|
INPATIENT MS-DRG 786: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC
|
Facility
IP
|
$46,045.09
|
|
|
Service Code
|
MS-DRG 786
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$46,045.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,045.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,456.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,726.04
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,024.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,131.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,541.55
|
| Rate for Payer: IEHP Medicare Advantage |
$24,541.55
|
| Rate for Payer: Innovage PACE Commercial |
$36,812.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,541.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,885.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,885.68
|
| Rate for Payer: Multiplan WC |
$34,024.90
|
| Rate for Payer: Preferred Health Network WC |
$34,719.29
|
| Rate for Payer: Prime Health Services Medicare |
$26,014.04
|
| Rate for Payer: Prime Health Services WC |
$32,827.97
|
| 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 787: CESAREAN SECTION WITHOUT STERILIZATION WITH CC
|
Facility
IP
|
$27,663.90
|
|
|
Service Code
|
MS-DRG 787
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$27,663.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,663.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,111.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,246.66
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,443.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,417.51
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,124.08
|
| Rate for Payer: IEHP Medicare Advantage |
$15,124.08
|
| Rate for Payer: Innovage PACE Commercial |
$22,686.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,124.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,266.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,266.27
|
| Rate for Payer: Multiplan WC |
$22,443.79
|
| Rate for Payer: Preferred Health Network WC |
$22,901.83
|
| Rate for Payer: Prime Health Services Medicare |
$16,031.52
|
| Rate for Payer: Prime Health Services WC |
$21,654.27
|
| 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 788: CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC
|
Facility
IP
|
$22,502.74
|
|
|
Service Code
|
MS-DRG 788
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$22,502.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,502.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,831.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,218.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,379.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,847.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,479.80
|
| Rate for Payer: IEHP Medicare Advantage |
$12,479.80
|
| Rate for Payer: Innovage PACE Commercial |
$18,719.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,479.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,722.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,722.93
|
| Rate for Payer: Multiplan WC |
$18,379.77
|
| Rate for Payer: Preferred Health Network WC |
$18,754.87
|
| Rate for Payer: Prime Health Services Medicare |
$13,228.59
|
| Rate for Payer: Prime Health Services WC |
$17,733.20
|
| 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 789: NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY
|
Facility
IP
|
$47,884.79
|
|
|
Service Code
|
MS-DRG 789
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$47,884.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,884.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,040.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,128.18
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,466.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,403.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,484.09
|
| Rate for Payer: IEHP Medicare Advantage |
$25,484.09
|
| Rate for Payer: Innovage PACE Commercial |
$38,226.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,484.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,148.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,148.68
|
| Rate for Payer: Multiplan WC |
$38,466.05
|
| Rate for Payer: Preferred Health Network WC |
$39,251.07
|
| Rate for Payer: Prime Health Services Medicare |
$27,013.14
|
| Rate for Payer: Prime Health Services WC |
$37,112.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,260.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 790: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE
|
Facility
IP
|
$157,916.63
|
|
|
Service Code
|
MS-DRG 790
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$157,916.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$157,916.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$102,364.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125,738.63
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$126,852.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$110,508.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$81,858.10
|
| Rate for Payer: IEHP Medicare Advantage |
$81,858.10
|
| Rate for Payer: Innovage PACE Commercial |
$122,787.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81,858.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$109,689.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$109,689.85
|
| Rate for Payer: Multiplan WC |
$126,852.85
|
| Rate for Payer: Preferred Health Network WC |
$129,441.68
|
| Rate for Payer: Prime Health Services Medicare |
$86,769.59
|
| Rate for Payer: Prime Health Services WC |
$122,390.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,260.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 791: PREMATURITY WITH MAJOR PROBLEMS
|
Facility
IP
|
$107,847.37
|
|
|
Service Code
|
MS-DRG 791
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$107,847.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107,847.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69,909.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85,872.98
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$86,633.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$75,877.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$56,205.49
|
| Rate for Payer: IEHP Medicare Advantage |
$56,205.49
|
| Rate for Payer: Innovage PACE Commercial |
$84,308.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,205.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75,315.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75,315.36
|
| Rate for Payer: Multiplan WC |
$86,633.94
|
| Rate for Payer: Preferred Health Network WC |
$88,401.98
|
| Rate for Payer: Prime Health Services Medicare |
$59,577.82
|
| Rate for Payer: Prime Health Services WC |
$83,586.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,260.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 792: PREMATURITY WITHOUT MAJOR PROBLEMS
|
Facility
IP
|
$65,073.73
|
|
|
Service Code
|
MS-DRG 792
