|
INPATIENT MS-DRG 867: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC
|
Facility
IP
|
$55,067.24
|
|
|
Service Code
|
MS-DRG 867
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,067.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,067.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35,929.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,134.13
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$44,525.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,371.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,163.97
|
| Rate for Payer: IEHP Medicare Advantage |
$29,163.97
|
| Rate for Payer: Innovage PACE Commercial |
$43,745.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,163.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,079.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,079.72
|
| Rate for Payer: Multiplan WC |
$44,525.22
|
| Rate for Payer: Preferred Health Network WC |
$45,433.90
|
| Rate for Payer: Prime Health Services Medicare |
$30,913.81
|
| Rate for Payer: Prime Health Services WC |
$42,958.91
|
| 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 868: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC
|
Facility
IP
|
$28,569.27
|
|
|
Service Code
|
MS-DRG 868
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$28,569.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,569.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,947.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,046.18
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,241.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,043.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15,587.93
|
| Rate for Payer: IEHP Medicare Advantage |
$15,587.93
|
| Rate for Payer: Innovage PACE Commercial |
$23,381.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,587.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,887.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,887.83
|
| Rate for Payer: Multiplan WC |
$22,241.54
|
| Rate for Payer: Preferred Health Network WC |
$22,695.45
|
| Rate for Payer: Prime Health Services Medicare |
$16,523.21
|
| Rate for Payer: Prime Health Services WC |
$21,459.13
|
| 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 869: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC
|
Facility
IP
|
$18,178.53
|
|
|
Service Code
|
MS-DRG 869
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,178.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,178.53
|
| 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 |
$13,856.83
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,264.32
|
| Rate for Payer: IEHP Medicare Advantage |
$10,264.32
|
| Rate for Payer: Innovage PACE Commercial |
$15,396.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,264.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,754.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,754.19
|
| 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 |
$10,880.18
|
| 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 870: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS
|
Facility
IP
|
$183,309.20
|
|
|
Service Code
|
MS-DRG 870
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$183,309.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$183,309.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115,452.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141,814.36
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$143,071.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$128,071.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$94,867.79
|
| Rate for Payer: IEHP Medicare Advantage |
$94,867.79
|
| Rate for Payer: Innovage PACE Commercial |
$142,301.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94,867.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$127,122.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$127,122.84
|
| Rate for Payer: Multiplan WC |
$143,071.03
|
| Rate for Payer: Preferred Health Network WC |
$145,990.85
|
| Rate for Payer: Prime Health Services Medicare |
$100,559.86
|
| Rate for Payer: Prime Health Services WC |
$138,038.08
|
| 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 871: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC
|
Facility
IP
|
$52,180.05
|
|
|
Service Code
|
MS-DRG 871
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$52,180.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,180.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,274.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,872.21
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,234.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,374.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,684.76
|
| Rate for Payer: IEHP Medicare Advantage |
$27,684.76
|
| Rate for Payer: Innovage PACE Commercial |
$41,527.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,684.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,097.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,097.58
|
| Rate for Payer: Multiplan WC |
$41,234.39
|
| Rate for Payer: Preferred Health Network WC |
$42,075.91
|
| Rate for Payer: Prime Health Services Medicare |
$29,345.85
|
| Rate for Payer: Prime Health Services WC |
$39,783.85
|
| 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 872: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC
|
Facility
IP
|
$27,105.94
|
|
|
Service Code
|
MS-DRG 872
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,105.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,105.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,477.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,467.72
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,657.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,031.60
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,838.22
|
| Rate for Payer: IEHP Medicare Advantage |
$14,838.22
|
| Rate for Payer: Innovage PACE Commercial |
$22,257.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,838.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,883.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,883.21
|
| Rate for Payer: Multiplan WC |
$21,657.96
|
| Rate for Payer: Preferred Health Network WC |
$22,099.96
|
| Rate for Payer: Prime Health Services Medicare |
$15,728.51
|
| Rate for Payer: Prime Health Services WC |
$20,896.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 876: O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS
|
Facility
IP
|
$98,209.35
|
|
|
Service Code
|
MS-DRG 876
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$98,209.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98,209.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54,340.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66,748.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$67,339.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$69,211.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,267.51
