|
Facility
IP
|
$142,480.54
|
|
|
Service Code
|
MS-DRG 653
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$142,480.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$142,480.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94,469.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$116,040.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$117,068.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$99,831.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$73,949.53
|
| Rate for Payer: IEHP Medicare Advantage |
$73,949.53
|
| Rate for Payer: Innovage PACE Commercial |
$110,924.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73,949.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$99,092.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,092.37
|
| Rate for Payer: Multiplan WC |
$117,068.84
|
| Rate for Payer: Preferred Health Network WC |
$119,458.00
|
| Rate for Payer: Prime Health Services Medicare |
$78,386.50
|
| Rate for Payer: Prime Health Services WC |
$112,950.60
|
| 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 654: MAJOR BLADDER PROCEDURES WITH CC
|
Facility
IP
|
$72,048.26
|
|
|
Service Code
|
MS-DRG 654
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$72,048.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,048.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$48,325.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59,359.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$59,885.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,116.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$37,864.09
|
| Rate for Payer: IEHP Medicare Advantage |
$37,864.09
|
| Rate for Payer: Innovage PACE Commercial |
$56,796.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,864.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,737.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,737.88
|
| Rate for Payer: Multiplan WC |
$59,885.94
|
| Rate for Payer: Preferred Health Network WC |
$61,108.10
|
| Rate for Payer: Prime Health Services Medicare |
$40,135.94
|
| Rate for Payer: Prime Health Services WC |
$57,779.27
|
| 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 655: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$55,475.19
|
|
|
Service Code
|
MS-DRG 655
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$55,475.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,475.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,700.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,080.13
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,479.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,653.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,372.99
|
| Rate for Payer: IEHP Medicare Advantage |
$29,372.99
|
| Rate for Payer: Innovage PACE Commercial |
$44,059.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,372.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,359.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,359.81
|
| Rate for Payer: Multiplan WC |
$45,479.60
|
| Rate for Payer: Preferred Health Network WC |
$46,407.76
|
| Rate for Payer: Prime Health Services Medicare |
$31,135.37
|
| Rate for Payer: Prime Health Services WC |
$43,879.73
|
| 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 656: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC
|
Facility
IP
|
$82,578.49
|
|
|
Service Code
|
MS-DRG 656
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$82,578.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,578.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56,193.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69,024.58
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$69,636.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,399.88
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$43,259.17
|
| Rate for Payer: IEHP Medicare Advantage |
$43,259.17
|
| Rate for Payer: Innovage PACE Commercial |
$64,888.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,259.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,967.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,967.29
|
| Rate for Payer: Multiplan WC |
$69,636.23
|
| Rate for Payer: Preferred Health Network WC |
$71,057.38
|
| Rate for Payer: Prime Health Services Medicare |
$45,854.72
|
| Rate for Payer: Prime Health Services WC |
$67,186.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 657: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC
|
Facility
IP
|
$48,537.50
|
|
|
Service Code
|
MS-DRG 657
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,537.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,537.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,927.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,218.27
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,565.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,854.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,818.50
|
| Rate for Payer: IEHP Medicare Advantage |
$25,818.50
|
| Rate for Payer: Innovage PACE Commercial |
$38,727.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,818.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,596.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,596.79
|
| Rate for Payer: Multiplan WC |
$39,565.80
|
| Rate for Payer: Preferred Health Network WC |
$40,373.27
|
| Rate for Payer: Prime Health Services Medicare |
$27,367.61
|
| Rate for Payer: Prime Health Services WC |
$38,173.95
|
| 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 658: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC
|
Facility
IP
|
$38,962.65
|
|
|
Service Code
|
MS-DRG 658
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$38,962.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,962.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,844.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,974.26
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,266.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,232.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,912.90
|
| Rate for Payer: IEHP Medicare Advantage |
$20,912.90
|
| Rate for Payer: Innovage PACE Commercial |
$31,369.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,912.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,023.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,023.29
|
| Rate for Payer: Multiplan WC |
$33,266.45
|
| Rate for Payer: Preferred Health Network WC |
$33,945.36
|
| Rate for Payer: Prime Health Services Medicare |
$22,167.67
|
| Rate for Payer: Prime Health Services WC |
$32,096.20
|
| 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 659: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