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$65,073.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,073.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42,182.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51,814.90
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$52,274.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,292.49
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$34,290.73
|
| Rate for Payer: IEHP Medicare Advantage |
$34,290.73
|
| Rate for Payer: Innovage PACE Commercial |
$51,436.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,290.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,949.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,949.58
|
| Rate for Payer: Multiplan WC |
$52,274.05
|
| Rate for Payer: Preferred Health Network WC |
$53,340.87
|
| Rate for Payer: Prime Health Services Medicare |
$36,348.17
|
| Rate for Payer: Prime Health Services WC |
$50,435.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,260.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 793: FULL TERM NEONATE WITH MAJOR PROBLEMS
|
Facility
IP
|
$110,784.57
|
|
|
Service Code
|
MS-DRG 793
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$110,784.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$110,784.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$71,812.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88,209.79
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$88,991.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,908.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$57,710.34
|
| Rate for Payer: IEHP Medicare Advantage |
$57,710.34
|
| Rate for Payer: Innovage PACE Commercial |
$86,565.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,710.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77,331.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77,331.86
|
| Rate for Payer: Multiplan WC |
$88,991.45
|
| Rate for Payer: Preferred Health Network WC |
$90,807.60
|
| Rate for Payer: Prime Health Services Medicare |
$61,172.96
|
| Rate for Payer: Prime Health Services WC |
$85,860.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,260.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 794: NEONATE WITH OTHER SIGNIFICANT PROBLEMS
|
Facility
IP
|
$39,212.68
|
|
|
Service Code
|
MS-DRG 794
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,212.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,212.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,418.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,222.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,498.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,405.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,041.01
|
| Rate for Payer: IEHP Medicare Advantage |
$21,041.01
|
| Rate for Payer: Innovage PACE Commercial |
$31,561.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,041.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,194.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,194.95
|
| Rate for Payer: Multiplan WC |
$31,498.85
|
| Rate for Payer: Preferred Health Network WC |
$32,141.68
|
| Rate for Payer: Prime Health Services Medicare |
$22,303.47
|
| Rate for Payer: Prime Health Services WC |
$30,390.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,260.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,191.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 795: NORMAL NEWBORN
|
Facility
IP
|
$5,505.72
|
|
|
Service Code
|
MS-DRG 795
|
| Min. Negotiated Rate |
$1,001.00 |
| Max. Negotiated Rate |
$5,505.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,308.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,441.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,226.72
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,264.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,955.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,670.48
|
| Rate for Payer: IEHP Medicare Advantage |
$3,670.48
|
| Rate for Payer: Innovage PACE Commercial |
$5,505.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,670.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,918.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,918.44
|
| Rate for Payer: Multiplan WC |
$4,264.18
|
| Rate for Payer: Preferred Health Network WC |
$4,351.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,890.71
|
| Rate for Payer: Prime Health Services WC |
$4,114.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,566.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,278.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,094.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,001.00
|
|
|
INPATIENT MS-DRG 796: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC
|
Facility
IP
|
$37,330.87
|
|
|
Service Code
|
MS-DRG 796
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$37,330.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,330.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,322.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,419.38
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,662.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,103.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$20,076.87
|
| Rate for Payer: IEHP Medicare Advantage |
$20,076.87
|
| Rate for Payer: Innovage PACE Commercial |
$30,115.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,076.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,903.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,903.01
|
| Rate for Payer: Multiplan WC |
$27,662.35
|
| Rate for Payer: Preferred Health Network WC |
$28,226.89
|
| Rate for Payer: Prime Health Services Medicare |
$21,281.48
|
| Rate for Payer: Prime Health Services WC |
$26,689.25
|
| 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 797: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC
|
Facility
IP
|
$26,211.09
|
|
|
Service Code
|
MS-DRG 797
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$26,211.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,211.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,775.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,377.34
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,549.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,412.66
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,379.75
|
| Rate for Payer: IEHP Medicare Advantage |
$14,379.75
|
| Rate for Payer: Innovage PACE Commercial |
$21,569.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,379.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,268.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,268.86
|
| Rate for Payer: Multiplan WC |
$19,549.05
|
| Rate for Payer: Preferred Health Network WC |
$19,948.01
|
| Rate for Payer: Prime Health Services Medicare |
$15,242.54
|
| Rate for Payer: Prime Health Services WC |
$18,861.35
|
| 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 798: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC
|
Facility
IP
|
$21,349.97
|
|
|
Service Code
|
MS-DRG 798
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$21,349.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,349.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,775.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,377.34
