|
INPATIENT MS-DRG 671: URETHRAL PROCEDURES WITH CC/MCC
|
Facility
IP
|
$45,055.50
|
|
|
Service Code
|
MS-DRG 671
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$45,055.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,055.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,137.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,247.21
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,586.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,446.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,034.53
|
| Rate for Payer: IEHP Medicare Advantage |
$24,034.53
|
| Rate for Payer: Innovage PACE Commercial |
$36,051.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,034.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,206.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,206.27
|
| Rate for Payer: Multiplan WC |
$38,586.14
|
| Rate for Payer: Preferred Health Network WC |
$39,373.61
|
| Rate for Payer: Prime Health Services Medicare |
$25,476.60
|
| Rate for Payer: Prime Health Services WC |
$37,228.76
|
| 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 672: URETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$24,284.54
|
|
|
Service Code
|
MS-DRG 672
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$24,284.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,284.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,709.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,753.82
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,946.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,349.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,592.26
|
| Rate for Payer: IEHP Medicare Advantage |
$13,592.26
|
| Rate for Payer: Innovage PACE Commercial |
$20,388.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,592.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,213.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,213.63
|
| Rate for Payer: Multiplan WC |
$21,946.59
|
| Rate for Payer: Preferred Health Network WC |
$22,394.48
|
| Rate for Payer: Prime Health Services Medicare |
$14,407.80
|
| Rate for Payer: Prime Health Services WC |
$21,174.56
|
| 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 673: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC
|
Facility
IP
|
$97,327.66
|
|
|
Service Code
|
MS-DRG 673
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$97,327.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97,327.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59,401.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72,965.20
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$73,611.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,601.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$50,815.79
|
| Rate for Payer: IEHP Medicare Advantage |
$50,815.79
|
| Rate for Payer: Innovage PACE Commercial |
$76,223.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50,815.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,093.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,093.16
|
| Rate for Payer: Multiplan WC |
$73,611.77
|
| Rate for Payer: Preferred Health Network WC |
$75,114.05
|
| Rate for Payer: Prime Health Services Medicare |
$53,864.74
|
| Rate for Payer: Prime Health Services WC |
$71,022.26
|
| 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 674: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC
|
Facility
IP
|
$62,697.12
|
|
|
Service Code
|
MS-DRG 674
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$62,697.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,697.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40,300.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49,503.15
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$49,941.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$33,073.10
|
| Rate for Payer: IEHP Medicare Advantage |
$33,073.10
|
| Rate for Payer: Innovage PACE Commercial |
$49,609.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,073.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,317.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,317.95
|
| Rate for Payer: Multiplan WC |
$49,941.82
|
| Rate for Payer: Preferred Health Network WC |
$50,961.04
|
| Rate for Payer: Prime Health Services Medicare |
$35,057.49
|
| Rate for Payer: Prime Health Services WC |
$48,184.96
|
| 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 675: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$41,755.09
|
|
|
Service Code
|
MS-DRG 675
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$41,755.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,755.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,670.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,217.09
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,529.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,163.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,343.59
|
| Rate for Payer: IEHP Medicare Advantage |
$22,343.59
|
| Rate for Payer: Innovage PACE Commercial |
$33,515.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,343.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,940.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,940.41
|
| Rate for Payer: Multiplan WC |
$35,529.16
|
| Rate for Payer: Preferred Health Network WC |
$36,254.25
|
| Rate for Payer: Prime Health Services Medicare |
$23,684.21
|
| Rate for Payer: Prime Health Services WC |
$34,279.32
|
| 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 682: RENAL FAILURE WITH MCC
|
Facility
IP
|
$39,499.56
|
|
|
Service Code
|
MS-DRG 682
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,499.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,499.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,273.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,044.67
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,319.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,603.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,187.99
|
| Rate for Payer: IEHP Medicare Advantage |
$21,187.99
|
| Rate for Payer: Innovage PACE Commercial |
$31,781.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,187.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,391.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,391.91
|
| Rate for Payer: Multiplan WC |
$31,319.76
|
| Rate for Payer: Preferred Health Network WC |
$31,958.94
|
| Rate for Payer: Prime Health Services Medicare |
$22,459.27
|
| Rate for Payer: Prime Health Services WC |
$30,218.00
|
| 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 683: RENAL FAILURE WITH CC
|
Facility
IP
|
$23,708.16
|
|
|
Service Code
|
MS-DRG 683
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,708.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,708.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,214.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,688.20
