|
INPATIENT MS-DRG 742: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC
|
Facility
IP
|
$46,897.83
|
|
|
Service Code
|
MS-DRG 742
|
| Min. Negotiated Rate |
$21,291.00 |
| Max. Negotiated Rate |
$46,897.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,897.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,637.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,633.25
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,966.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,720.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,978.45
|
| Rate for Payer: IEHP Medicare Advantage |
$24,978.45
|
| Rate for Payer: Innovage PACE Commercial |
$37,467.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,978.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,471.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,471.12
|
| Rate for Payer: Multiplan WC |
$37,966.74
|
| Rate for Payer: Preferred Health Network WC |
$38,741.57
|
| Rate for Payer: Prime Health Services Medicare |
$26,477.16
|
| Rate for Payer: Prime Health Services WC |
$36,631.15
|
| 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 743: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC
|
Facility
IP
|
$30,582.68
|
|
|
Service Code
|
MS-DRG 743
|
| Min. Negotiated Rate |
$16,619.49 |
| Max. Negotiated Rate |
$30,582.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,582.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,901.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,445.64
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,662.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,436.31
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16,619.49
|
| Rate for Payer: IEHP Medicare Advantage |
$16,619.49
|
| Rate for Payer: Innovage PACE Commercial |
$24,929.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,619.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,270.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,270.12
|
| Rate for Payer: Multiplan WC |
$24,662.26
|
| Rate for Payer: Preferred Health Network WC |
$25,165.57
|
| Rate for Payer: Prime Health Services Medicare |
$17,616.66
|
| Rate for Payer: Prime Health Services WC |
$23,794.69
|
| 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 744: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC
|
Facility
IP
|
$49,542.89
|
|
|
Service Code
|
MS-DRG 744
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,542.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,542.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,273.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,642.20
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,993.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,550.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,333.62
|
| Rate for Payer: IEHP Medicare Advantage |
$26,333.62
|
| Rate for Payer: Innovage PACE Commercial |
$39,500.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,333.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,287.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,287.05
|
| Rate for Payer: Multiplan WC |
$39,993.49
|
| Rate for Payer: Preferred Health Network WC |
$40,809.68
|
| Rate for Payer: Prime Health Services Medicare |
$27,913.64
|
| Rate for Payer: Prime Health Services WC |
$38,586.59
|
| 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 745: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC
|
Facility
IP
|
$27,263.85
|
|
|
Service Code
|
MS-DRG 745
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$27,263.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,263.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,564.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,032.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,245.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,140.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,919.12
|
| Rate for Payer: IEHP Medicare Advantage |
$14,919.12
|
| Rate for Payer: Innovage PACE Commercial |
$22,378.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,919.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,991.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,991.62
|
| Rate for Payer: Multiplan WC |
$24,245.11
|
| Rate for Payer: Preferred Health Network WC |
$24,739.91
|
| Rate for Payer: Prime Health Services Medicare |
$15,814.27
|
| Rate for Payer: Prime Health Services WC |
$23,392.22
|
| 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
|
|
|
INPATIENT MS-DRG 746: VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC
|
Facility
IP
|
$44,113.28
|
|
|
Service Code
|
MS-DRG 746
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$44,113.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,113.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,579.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,648.48
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,937.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,794.94
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,551.81
|
| Rate for Payer: IEHP Medicare Advantage |
$23,551.81
|
| Rate for Payer: Innovage PACE Commercial |
$35,327.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,551.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,559.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,559.43
|
| Rate for Payer: Multiplan WC |
$32,937.79
|
| Rate for Payer: Preferred Health Network WC |
$33,609.99
|
| Rate for Payer: Prime Health Services Medicare |
$24,964.92
|
| Rate for Payer: Prime Health Services WC |
$31,779.11
|
| 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 747: VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$23,350.22
|
|
|
Service Code
|
MS-DRG 747
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$23,350.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,350.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,637.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,436.10
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,617.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,433.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,913.98
|
| Rate for Payer: IEHP Medicare Advantage |
$12,913.98
|
| Rate for Payer: Innovage PACE Commercial |
$19,370.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,913.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,304.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,304.73
|
| Rate for Payer: Multiplan WC |
$20,617.19
|
| Rate for Payer: Preferred Health Network WC |
$21,037.95
|
| Rate for Payer: Prime Health Services Medicare |
$13,688.82
|
| Rate for Payer: Prime Health Services WC |
$19,891.93
|
| 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 748: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES
|
Facility
IP
|
$36,975.56
|
|
|
Service Code
|
MS-DRG 748