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,549.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,485.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,211.48
|
| Rate for Payer: IEHP Medicare Advantage |
$12,211.48
|
| Rate for Payer: Innovage PACE Commercial |
$18,317.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,211.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,363.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,363.38
|
| Rate for Payer: Multiplan WC |
$19,549.05
|
| Rate for Payer: Preferred Health Network WC |
$19,948.01
|
| Rate for Payer: Prime Health Services Medicare |
$12,944.17
|
| Rate for Payer: Prime Health Services WC |
$18,861.35
|
| 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 799: SPLENIC PROCEDURES WITH MCC
|
Facility
IP
|
$130,400.12
|
|
|
Service Code
|
MS-DRG 799
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$130,400.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$130,400.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88,536.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108,752.40
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$109,716.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$91,476.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$67,760.21
|
| Rate for Payer: IEHP Medicare Advantage |
$67,760.21
|
| Rate for Payer: Innovage PACE Commercial |
$101,640.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,760.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90,798.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,798.68
|
| Rate for Payer: Multiplan WC |
$109,716.10
|
| Rate for Payer: Preferred Health Network WC |
$111,955.20
|
| Rate for Payer: Prime Health Services Medicare |
$71,825.82
|
| Rate for Payer: Prime Health Services WC |
$105,856.51
|
| 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 800: SPLENIC PROCEDURES WITH CC
|
Facility
IP
|
$74,159.05
|
|
|
Service Code
|
MS-DRG 800
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$74,159.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$74,159.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45,197.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55,517.46
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,009.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,576.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$38,945.53
|
| Rate for Payer: IEHP Medicare Advantage |
$38,945.53
|
| Rate for Payer: Innovage PACE Commercial |
$58,418.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,945.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52,187.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,187.01
|
| Rate for Payer: Multiplan WC |
$56,009.41
|
| Rate for Payer: Preferred Health Network WC |
$57,152.46
|
| Rate for Payer: Prime Health Services Medicare |
$41,282.26
|
| Rate for Payer: Prime Health Services WC |
$54,039.12
|
| 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 801: SPLENIC PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$47,103.11
|
|
|
Service Code
|
MS-DRG 801
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$47,103.11 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,103.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,533.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,505.87
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,838.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,862.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,083.63
|
| Rate for Payer: IEHP Medicare Advantage |
$25,083.63
|
| Rate for Payer: Innovage PACE Commercial |
$37,625.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,083.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,612.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,612.06
|
| Rate for Payer: Multiplan WC |
$37,838.22
|
| Rate for Payer: Preferred Health Network WC |
$38,610.43
|
| Rate for Payer: Prime Health Services Medicare |
$26,588.65
|
| Rate for Payer: Prime Health Services WC |
$36,507.15
|
| 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 802: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC
|
Facility
IP
|
$89,229.31
|
|
|
Service Code
|
MS-DRG 802
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$89,229.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$89,229.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64,807.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79,606.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$80,311.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,737.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47,212.79
|
| Rate for Payer: IEHP Medicare Advantage |
$47,212.79
|
| Rate for Payer: Innovage PACE Commercial |
$70,819.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,212.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63,265.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,265.14
|
| Rate for Payer: Multiplan WC |
$80,311.41
|
| Rate for Payer: Preferred Health Network WC |
$81,950.42
|
| Rate for Payer: Prime Health Services Medicare |
$50,045.56
|
| Rate for Payer: Prime Health Services WC |
$77,486.22
|
| 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 803: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC
|
Facility
IP
|
$48,905.97
|
|
|
Service Code
|
MS-DRG 803
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,905.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,905.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,908.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,879.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$43,259.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,109.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,007.29
|
| Rate for Payer: IEHP Medicare Advantage |
$26,007.29
|
| Rate for Payer: Innovage PACE Commercial |
$39,010.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,007.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,849.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,849.77
|
| Rate for Payer: Multiplan WC |
$43,259.03
|
| Rate for Payer: Preferred Health Network WC |
$44,141.87
|
| Rate for Payer: Prime Health Services Medicare |
$27,567.73
|
| Rate for Payer: Prime Health Services WC |
$41,737.27
|
| 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 804: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC
|
Facility
IP
|
$31,856.52
|
|
|
Service Code
|
MS-DRG 804
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$31,856.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,856.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,451.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,350.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$26,583.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,317.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,272.14
|
| Rate for Payer: IEHP Medicare Advantage |
$17,272.14
|
| Rate for Payer: Innovage PACE Commercial |