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,853.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,681.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,097.38
|
| Rate for Payer: IEHP Medicare Advantage |
$13,097.38
|
| Rate for Payer: Innovage PACE Commercial |
$19,646.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,097.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,550.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,550.49
|
| Rate for Payer: Multiplan WC |
$18,853.80
|
| Rate for Payer: Preferred Health Network WC |
$19,238.57
|
| Rate for Payer: Prime Health Services Medicare |
$13,883.22
|
| Rate for Payer: Prime Health Services WC |
$18,190.57
|
| 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 684: RENAL FAILURE WITHOUT CC/MCC
|
Facility
IP
|
$16,015.11
|
|
|
Service Code
|
MS-DRG 684
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$16,015.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,015.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,282.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,630.04
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$12,741.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,360.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,155.91
|
| Rate for Payer: IEHP Medicare Advantage |
$9,155.91
|
| Rate for Payer: Innovage PACE Commercial |
$13,733.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,155.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,268.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,268.92
|
| Rate for Payer: Multiplan WC |
$12,741.96
|
| Rate for Payer: Preferred Health Network WC |
$13,002.00
|
| Rate for Payer: Prime Health Services Medicare |
$9,705.26
|
| Rate for Payer: Prime Health Services WC |
$12,293.72
|
| 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 686: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC
|
Facility
IP
|
$48,411.17
|
|
|
Service Code
|
MS-DRG 686
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$48,411.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,411.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,864.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,455.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,769.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,767.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,753.78
|
| Rate for Payer: IEHP Medicare Advantage |
$25,753.78
|
| Rate for Payer: Innovage PACE Commercial |
$38,630.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,753.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,510.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,510.07
|
| Rate for Payer: Multiplan WC |
$35,769.33
|
| Rate for Payer: Preferred Health Network WC |
$36,499.32
|
| Rate for Payer: Prime Health Services Medicare |
$27,299.01
|
| Rate for Payer: Prime Health Services WC |
$34,511.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 687: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC
|
Facility
IP
|
$27,511.25
|
|
|
Service Code
|
MS-DRG 687
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,511.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,511.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,677.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,714.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,906.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,311.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,045.87
|
| Rate for Payer: IEHP Medicare Advantage |
$15,045.87
|
| Rate for Payer: Innovage PACE Commercial |
$22,568.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,045.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,161.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,161.47
|
| Rate for Payer: Multiplan WC |
$21,906.56
|
| Rate for Payer: Preferred Health Network WC |
$22,353.63
|
| Rate for Payer: Prime Health Services Medicare |
$15,948.62
|
| Rate for Payer: Prime Health Services WC |
$21,135.93
|
| 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 688: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC
|
Facility
IP
|
$20,552.51
|
|
|
Service Code
|
MS-DRG 688
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,552.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,552.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,729.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,093.03
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,253.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,498.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,480.62
|
| Rate for Payer: IEHP Medicare Advantage |
$11,480.62
|
| Rate for Payer: Innovage PACE Commercial |
$17,220.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,480.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,384.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,384.03
|
| Rate for Payer: Multiplan WC |
$18,253.36
|
| Rate for Payer: Preferred Health Network WC |
$18,625.88
|
| Rate for Payer: Prime Health Services Medicare |
$12,169.46
|
| Rate for Payer: Prime Health Services WC |
$17,611.24
|
| 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 689: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC
|
Facility
IP
|
$30,909.03
|
|
|
Service Code
|
MS-DRG 689
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$30,909.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,909.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,501.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,954.89
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,167.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,662.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16,786.70
|
| Rate for Payer: IEHP Medicare Advantage |
$16,786.70
|
| Rate for Payer: Innovage PACE Commercial |
$25,180.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,786.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,494.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,494.18
|
| Rate for Payer: Multiplan WC |
$24,167.16
|
| Rate for Payer: Preferred Health Network WC |
$24,660.37
|
| Rate for Payer: Prime Health Services Medicare |
$17,793.90
|
| Rate for Payer: Prime Health Services WC |
$23,317.01
|
| 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 690: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC
|
Facility
IP
|
$21,236.80
|
|
|
Service Code
|
MS-DRG 690
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$21,236.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,236.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,526.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,614.51
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,761.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,972.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,831.21
|
| Rate for Payer: IEHP Medicare Advantage |