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$36,975.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,975.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,093.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,595.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,857.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,858.03
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,894.84
|
| Rate for Payer: IEHP Medicare Advantage |
$19,894.84
|
| Rate for Payer: Innovage PACE Commercial |
$29,842.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,894.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,659.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,659.09
|
| Rate for Payer: Multiplan WC |
$29,857.64
|
| Rate for Payer: Preferred Health Network WC |
$30,466.98
|
| Rate for Payer: Prime Health Services Medicare |
$21,088.53
|
| Rate for Payer: Prime Health Services WC |
$28,807.31
|
| 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 749: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC
|
Facility
IP
|
$66,250.19
|
|
|
Service Code
|
MS-DRG 749
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$66,250.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66,250.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42,947.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52,754.63
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$53,222.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,106.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,893.49
|
| Rate for Payer: IEHP Medicare Advantage |
$34,893.49
|
| Rate for Payer: Innovage PACE Commercial |
$52,340.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,893.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,757.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,757.28
|
| Rate for Payer: Multiplan WC |
$53,222.11
|
| Rate for Payer: Preferred Health Network WC |
$54,308.28
|
| Rate for Payer: Prime Health Services Medicare |
$36,987.10
|
| Rate for Payer: Prime Health Services WC |
$51,349.87
|
| 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 750: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$35,793.84
|
|
|
Service Code
|
MS-DRG 750
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,793.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,793.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,260.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,800.04
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,064.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,040.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,289.40
|
| Rate for Payer: IEHP Medicare Advantage |
$19,289.40
|
| Rate for Payer: Innovage PACE Commercial |
$28,934.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,289.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,847.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,847.80
|
| Rate for Payer: Multiplan WC |
$30,064.11
|
| Rate for Payer: Preferred Health Network WC |
$30,677.66
|
| Rate for Payer: Prime Health Services Medicare |
$20,446.76
|
| Rate for Payer: Prime Health Services WC |
$29,006.51
|
| 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 754: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
IP
|
$48,755.95
|
|
|
Service Code
|
MS-DRG 754
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$48,755.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,755.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,529.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,271.68
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,593.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,006.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,930.43
|
| Rate for Payer: IEHP Medicare Advantage |
$25,930.43
|
| Rate for Payer: Innovage PACE Commercial |
$38,895.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,930.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,746.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,746.78
|
| Rate for Payer: Multiplan WC |
$36,593.10
|
| Rate for Payer: Preferred Health Network WC |
$37,339.90
|
| Rate for Payer: Prime Health Services Medicare |
$27,486.26
|
| Rate for Payer: Prime Health Services WC |
$35,305.83
|
| 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 755: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
IP
|
$28,548.22
|
|
|
Service Code
|
MS-DRG 755
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,548.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,548.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,379.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,576.61
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,776.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,029.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,577.17
|
| Rate for Payer: IEHP Medicare Advantage |
$15,577.17
|
| Rate for Payer: Innovage PACE Commercial |
$23,365.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,577.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,873.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,873.41
|
| Rate for Payer: Multiplan WC |
$22,776.67
|
| Rate for Payer: Preferred Health Network WC |
$23,241.50
|
| Rate for Payer: Prime Health Services Medicare |
$16,511.80
|
| Rate for Payer: Prime Health Services WC |
$21,975.44
|
| 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 756: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
IP
|
$26,047.91
|
|
|
Service Code
|
MS-DRG 756
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,047.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,047.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,946.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,816.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,000.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,299.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,296.14
|
| Rate for Payer: IEHP Medicare Advantage |
$14,296.14
|
| Rate for Payer: Innovage PACE Commercial |
$21,444.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,296.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,156.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,156.83
|
| Rate for Payer: Multiplan WC |
$21,000.64
|
| Rate for Payer: Preferred Health Network WC |
$21,429.22
|
| Rate for Payer: Prime Health Services Medicare |
$15,153.91
|
| Rate for Payer: Prime Health Services WC |
$20,261.87
|
| 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 757: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
IP
|
$39,257.42
|
|
|
Service Code
|
MS-DRG 757
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,257.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,257.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,328.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,655.65
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,909.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,436.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,063.94
|
| Rate for Payer: IEHP Medicare Advantage |
$21,063.94
|
