|
INPATIENT MS-DRG 907: OTHER O.R. PROCEDURES FOR INJURIES WITH MCC
|
Facility
IP
|
$97,893.52
|
|
|
Service Code
|
MS-DRG 907
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$97,893.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$97,893.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65,720.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80,727.41
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$81,442.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$68,992.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$51,105.69
|
| Rate for Payer: IEHP Medicare Advantage |
$51,105.69
|
| Rate for Payer: Innovage PACE Commercial |
$76,658.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,105.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68,481.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68,481.62
|
| Rate for Payer: Multiplan WC |
$81,442.76
|
| Rate for Payer: Preferred Health Network WC |
$83,104.86
|
| Rate for Payer: Prime Health Services Medicare |
$54,172.03
|
| Rate for Payer: Prime Health Services WC |
$78,577.78
|
| 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 908: OTHER O.R. PROCEDURES FOR INJURIES WITH CC
|
Facility
IP
|
$52,745.91
|
|
|
Service Code
|
MS-DRG 908
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$52,745.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,745.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,962.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,945.89
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$43,326.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,765.78
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$27,974.65
|
| Rate for Payer: IEHP Medicare Advantage |
$27,974.65
|
| Rate for Payer: Innovage PACE Commercial |
$41,961.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,974.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,486.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,486.03
|
| Rate for Payer: Multiplan WC |
$43,326.45
|
| Rate for Payer: Preferred Health Network WC |
$44,210.66
|
| Rate for Payer: Prime Health Services Medicare |
$29,653.13
|
| Rate for Payer: Prime Health Services WC |
$41,802.31
|
| 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 909: OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC
|
Facility
IP
|
$35,696.46
|
|
|
Service Code
|
MS-DRG 909
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$35,696.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,696.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,201.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,499.03
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,751.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,973.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19,239.51
|
| Rate for Payer: IEHP Medicare Advantage |
$19,239.51
|
| Rate for Payer: Innovage PACE Commercial |
$28,859.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,239.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,780.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,780.94
|
| Rate for Payer: Multiplan WC |
$28,751.57
|
| Rate for Payer: Preferred Health Network WC |
$29,338.34
|
| Rate for Payer: Prime Health Services Medicare |
$20,393.88
|
| Rate for Payer: Prime Health Services WC |
$27,740.15
|
| 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 913: TRAUMATIC INJURY WITH MCC
|
Facility
IP
|
$39,333.75
|
|
|
Service Code
|
MS-DRG 913
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$39,333.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,333.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,741.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,618.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,899.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,489.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,103.04
|
| Rate for Payer: IEHP Medicare Advantage |
$21,103.04
|
| Rate for Payer: Innovage PACE Commercial |
$31,654.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,103.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,278.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,278.07
|
| Rate for Payer: Multiplan WC |
$31,899.14
|
| Rate for Payer: Preferred Health Network WC |
$32,550.14
|
| Rate for Payer: Prime Health Services Medicare |
$22,369.22
|
| Rate for Payer: Prime Health Services WC |
$30,776.99
|
| 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 914: TRAUMATIC INJURY WITHOUT MCC
|
Facility
IP
|
$23,889.76
|
|
|
Service Code
|
MS-DRG 914
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$23,889.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,889.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,115.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,567.08
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,731.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,807.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,190.44
|
| Rate for Payer: IEHP Medicare Advantage |
$13,190.44
|
| Rate for Payer: Innovage PACE Commercial |
$19,785.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,190.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,675.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,675.19
|
| Rate for Payer: Multiplan WC |
$18,731.60
|
| Rate for Payer: Preferred Health Network WC |
$19,113.88
|
| Rate for Payer: Prime Health Services Medicare |
$13,981.87
|
| Rate for Payer: Prime Health Services WC |
$18,072.66
|
| 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 915: ALLERGIC REACTIONS WITH MCC
|
Facility
IP
|
$46,689.91
|
|
|
Service Code
|
MS-DRG 915
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$46,689.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,689.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,943.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,009.15
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,345.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,577.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,871.92
|
| Rate for Payer: IEHP Medicare Advantage |
$24,871.92
|
| Rate for Payer: Innovage PACE Commercial |
$37,307.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,871.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,328.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,328.37
|
| Rate for Payer: Multiplan WC |
$38,345.96
|
| Rate for Payer: Preferred Health Network WC |
$39,128.53
|
| Rate for Payer: Prime Health Services Medicare |
$26,364.24
|
| Rate for Payer: Prime Health Services WC |
$36,997.03
|
| 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 916: ALLERGIC REACTIONS WITHOUT MCC
|
Facility
IP
|
$17,338.96
|
|
|
Service Code
|
MS-DRG 916
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$17,338.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,338.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,292.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,870.49
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,993.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,276.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,834.18
|
| Rate for Payer: IEHP Medicare Advantage |
$9,834.18
|
| Rate for Payer: Innovage PACE Commercial |
$14,751.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,834.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,177.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,177.80
|