$11,831.21
|
| Rate for Payer: Innovage PACE Commercial |
$17,746.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,831.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,853.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,853.82
|
| Rate for Payer: Multiplan WC |
$16,761.74
|
| Rate for Payer: Preferred Health Network WC |
$17,103.82
|
| Rate for Payer: Prime Health Services Medicare |
$12,541.08
|
| Rate for Payer: Prime Health Services WC |
$16,172.10
|
| 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 693: URINARY STONES WITH MCC
|
Facility
IP
|
$37,275.60
|
|
|
Service Code
|
MS-DRG 693
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$37,275.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,275.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,325.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,879.40
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,144.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,065.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,048.56
|
| Rate for Payer: IEHP Medicare Advantage |
$20,048.56
|
| Rate for Payer: Innovage PACE Commercial |
$30,072.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,048.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,865.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,865.07
|
| Rate for Payer: Multiplan WC |
$30,144.17
|
| Rate for Payer: Preferred Health Network WC |
$30,759.36
|
| Rate for Payer: Prime Health Services Medicare |
$21,251.47
|
| Rate for Payer: Prime Health Services WC |
$29,083.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 694: URINARY STONES WITHOUT MCC
|
Facility
IP
|
$20,599.88
|
|
|
Service Code
|
MS-DRG 694
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$20,599.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,599.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,551.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,645.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,793.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,531.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,504.88
|
| Rate for Payer: IEHP Medicare Advantage |
$11,504.88
|
| Rate for Payer: Innovage PACE Commercial |
$17,257.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,504.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,416.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,416.54
|
| Rate for Payer: Multiplan WC |
$16,793.35
|
| Rate for Payer: Preferred Health Network WC |
$17,136.07
|
| Rate for Payer: Prime Health Services Medicare |
$12,195.17
|
| Rate for Payer: Prime Health Services WC |
$16,202.59
|
| 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 695: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC
|
Facility
IP
|
$31,477.52
|
|
|
Service Code
|
MS-DRG 695
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,477.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,477.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,522.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,979.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,192.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,055.25
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,077.96
|
| Rate for Payer: IEHP Medicare Advantage |
$17,077.96
|
| Rate for Payer: Innovage PACE Commercial |
$25,616.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,077.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,884.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,884.47
|
| Rate for Payer: Multiplan WC |
$24,192.45
|
| Rate for Payer: Preferred Health Network WC |
$24,686.17
|
| Rate for Payer: Prime Health Services Medicare |
$18,102.64
|
| Rate for Payer: Prime Health Services WC |
$23,341.40
|
| 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 696: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
IP
|
$18,215.38
|
|
|
Service Code
|
MS-DRG 696
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,215.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,215.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,781.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,471.92
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,600.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,882.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,283.20
|
| Rate for Payer: IEHP Medicare Advantage |
$10,283.20
|
| Rate for Payer: Innovage PACE Commercial |
$15,424.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,283.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,779.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,779.49
|
| Rate for Payer: Multiplan WC |
$14,600.16
|
| Rate for Payer: Preferred Health Network WC |
$14,898.12
|
| Rate for Payer: Prime Health Services Medicare |
$10,900.19
|
| Rate for Payer: Prime Health Services WC |
$14,086.55
|
| 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 697: URETHRAL STRICTURE
|
Facility
IP
|
$29,295.68
|
|
|
Service Code
|
MS-DRG 697
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$29,295.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,295.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,871.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,724.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,907.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,546.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,960.11
|
| Rate for Payer: IEHP Medicare Advantage |
$15,960.11
|
| Rate for Payer: Innovage PACE Commercial |
$23,940.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,960.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,386.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,386.55
|
| Rate for Payer: Multiplan WC |
$20,907.94
|
| Rate for Payer: Preferred Health Network WC |
$21,334.63
|
| Rate for Payer: Prime Health Services Medicare |
$16,917.72
|
| Rate for Payer: Prime Health Services WC |
$20,172.44
|
| 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 698: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC
|
Facility
IP
|
$43,542.15
|
|
|
Service Code
|
MS-DRG 698
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$43,542.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,542.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,244.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,465.01
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,761.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,399.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,259.19
|
| Rate for Payer: IEHP Medicare Advantage |
$23,259.19
|
| Rate for Payer: Innovage PACE Commercial |
$34,888.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,259.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,167.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,167.31
|
| Rate for Payer: Multiplan WC |
$33,761.55
|