|
Facility
IP
|
$68,137.26
|
|
|
Service Code
|
MS-DRG 659
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$68,137.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,137.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43,809.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53,813.40
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$54,290.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,411.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$35,860.30
|
| Rate for Payer: IEHP Medicare Advantage |
$35,860.30
|
| Rate for Payer: Innovage PACE Commercial |
$53,790.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,860.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$48,052.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,052.80
|
| Rate for Payer: Multiplan WC |
$54,290.27
|
| Rate for Payer: Preferred Health Network WC |
$55,398.23
|
| Rate for Payer: Prime Health Services Medicare |
$38,011.92
|
| Rate for Payer: Prime Health Services WC |
$52,380.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 660: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC
|
Facility
IP
|
$35,422.74
|
|
|
Service Code
|
MS-DRG 660
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,422.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,422.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,991.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,470.09
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,731.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,784.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,099.27
|
| Rate for Payer: IEHP Medicare Advantage |
$19,099.27
|
| Rate for Payer: Innovage PACE Commercial |
$28,648.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,099.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,593.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,593.02
|
| Rate for Payer: Multiplan WC |
$29,731.23
|
| Rate for Payer: Preferred Health Network WC |
$30,337.99
|
| Rate for Payer: Prime Health Services Medicare |
$20,245.23
|
| Rate for Payer: Prime Health Services WC |
$28,685.35
|
| 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 661: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
|
Facility
IP
|
$27,592.84
|
|
|
Service Code
|
MS-DRG 661
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$27,592.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,592.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,325.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,509.79
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,709.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,368.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,087.67
|
| Rate for Payer: IEHP Medicare Advantage |
$15,087.67
|
| Rate for Payer: Innovage PACE Commercial |
$22,631.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,087.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,217.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,217.48
|
| Rate for Payer: Multiplan WC |
$22,709.26
|
| Rate for Payer: Preferred Health Network WC |
$23,172.71
|
| Rate for Payer: Prime Health Services Medicare |
$15,992.93
|
| Rate for Payer: Prime Health Services WC |
$21,910.39
|
| 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 662: MINOR BLADDER PROCEDURES WITH MCC
|
Facility
IP
|
$78,870.15
|
|
|
Service Code
|
MS-DRG 662
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$78,870.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78,870.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51,660.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63,457.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,019.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,834.95
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,359.22
|
| Rate for Payer: IEHP Medicare Advantage |
$41,359.22
|
| Rate for Payer: Innovage PACE Commercial |
$62,038.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,359.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,421.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,421.35
|
| Rate for Payer: Multiplan WC |
$64,019.49
|
| Rate for Payer: Preferred Health Network WC |
$65,326.01
|
| Rate for Payer: Prime Health Services Medicare |
$43,840.77
|
| Rate for Payer: Prime Health Services WC |
$61,767.42
|
| 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 663: MINOR BLADDER PROCEDURES WITH CC
|
Facility
IP
|
$38,399.42
|
|
|
Service Code
|
MS-DRG 663
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$38,399.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,399.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,926.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,846.58
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,128.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,842.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,624.34
|
| Rate for Payer: IEHP Medicare Advantage |
$20,624.34
|
| Rate for Payer: Innovage PACE Commercial |
$30,936.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,624.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,636.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,636.62
|
| Rate for Payer: Multiplan WC |
$32,128.78
|
| Rate for Payer: Preferred Health Network WC |
$32,784.47
|
| Rate for Payer: Prime Health Services Medicare |
$21,861.80
|
| Rate for Payer: Prime Health Services WC |
$30,998.55
|
| 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 664: MINOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$27,940.25
|
|
|
Service Code
|
MS-DRG 664
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$27,940.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,940.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,155.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,528.88
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,737.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,608.65
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,265.67
|
| Rate for Payer: IEHP Medicare Advantage |
$15,265.67
|
| Rate for Payer: Innovage PACE Commercial |
$22,898.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,265.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,456.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,456.00
|
| Rate for Payer: Multiplan WC |
$23,737.37
|
| Rate for Payer: Preferred Health Network WC |
$24,221.81
|
| Rate for Payer: Prime Health Services Medicare |
$16,181.61
|
| Rate for Payer: Prime Health Services WC |
$22,902.34
|
| 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 665: PROSTATECTOMY WITH MCC
|
Facility
IP
|
$81,302.02
|
|
|
Service Code
|
MS-DRG 665