$25,908.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,272.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,144.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,144.67
|
| Rate for Payer: Multiplan WC |
$26,583.67
|
| Rate for Payer: Preferred Health Network WC |
$27,126.19
|
| Rate for Payer: Prime Health Services Medicare |
$18,308.47
|
| Rate for Payer: Prime Health Services WC |
$25,648.51
|
| 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 805: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC
|
Facility
IP
|
$26,534.82
|
|
|
Service Code
|
MS-DRG 805
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,534.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,534.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,096.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,999.94
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,186.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,636.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,545.61
|
| Rate for Payer: IEHP Medicare Advantage |
$14,545.61
|
| Rate for Payer: Innovage PACE Commercial |
$21,818.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,545.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,491.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,491.12
|
| Rate for Payer: Multiplan WC |
$21,186.03
|
| Rate for Payer: Preferred Health Network WC |
$21,618.40
|
| Rate for Payer: Prime Health Services Medicare |
$15,418.35
|
| Rate for Payer: Prime Health Services WC |
$20,440.75
|
| 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 806: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC
|
Facility
IP
|
$19,652.40
|
|
|
Service Code
|
MS-DRG 806
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$19,652.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,652.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,863.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,572.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,701.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,876.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11,019.45
|
| Rate for Payer: IEHP Medicare Advantage |
$11,019.45
|
| Rate for Payer: Innovage PACE Commercial |
$16,529.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,019.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,766.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,766.06
|
| Rate for Payer: Multiplan WC |
$14,701.28
|
| Rate for Payer: Preferred Health Network WC |
$15,001.31
|
| Rate for Payer: Prime Health Services Medicare |
$11,680.62
|
| Rate for Payer: Prime Health Services WC |
$14,184.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 807: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC
|
Facility
IP
|
$17,220.52
|
|
|
Service Code
|
MS-DRG 807
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$17,220.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,220.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,734.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,185.53
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,302.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,194.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,773.48
|
| Rate for Payer: IEHP Medicare Advantage |
$9,773.48
|
| Rate for Payer: Innovage PACE Commercial |
$14,660.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,773.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,096.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,096.46
|
| Rate for Payer: Multiplan WC |
$13,302.36
|
| Rate for Payer: Preferred Health Network WC |
$13,573.84
|
| Rate for Payer: Prime Health Services Medicare |
$10,359.89
|
| Rate for Payer: Prime Health Services WC |
$12,834.42
|
| 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 808: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
IP
|
$57,641.24
|
|
|
Service Code
|
MS-DRG 808
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$57,641.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,641.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,399.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,710.50
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,106.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,151.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,482.75
|
| Rate for Payer: IEHP Medicare Advantage |
$30,482.75
|
| Rate for Payer: Innovage PACE Commercial |
$45,724.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,482.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,846.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,846.88
|
| Rate for Payer: Multiplan WC |
$45,106.70
|
| Rate for Payer: Preferred Health Network WC |
$46,027.24
|
| Rate for Payer: Prime Health Services Medicare |
$32,311.72
|
| Rate for Payer: Prime Health Services WC |
$43,519.93
|
| 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 809: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
IP
|
$31,698.60
|
|
|
Service Code
|
MS-DRG 809
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$31,698.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31,698.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,668.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,387.46
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,612.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,208.15
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,191.22
|
| Rate for Payer: IEHP Medicare Advantage |
$17,191.22
|
| Rate for Payer: Innovage PACE Commercial |
$25,786.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,191.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,036.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,036.23
|
| Rate for Payer: Multiplan WC |
$25,612.43
|
| Rate for Payer: Preferred Health Network WC |
$26,135.13
|
| Rate for Payer: Prime Health Services Medicare |
$18,222.69
|
| Rate for Payer: Prime Health Services WC |
$24,711.44
|
| 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 810: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$26,437.44
|
|
|
Service Code
|
MS-DRG 810
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,437.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,437.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,960.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,604.96
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,778.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,569.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,495.72
|
| Rate for Payer: IEHP Medicare Advantage |
$14,495.72
|
| Rate for Payer: Innovage PACE Commercial |
$21,743.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,495.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,424.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,424.26
|
| Rate for Payer: Multiplan WC |
$19,778.68
|
| Rate for Payer: Preferred Health Network WC |
$20,182.33
|
| Rate for Payer: Prime Health Services Medicare |
$15,365.46
|
| Rate for Payer: Prime Health Services WC |
$19,082.92
|
| 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
|
|