| Rate for Payer: Multiplan WC |
$13,993.40
|
| Rate for Payer: Preferred Health Network WC |
$14,278.98
|
| Rate for Payer: Prime Health Services Medicare |
$10,424.23
|
| Rate for Payer: Prime Health Services WC |
$13,501.14
|
| 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 917: POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC
|
Facility
IP
|
$42,002.49
|
|
|
Service Code
|
MS-DRG 917
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$42,002.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,002.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,884.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,794.37
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,076.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,334.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$22,470.36
|
| Rate for Payer: IEHP Medicare Advantage |
$22,470.36
|
| Rate for Payer: Innovage PACE Commercial |
$33,705.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,470.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,110.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,110.28
|
| Rate for Payer: Multiplan WC |
$32,076.11
|
| Rate for Payer: Preferred Health Network WC |
$32,730.72
|
| Rate for Payer: Prime Health Services Medicare |
$23,818.58
|
| Rate for Payer: Prime Health Services WC |
$30,947.73
|
| 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 918: POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC
|
Facility
IP
|
$22,658.03
|
|
|
Service Code
|
MS-DRG 918
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$22,658.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,658.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,901.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,076.03
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,227.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,955.14
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,559.36
|
| Rate for Payer: IEHP Medicare Advantage |
$12,559.36
|
| Rate for Payer: Innovage PACE Commercial |
$18,839.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,559.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,829.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,829.54
|
| Rate for Payer: Multiplan WC |
$17,227.34
|
| Rate for Payer: Preferred Health Network WC |
$17,578.92
|
| Rate for Payer: Prime Health Services Medicare |
$13,312.92
|
| Rate for Payer: Prime Health Services WC |
$16,621.32
|
| 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 919: COMPLICATIONS OF TREATMENT WITH MCC
|
Facility
IP
|
$48,024.28
|
|
|
Service Code
|
MS-DRG 919
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$48,024.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,024.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,492.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,455.75
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,787.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,500.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,555.57
|
| Rate for Payer: IEHP Medicare Advantage |
$25,555.57
|
| Rate for Payer: Innovage PACE Commercial |
$38,333.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,555.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,244.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,244.46
|
| Rate for Payer: Multiplan WC |
$37,787.65
|
| Rate for Payer: Preferred Health Network WC |
$38,558.83
|
| Rate for Payer: Prime Health Services Medicare |
$27,088.90
|
| Rate for Payer: Prime Health Services WC |
$36,458.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 920: COMPLICATIONS OF TREATMENT WITH CC
|
Facility
IP
|
$27,208.58
|
|
|
Service Code
|
MS-DRG 920
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$27,208.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,208.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,371.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,338.25
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,527.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,102.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,890.80
|
| Rate for Payer: IEHP Medicare Advantage |
$14,890.80
|
| Rate for Payer: Innovage PACE Commercial |
$22,336.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,890.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,953.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,953.67
|
| Rate for Payer: Multiplan WC |
$21,527.34
|
| Rate for Payer: Preferred Health Network WC |
$21,966.67
|
| Rate for Payer: Prime Health Services Medicare |
$15,784.25
|
| Rate for Payer: Prime Health Services WC |
$20,770.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 921: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC
|
Facility
IP
|
$18,365.40
|
|
|
Service Code
|
MS-DRG 921
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$18,365.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,365.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,375.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,200.74
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,335.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,986.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,360.05
|
| Rate for Payer: IEHP Medicare Advantage |
$10,360.05
|
| Rate for Payer: Innovage PACE Commercial |
$15,540.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,360.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,882.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,882.47
|
| Rate for Payer: Multiplan WC |
$15,335.43
|
| Rate for Payer: Preferred Health Network WC |
$15,648.40
|
| Rate for Payer: Prime Health Services Medicare |
$10,981.65
|
| Rate for Payer: Prime Health Services WC |
$14,795.96
|
| 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 922: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC
|
Facility
IP
|
$45,924.02
|
|
|
Service Code
|
MS-DRG 922
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$45,924.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,924.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,450.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,489.77
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,777.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,047.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,479.51
|
| Rate for Payer: IEHP Medicare Advantage |
$24,479.51
|
| Rate for Payer: Innovage PACE Commercial |
$36,719.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,479.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,802.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,802.54
|
| Rate for Payer: Multiplan WC |
$32,777.68
|
| Rate for Payer: Preferred Health Network WC |
$33,446.61
|
| Rate for Payer: Prime Health Services Medicare |
$25,948.28
|
| Rate for Payer: Prime Health Services WC |
$31,624.62
|
| 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 923: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC
|
Facility
IP
|
$26,619.04
|
|
|
Service Code
|
MS-DRG 923
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$26,619.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,619.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,035.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,696.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,871.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,694.81
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,588.75