|
| Rate for Payer: IEHP Medicare Advantage |
$51,267.51
|
| Rate for Payer: Innovage PACE Commercial |
$76,901.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,267.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,698.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,698.46
|
| Rate for Payer: Multiplan WC |
$67,339.82
|
| Rate for Payer: Preferred Health Network WC |
$68,714.10
|
| Rate for Payer: Prime Health Services Medicare |
$54,343.56
|
| Rate for Payer: Prime Health Services WC |
$64,970.94
|
| 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 880: ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION
|
Facility
IP
|
$25,124.12
|
|
|
Service Code
|
MS-DRG 880
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$25,124.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,124.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,406.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,924.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,091.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,660.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,822.85
|
| Rate for Payer: IEHP Medicare Advantage |
$13,822.85
|
| Rate for Payer: Innovage PACE Commercial |
$20,734.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,822.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,522.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,522.62
|
| Rate for Payer: Multiplan WC |
$19,091.87
|
| Rate for Payer: Preferred Health Network WC |
$19,481.50
|
| Rate for Payer: Prime Health Services Medicare |
$14,652.22
|
| Rate for Payer: Prime Health Services WC |
$18,420.25
|
| 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 881: DEPRESSIVE NEUROSES
|
Facility
IP
|
$23,858.17
|
|
|
Service Code
|
MS-DRG 881
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,858.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,858.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,544.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,865.41
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,023.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,785.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,174.24
|
| Rate for Payer: IEHP Medicare Advantage |
$13,174.24
|
| Rate for Payer: Innovage PACE Commercial |
$19,761.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,174.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,653.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,653.48
|
| Rate for Payer: Multiplan WC |
$18,023.72
|
| Rate for Payer: Preferred Health Network WC |
$18,391.55
|
| Rate for Payer: Prime Health Services Medicare |
$13,964.69
|
| Rate for Payer: Prime Health Services WC |
$17,389.68
|
| 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 882: NEUROSES EXCEPT DEPRESSIVE
|
Facility
IP
|
$24,721.44
|
|
|
Service Code
|
MS-DRG 882
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$24,721.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,721.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,850.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,241.30
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,402.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,382.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,616.53
|
| Rate for Payer: IEHP Medicare Advantage |
$13,616.53
|
| Rate for Payer: Innovage PACE Commercial |
$20,424.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,616.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,246.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,246.15
|
| Rate for Payer: Multiplan WC |
$18,402.94
|
| Rate for Payer: Preferred Health Network WC |
$18,778.51
|
| Rate for Payer: Prime Health Services Medicare |
$14,433.52
|
| Rate for Payer: Prime Health Services WC |
$17,755.57
|
| 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 883: DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
IP
|
$49,358.65
|
|
|
Service Code
|
MS-DRG 883
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$49,358.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,358.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,448.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,715.60
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,014.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,422.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,239.23
|
| Rate for Payer: IEHP Medicare Advantage |
$26,239.23
|
| Rate for Payer: Innovage PACE Commercial |
$39,358.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,239.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,160.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,160.57
|
| Rate for Payer: Multiplan WC |
$34,014.37
|
| Rate for Payer: Preferred Health Network WC |
$34,708.54
|
| Rate for Payer: Prime Health Services Medicare |
$27,813.58
|
| Rate for Payer: Prime Health Services WC |
$32,817.82
|
| 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 884: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY
|
Facility
IP
|
$46,239.85
|
|
|
Service Code
|
MS-DRG 884
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$46,239.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,239.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,691.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,786.31
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,076.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,265.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,641.32
|
| Rate for Payer: IEHP Medicare Advantage |
$24,641.32
|
| Rate for Payer: Innovage PACE Commercial |
$36,961.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,641.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,019.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,019.37
|
| Rate for Payer: Multiplan WC |
$33,076.84
|
| Rate for Payer: Preferred Health Network WC |
$33,751.88
|
| Rate for Payer: Prime Health Services Medicare |
$26,119.80
|
| Rate for Payer: Prime Health Services WC |
$31,913.26
|
| 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 885: PSYCHOSES
|
Facility
IP
|
$35,962.28
|
|
|
Service Code
|
MS-DRG 885
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$35,962.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,962.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,024.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,053.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,293.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,157.20
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,375.70
|
| Rate for Payer: IEHP Medicare Advantage |
$19,375.70
|
| Rate for Payer: Innovage PACE Commercial |
$29,063.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,375.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,963.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,963.44