| Rate for Payer: Preferred Health Network WC |
$34,450.56
|
| Rate for Payer: Prime Health Services Medicare |
$24,654.74
|
| Rate for Payer: Prime Health Services WC |
$32,573.89
|
| 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 699: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC
|
Facility
IP
|
$26,866.44
|
|
|
Service Code
|
MS-DRG 699
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,866.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,866.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,206.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,135.68
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,322.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,865.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,715.51
|
| Rate for Payer: IEHP Medicare Advantage |
$14,715.51
|
| Rate for Payer: Innovage PACE Commercial |
$22,073.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,715.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,718.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,718.78
|
| Rate for Payer: Multiplan WC |
$21,322.98
|
| Rate for Payer: Preferred Health Network WC |
$21,758.14
|
| Rate for Payer: Prime Health Services Medicare |
$15,598.44
|
| Rate for Payer: Prime Health Services WC |
$20,572.88
|
| 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 700: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC
|
Facility
IP
|
$18,641.75
|
|
|
Service Code
|
MS-DRG 700
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,641.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,641.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,594.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,470.13
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,607.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,177.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,501.64
|
| Rate for Payer: IEHP Medicare Advantage |
$10,501.64
|
| Rate for Payer: Innovage PACE Commercial |
$15,752.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,501.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,072.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,072.20
|
| Rate for Payer: Multiplan WC |
$15,607.22
|
| Rate for Payer: Preferred Health Network WC |
$15,925.73
|
| Rate for Payer: Prime Health Services Medicare |
$11,131.74
|
| Rate for Payer: Prime Health Services WC |
$15,058.18
|
| 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 707: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
IP
|
$51,635.25
|
|
|
Service Code
|
MS-DRG 707
|
| Min. Negotiated Rate |
$21,291.00 |
| Max. Negotiated Rate |
$51,635.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,635.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,922.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,667.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,037.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,997.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,405.62
|
| Rate for Payer: IEHP Medicare Advantage |
$27,405.62
|
| Rate for Payer: Innovage PACE Commercial |
$41,108.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,405.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,723.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,723.53
|
| Rate for Payer: Multiplan WC |
$42,037.08
|
| Rate for Payer: Preferred Health Network WC |
$42,894.98
|
| Rate for Payer: Prime Health Services Medicare |
$29,049.96
|
| Rate for Payer: Prime Health Services WC |
$40,558.30
|
| 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 708: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$38,386.26
|
|
|
Service Code
|
MS-DRG 708
|
| Min. Negotiated Rate |
$20,617.60 |
| Max. Negotiated Rate |
$38,386.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,386.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,241.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,004.99
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,279.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,833.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,617.60
|
| Rate for Payer: IEHP Medicare Advantage |
$20,617.60
|
| Rate for Payer: Innovage PACE Commercial |
$30,926.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,617.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,627.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,627.58
|
| Rate for Payer: Multiplan WC |
$31,279.74
|
| Rate for Payer: Preferred Health Network WC |
$31,918.10
|
| Rate for Payer: Prime Health Services Medicare |
$21,854.66
|
| Rate for Payer: Prime Health Services WC |
$30,179.38
|
| 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 709: PENIS PROCEDURES WITH CC/MCC
|
Facility
IP
|
$55,796.28
|
|
|
Service Code
|
MS-DRG 709
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$55,796.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,796.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41,006.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50,369.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$50,816.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,800.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,222.50
|
| Rate for Payer: IEHP Medicare Advantage |
$30,222.50
|
| Rate for Payer: Innovage PACE Commercial |
$45,333.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,222.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,498.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,498.15
|
| Rate for Payer: Multiplan WC |
$50,816.14
|
| Rate for Payer: Preferred Health Network WC |
$51,853.20
|
| Rate for Payer: Prime Health Services Medicare |
$32,035.85
|
| Rate for Payer: Prime Health Services WC |
$49,028.53
|
| 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 710: PENIS PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$32,485.54
|
|
|
Service Code
|
MS-DRG 710
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$32,485.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,485.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,505.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,100.76
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,367.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,899.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,443.91
|
| Rate for Payer: IEHP Medicare Advantage |
$18,443.91
|
| Rate for Payer: Innovage PACE Commercial |
$27,665.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,443.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,714.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,714.84
|
| Rate for Payer: Multiplan WC |
$30,367.49
|
| Rate for Payer: Preferred Health Network WC |
$30,987.23
|
| Rate for Payer: Prime Health Services Medicare |
$19,550.54
|
| Rate for Payer: Prime Health Services WC |
$29,299.22
|
| 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
|
|