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$81,302.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81,302.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52,028.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63,908.24
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,474.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,516.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$42,605.18
|
| Rate for Payer: IEHP Medicare Advantage |
$42,605.18
|
| Rate for Payer: Innovage PACE Commercial |
$63,907.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,605.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,090.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,090.94
|
| Rate for Payer: Multiplan WC |
$64,474.56
|
| Rate for Payer: Preferred Health Network WC |
$65,790.37
|
| Rate for Payer: Prime Health Services Medicare |
$45,161.49
|
| Rate for Payer: Prime Health Services WC |
$62,206.48
|
| 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 666: PROSTATECTOMY WITH CC
|
Facility
IP
|
$45,200.25
|
|
|
Service Code
|
MS-DRG 666
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,200.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,200.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,274.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,958.44
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,277.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,546.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,108.71
|
| Rate for Payer: IEHP Medicare Advantage |
$24,108.71
|
| Rate for Payer: Innovage PACE Commercial |
$36,163.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,108.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,305.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,305.67
|
| Rate for Payer: Multiplan WC |
$36,277.08
|
| Rate for Payer: Preferred Health Network WC |
$37,017.43
|
| Rate for Payer: Prime Health Services Medicare |
$25,555.23
|
| Rate for Payer: Prime Health Services WC |
$35,000.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 667: PROSTATECTOMY WITHOUT CC/MCC
|
Facility
IP
|
$27,624.42
|
|
|
Service Code
|
MS-DRG 667
|
| Min. Negotiated Rate |
$15,103.86 |
| Max. Negotiated Rate |
$27,624.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,624.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,727.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,546.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,728.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,390.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,103.86
|
| Rate for Payer: IEHP Medicare Advantage |
$15,103.86
|
| Rate for Payer: Innovage PACE Commercial |
$22,655.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,103.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,239.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,239.17
|
| Rate for Payer: Multiplan WC |
$20,728.85
|
| Rate for Payer: Preferred Health Network WC |
$21,151.89
|
| Rate for Payer: Prime Health Services Medicare |
$16,010.09
|
| Rate for Payer: Prime Health Services WC |
$19,999.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$23,727.00
|
| Rate for Payer: United Healthcare All Other HMO |
$23,328.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,284.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,291.00
|
|
|
INPATIENT MS-DRG 668: TRANSURETHRAL PROCEDURES WITH MCC
|
Facility
IP
|
$74,166.94
|
|
|
Service Code
|
MS-DRG 668
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$74,166.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$74,166.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47,992.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58,950.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$59,473.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,581.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,949.56
|
| Rate for Payer: IEHP Medicare Advantage |
$38,949.56
|
| Rate for Payer: Innovage PACE Commercial |
$58,424.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,949.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52,192.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,192.41
|
| Rate for Payer: Multiplan WC |
$59,473.01
|
| Rate for Payer: Preferred Health Network WC |
$60,686.74
|
| Rate for Payer: Prime Health Services Medicare |
$41,286.53
|
| Rate for Payer: Prime Health Services WC |
$57,380.86
|
| 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 669: TRANSURETHRAL PROCEDURES WITH CC
|
Facility
IP
|
$40,389.14
|
|
|
Service Code
|
MS-DRG 669
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,389.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,389.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,762.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,874.02
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,165.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,219.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,643.75
|
| Rate for Payer: IEHP Medicare Advantage |
$21,643.75
|
| Rate for Payer: Innovage PACE Commercial |
$32,465.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,643.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,002.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,002.62
|
| Rate for Payer: Multiplan WC |
$33,165.33
|
| Rate for Payer: Preferred Health Network WC |
$33,842.17
|
| Rate for Payer: Prime Health Services Medicare |
$22,942.38
|
| Rate for Payer: Prime Health Services WC |
$31,998.64
|
| 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 670: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$25,334.67
|
|
|
Service Code
|
MS-DRG 670
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$25,334.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,334.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,788.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,621.96
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,804.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,806.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,930.72
|
| Rate for Payer: IEHP Medicare Advantage |
$13,930.72
|
| Rate for Payer: Innovage PACE Commercial |
$20,896.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,930.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,667.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,667.16
|
| Rate for Payer: Multiplan WC |
$20,804.70
|
| Rate for Payer: Preferred Health Network WC |
$21,229.29
|
| Rate for Payer: Prime Health Services Medicare |
$14,766.56
|
| Rate for Payer: Prime Health Services WC |
$20,072.83
|
| 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
|
|