|
| Rate for Payer: Multiplan WC |
$27,293.66
|
| Rate for Payer: Preferred Health Network WC |
$27,850.67
|
| Rate for Payer: Prime Health Services Medicare |
$20,538.24
|
| Rate for Payer: Prime Health Services WC |
$26,333.52
|
| 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 886: BEHAVIORAL AND DEVELOPMENTAL DISORDERS
|
Facility
IP
|
$44,260.66
|
|
|
Service Code
|
MS-DRG 886
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$44,260.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,260.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,206.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,505.30
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,757.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,896.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,627.30
|
| Rate for Payer: IEHP Medicare Advantage |
$23,627.30
|
| Rate for Payer: Innovage PACE Commercial |
$35,440.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,627.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,660.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,660.58
|
| Rate for Payer: Multiplan WC |
$28,757.89
|
| Rate for Payer: Preferred Health Network WC |
$29,344.79
|
| Rate for Payer: Prime Health Services Medicare |
$25,044.94
|
| Rate for Payer: Prime Health Services WC |
$27,746.25
|
| 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 887: OTHER MENTAL DISORDER DIAGNOSES
|
Facility
IP
|
$34,098.90
|
|
|
Service Code
|
MS-DRG 887
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$34,098.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,098.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,041.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,074.81
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,314.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,868.35
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$18,421.00
|
| Rate for Payer: IEHP Medicare Advantage |
$18,421.00
|
| Rate for Payer: Innovage PACE Commercial |
$27,631.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,421.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,684.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,684.14
|
| Rate for Payer: Multiplan WC |
$27,314.73
|
| Rate for Payer: Preferred Health Network WC |
$27,872.17
|
| Rate for Payer: Prime Health Services Medicare |
$19,526.26
|
| Rate for Payer: Prime Health Services WC |
$26,353.85
|
| 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 894: ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA
|
Facility
IP
|
$15,120.27
|
|
|
Service Code
|
MS-DRG 894
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$15,120.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,120.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,721.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,940.90
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$12,046.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,741.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,697.44
|
| Rate for Payer: IEHP Medicare Advantage |
$8,697.44
|
| Rate for Payer: Innovage PACE Commercial |
$13,046.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,697.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,654.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,654.57
|
| Rate for Payer: Multiplan WC |
$12,046.71
|
| Rate for Payer: Preferred Health Network WC |
$12,292.56
|
| Rate for Payer: Prime Health Services Medicare |
$9,219.29
|
| Rate for Payer: Prime Health Services WC |
$11,622.94
|
| 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 895: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY
|
Facility
IP
|
$42,342.01
|
|
|
Service Code
|
MS-DRG 895
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,342.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,342.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,499.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,550.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,838.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,569.80
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,644.30
|
| Rate for Payer: IEHP Medicare Advantage |
$22,644.30
|
| Rate for Payer: Innovage PACE Commercial |
$33,966.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,644.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,343.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,343.36
|
| Rate for Payer: Multiplan WC |
$32,838.77
|
| Rate for Payer: Preferred Health Network WC |
$33,508.95
|
| Rate for Payer: Prime Health Services Medicare |
$24,002.96
|
| Rate for Payer: Prime Health Services WC |
$31,683.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 896: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC
|
Facility
IP
|
$46,797.81
|
|
|
Service Code
|
MS-DRG 896
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$46,797.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,797.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,846.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,662.19
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,987.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,651.72
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,927.20
|
| Rate for Payer: IEHP Medicare Advantage |
$24,927.20
|
| Rate for Payer: Innovage PACE Commercial |
$37,390.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,927.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,402.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,402.45
|
| Rate for Payer: Multiplan WC |
$36,987.07
|
| Rate for Payer: Preferred Health Network WC |
$37,741.91
|
| Rate for Payer: Prime Health Services Medicare |
$26,422.83
|
| Rate for Payer: Prime Health Services WC |
$35,685.94
|
| 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 897: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC
|
Facility
IP
|
$22,518.54
|
|
|
Service Code
|
MS-DRG 897
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$22,518.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,518.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,472.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,777.70
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,935.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,858.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,487.91
|
| Rate for Payer: IEHP Medicare Advantage |
$12,487.91
|
| Rate for Payer: Innovage PACE Commercial |
$18,731.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,487.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,733.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,733.80
|
| Rate for Payer: Multiplan WC |
$17,935.23
|
| Rate for Payer: Preferred Health Network WC |
$18,301.26
|
| Rate for Payer: Prime Health Services Medicare |
$13,237.18
|