| Rate for Payer: Innovage PACE Commercial |
$31,595.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,063.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,225.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,225.68
|
| Rate for Payer: Multiplan WC |
$28,909.58
|
| Rate for Payer: Preferred Health Network WC |
$29,499.57
|
| Rate for Payer: Prime Health Services Medicare |
$22,327.78
|
| Rate for Payer: Prime Health Services WC |
$27,892.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 758: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
IP
|
$26,124.24
|
|
|
Service Code
|
MS-DRG 758
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,124.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,124.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,244.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,953.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,130.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,352.59
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,335.25
|
| Rate for Payer: IEHP Medicare Advantage |
$14,335.25
|
| Rate for Payer: Innovage PACE Commercial |
$21,502.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,335.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,209.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,209.24
|
| Rate for Payer: Multiplan WC |
$20,130.52
|
| Rate for Payer: Preferred Health Network WC |
$20,541.35
|
| Rate for Payer: Prime Health Services Medicare |
$15,195.36
|
| Rate for Payer: Prime Health Services WC |
$19,422.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 759: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
IP
|
$17,007.34
|
|
|
Service Code
|
MS-DRG 759
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$17,007.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,007.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,547.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,955.81
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,070.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,046.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,664.28
|
| Rate for Payer: IEHP Medicare Advantage |
$9,664.28
|
| Rate for Payer: Innovage PACE Commercial |
$14,496.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,664.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,950.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,950.14
|
| Rate for Payer: Multiplan WC |
$13,070.62
|
| Rate for Payer: Preferred Health Network WC |
$13,337.37
|
| Rate for Payer: Prime Health Services Medicare |
$10,244.14
|
| Rate for Payer: Prime Health Services WC |
$12,610.82
|
| 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 760: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC
|
Facility
IP
|
$26,197.93
|
|
|
Service Code
|
MS-DRG 760
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,197.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,197.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,433.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,185.51
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,364.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,403.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,373.01
|
| Rate for Payer: IEHP Medicare Advantage |
$14,373.01
|
| Rate for Payer: Innovage PACE Commercial |
$21,559.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,373.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,259.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,259.83
|
| Rate for Payer: Multiplan WC |
$20,364.38
|
| Rate for Payer: Preferred Health Network WC |
$20,779.98
|
| Rate for Payer: Prime Health Services Medicare |
$15,235.39
|
| Rate for Payer: Prime Health Services WC |
$19,648.00
|
| 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 761: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$15,938.79
|
|
|
Service Code
|
MS-DRG 761
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$15,938.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,938.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,617.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,813.51
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,918.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,307.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,116.81
|
| Rate for Payer: IEHP Medicare Advantage |
$9,116.81
|
| Rate for Payer: Innovage PACE Commercial |
$13,675.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,116.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,216.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,216.53
|
| Rate for Payer: Multiplan WC |
$11,918.20
|
| Rate for Payer: Preferred Health Network WC |
$12,161.43
|
| Rate for Payer: Prime Health Services Medicare |
$9,663.82
|
| Rate for Payer: Prime Health Services WC |
$11,498.94
|
| 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 768: VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C
|
Facility
IP
|
$32,059.17
|
|
|
Service Code
|
MS-DRG 768
|
| Min. Negotiated Rate |
$4,760.00 |
| Max. Negotiated Rate |
$32,059.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,059.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,496.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,948.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,160.84
|
| Rate for Payer: Cigna of CA HMO |
$4,760.00
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,457.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,375.97
|
| Rate for Payer: IEHP Medicare Advantage |
$17,375.97
|
| Rate for Payer: Innovage PACE Commercial |
$26,063.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,375.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,283.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,283.80
|
| Rate for Payer: Multiplan WC |
$24,160.84
|
| Rate for Payer: Preferred Health Network WC |
$24,653.92
|
| Rate for Payer: Prime Health Services Medicare |
$18,418.53
|
| Rate for Payer: Prime Health Services WC |
$23,310.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,210.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,461.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,443.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,977.00
|
|
|
INPATIENT MS-DRG 769: POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES
|
Facility
IP
|
$40,633.90
|
|
|
Service Code
|
MS-DRG 769
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$40,633.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,633.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,243.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,692.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,000.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,388.38
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,769.17
|
| Rate for Payer: IEHP Medicare Advantage |
$21,769.17
|
| Rate for Payer: Innovage PACE Commercial |