| Rate for Payer: Prime Health Services WC |
$17,304.31
|
| 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 901: WOUND DEBRIDEMENTS FOR INJURIES WITH MCC
|
Facility
IP
|
$113,903.37
|
|
|
Service Code
|
MS-DRG 901
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$113,903.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$113,903.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$74,780.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91,855.96
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$92,669.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,066.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59,308.23
|
| Rate for Payer: IEHP Medicare Advantage |
$59,308.23
|
| Rate for Payer: Innovage PACE Commercial |
$88,962.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,308.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79,473.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,473.03
|
| Rate for Payer: Multiplan WC |
$92,669.94
|
| Rate for Payer: Preferred Health Network WC |
$94,561.16
|
| Rate for Payer: Prime Health Services Medicare |
$62,866.72
|
| Rate for Payer: Prime Health Services WC |
$89,409.99
|
| 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 902: WOUND DEBRIDEMENTS FOR INJURIES WITH CC
|
Facility
IP
|
$49,603.42
|
|
|
Service Code
|
MS-DRG 902
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,603.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,603.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,692.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,385.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,752.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,592.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,364.62
|
| Rate for Payer: IEHP Medicare Advantage |
$26,364.62
|
| Rate for Payer: Innovage PACE Commercial |
$39,546.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,364.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,328.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,328.59
|
| Rate for Payer: Multiplan WC |
$41,752.66
|
| Rate for Payer: Preferred Health Network WC |
$42,604.76
|
| Rate for Payer: Prime Health Services Medicare |
$27,946.50
|
| Rate for Payer: Prime Health Services WC |
$40,283.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 903: WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC
|
Facility
IP
|
$32,675.04
|
|
|
Service Code
|
MS-DRG 903
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$32,675.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,675.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,666.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,385.37
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,610.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,883.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17,691.50
|
| Rate for Payer: IEHP Medicare Advantage |
$17,691.50
|
| Rate for Payer: Innovage PACE Commercial |
$26,537.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,691.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,706.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,706.61
|
| Rate for Payer: Multiplan WC |
$25,610.32
|
| Rate for Payer: Preferred Health Network WC |
$26,132.98
|
| Rate for Payer: Prime Health Services Medicare |
$18,752.99
|
| Rate for Payer: Prime Health Services WC |
$24,709.40
|
| 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 904: SKIN GRAFTS FOR INJURIES WITH CC/MCC
|
Facility
IP
|
$85,699.93
|
|
|
Service Code
|
MS-DRG 904
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$85,699.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$85,699.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60,385.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74,174.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$74,831.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$60,558.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,858.41
|
| Rate for Payer: IEHP Medicare Advantage |
$44,858.41
|
| Rate for Payer: Innovage PACE Commercial |
$67,287.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,858.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60,110.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,110.27
|
| Rate for Payer: Multiplan WC |
$74,831.61
|
| Rate for Payer: Preferred Health Network WC |
$76,358.79
|
| Rate for Payer: Prime Health Services Medicare |
$47,549.91
|
| Rate for Payer: Prime Health Services WC |
$72,199.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,192.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,911.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,235.00
|
|
|
INPATIENT MS-DRG 905: SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC
|
Facility
IP
|
$41,681.40
|
|
|
Service Code
|
MS-DRG 905
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$41,681.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,681.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,519.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,575.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,864.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,112.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,305.85
|
| Rate for Payer: IEHP Medicare Advantage |
$22,305.85
|
| Rate for Payer: Innovage PACE Commercial |
$33,458.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,305.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,889.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,889.84
|
| Rate for Payer: Multiplan WC |
$32,864.06
|
| Rate for Payer: Preferred Health Network WC |
$33,534.75
|
| Rate for Payer: Prime Health Services Medicare |
$23,644.20
|
| Rate for Payer: Prime Health Services WC |
$31,707.96
|
| 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 906: HAND PROCEDURES FOR INJURIES
|
Facility
IP
|
$49,521.83
|
|
|
Service Code
|
MS-DRG 906
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$49,521.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49,521.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,394.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,334.63
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,665.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,535.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26,322.83
|
| Rate for Payer: IEHP Medicare Advantage |
$26,322.83
|
| Rate for Payer: Innovage PACE Commercial |
$39,484.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,322.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,272.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,272.59
|
| Rate for Payer: Multiplan WC |
$37,665.47
|
| Rate for Payer: Preferred Health Network WC |
$38,434.15
|
| Rate for Payer: Prime Health Services Medicare |
$27,902.20
|
| Rate for Payer: Prime Health Services WC |
$36,340.47
|
| 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
|
|