$32,653.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,769.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,170.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,170.69
|
| Rate for Payer: Multiplan WC |
$35,000.36
|
| Rate for Payer: Preferred Health Network WC |
$35,714.65
|
| Rate for Payer: Prime Health Services Medicare |
$23,075.32
|
| Rate for Payer: Prime Health Services WC |
$33,769.11
|
| 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 770: ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
IP
|
$21,020.99
|
|
|
Service Code
|
MS-DRG 770
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$21,020.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,020.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,719.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,080.50
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,240.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,822.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,720.64
|
| Rate for Payer: IEHP Medicare Advantage |
$11,720.64
|
| Rate for Payer: Innovage PACE Commercial |
$17,580.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,720.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,705.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,705.66
|
| Rate for Payer: Multiplan WC |
$18,240.72
|
| Rate for Payer: Preferred Health Network WC |
$18,612.98
|
| Rate for Payer: Prime Health Services Medicare |
$12,423.88
|
| Rate for Payer: Prime Health Services WC |
$17,599.05
|
| 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 776: POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES
|
Facility
IP
|
$18,862.83
|
|
|
Service Code
|
MS-DRG 776
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,862.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,862.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,851.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,557.54
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,686.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,330.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.92
|
| Rate for Payer: IEHP Medicare Advantage |
$10,614.92
|
| Rate for Payer: Innovage PACE Commercial |
$15,922.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,223.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.99
|
| Rate for Payer: Multiplan WC |
$14,686.53
|
| Rate for Payer: Preferred Health Network WC |
$14,986.26
|
| Rate for Payer: Prime Health Services Medicare |
$11,251.82
|
| Rate for Payer: Prime Health Services WC |
$14,169.90
|
| 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 779: ABORTION WITHOUT D&C
|
Facility
IP
|
$26,034.75
|
|
|
Service Code
|
MS-DRG 779
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,034.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,034.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,317.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,271.42
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,459.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,290.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,289.41
|
| Rate for Payer: IEHP Medicare Advantage |
$14,289.41
|
| Rate for Payer: Innovage PACE Commercial |
$21,434.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,289.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,147.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,147.81
|
| Rate for Payer: Multiplan WC |
$21,459.92
|
| Rate for Payer: Preferred Health Network WC |
$21,897.88
|
| Rate for Payer: Prime Health Services Medicare |
$15,146.77
|
| Rate for Payer: Prime Health Services WC |
$20,705.00
|
| 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 783: CESAREAN SECTION WITH STERILIZATION WITH MCC
|
Facility
IP
|
$46,632.00
|
|
|
Service Code
|
MS-DRG 783
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$46,632.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,632.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,806.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,297.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,655.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,537.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,842.25
|
| Rate for Payer: IEHP Medicare Advantage |
$24,842.25
|
| Rate for Payer: Innovage PACE Commercial |
$37,263.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,842.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,288.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,288.62
|
| Rate for Payer: Multiplan WC |
$40,655.02
|
| Rate for Payer: Preferred Health Network WC |
$41,484.71
|
| Rate for Payer: Prime Health Services Medicare |
$26,332.78
|
| Rate for Payer: Prime Health Services WC |
$39,224.86
|
| 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 784: CESAREAN SECTION WITH STERILIZATION WITH CC
|
Facility
IP
|
$26,953.29
|
|
|
Service Code
|
MS-DRG 784
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$26,953.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,953.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,749.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,801.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,995.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,926.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,760.01
|
| Rate for Payer: IEHP Medicare Advantage |
$14,760.01
|
| Rate for Payer: Innovage PACE Commercial |
$22,140.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,760.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,778.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,778.41
|
| Rate for Payer: Multiplan WC |
$21,995.04
|
| Rate for Payer: Preferred Health Network WC |
$22,443.92
|
| Rate for Payer: Prime Health Services Medicare |
$15,645.61
|
| Rate for Payer: Prime Health Services WC |
$21,221.30
|
| 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 785: CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC
|
Facility
IP
|
$22,800.15
|
|
|
Service Code
|
MS-DRG 785
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$22,800.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,800.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,506.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,047.38
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,216.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,053.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,632.18
|
| Rate for Payer: IEHP Medicare Advantage |
$12,632.18
|
| Rate for Payer: Innovage PACE Commercial |
$18,948.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,632.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,927.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,927.12
|
| Rate for Payer: Multiplan WC |
$19,216.17
|
| Rate for Payer: Preferred Health Network WC |
$19,608.34
|
| Rate for Payer: Prime Health Services Medicare |
$13,390.11
|
| Rate for Payer: Prime Health Services WC |
$18,540.18
|
| 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
|
|