|
| Rate for Payer: IEHP Medicare Advantage |
$14,588.75
|
| Rate for Payer: Innovage PACE Commercial |
$21,883.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,588.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,548.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,548.92
|
| Rate for Payer: Multiplan WC |
$19,871.38
|
| Rate for Payer: Preferred Health Network WC |
$20,276.92
|
| Rate for Payer: Prime Health Services Medicare |
$15,464.08
|
| Rate for Payer: Prime Health Services WC |
$19,172.35
|
| 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 927: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT
|
Facility
IP
|
$693,734.63
|
|
|
Service Code
|
MS-DRG 927
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$693,734.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$693,734.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$322,716.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$396,405.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$399,917.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$481,113.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$356,380.42
|
| Rate for Payer: IEHP Medicare Advantage |
$356,380.42
|
| Rate for Payer: Innovage PACE Commercial |
$534,570.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$356,380.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$477,549.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$477,549.76
|
| Rate for Payer: Multiplan WC |
$399,917.97
|
| Rate for Payer: Preferred Health Network WC |
$408,079.56
|
| Rate for Payer: Prime Health Services Medicare |
$377,763.25
|
| Rate for Payer: Prime Health Services WC |
$385,849.67
|
| 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 928: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC
|
Facility
IP
|
$182,119.58
|
|
|
Service Code
|
MS-DRG 928
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$182,119.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$182,119.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105,258.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129,292.92
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$130,438.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$127,248.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$94,258.28
|
| Rate for Payer: IEHP Medicare Advantage |
$94,258.28
|
| Rate for Payer: Innovage PACE Commercial |
$141,387.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94,258.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126,306.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$126,306.10
|
| Rate for Payer: Multiplan WC |
$130,438.63
|
| Rate for Payer: Preferred Health Network WC |
$133,100.64
|
| Rate for Payer: Prime Health Services Medicare |
$99,913.78
|
| Rate for Payer: Prime Health Services WC |
$125,850.06
|
| 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 929: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC
|
Facility
IP
|
$84,628.74
|
|
|
Service Code
|
MS-DRG 929
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$84,628.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$84,628.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49,962.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61,370.96
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$61,914.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,817.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,309.61
|
| Rate for Payer: IEHP Medicare Advantage |
$44,309.61
|
| Rate for Payer: Innovage PACE Commercial |
$66,464.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,309.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,374.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,374.88
|
| Rate for Payer: Multiplan WC |
$61,914.79
|
| Rate for Payer: Preferred Health Network WC |
$63,178.36
|
| Rate for Payer: Prime Health Services Medicare |
$46,968.19
|
| Rate for Payer: Prime Health Services WC |
$59,736.75
|
| 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 933: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT
|
Facility
IP
|
$79,799.21
|
|
|
Service Code
|
MS-DRG 933
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$79,799.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$79,799.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51,564.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63,338.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$63,899.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,477.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,835.21
|
| Rate for Payer: IEHP Medicare Advantage |
$41,835.21
|
| Rate for Payer: Innovage PACE Commercial |
$62,752.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,835.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,059.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,059.18
|
| Rate for Payer: Multiplan WC |
$63,899.40
|
| Rate for Payer: Preferred Health Network WC |
$65,203.47
|
| Rate for Payer: Prime Health Services Medicare |
$44,345.32
|
| Rate for Payer: Prime Health Services WC |
$61,651.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 934: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY
|
Facility
IP
|
$55,072.51
|
|
|
Service Code
|
MS-DRG 934
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$55,072.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,072.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,893.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,176.51
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,523.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,375.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29,166.68
|
| Rate for Payer: IEHP Medicare Advantage |
$29,166.68
|
| Rate for Payer: Innovage PACE Commercial |
$43,750.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,166.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,083.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,083.35
|
| Rate for Payer: Multiplan WC |
$39,523.66
|
| Rate for Payer: Preferred Health Network WC |
$40,330.27
|
| Rate for Payer: Prime Health Services Medicare |
$30,916.68
|
| Rate for Payer: Prime Health Services WC |
$38,133.30
|
| 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 935: NON-EXTENSIVE BURNS
|
Facility
IP
|
$53,719.71
|
|
|
Service Code
|
MS-DRG 935
|
| Min. Negotiated Rate |
$6,486.00 |
| Max. Negotiated Rate |
$53,719.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,719.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,411.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,269.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,643.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,439.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$28,473.58
|
| Rate for Payer: IEHP Medicare Advantage |
$28,473.58
|
| Rate for Payer: Innovage PACE Commercial |
$42,710.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,473.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,154.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,154.60
|
| Rate for Payer: Multiplan WC |
$42,643.85
|
| Rate for Payer: Preferred Health Network WC |
$43,514.13
|
| Rate for Payer: Prime Health Services Medicare |
$30,181.99
|
| Rate for Payer: Prime Health Services WC |
$41,143.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,986.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,486.00
|
|
|
INPATIENT MS-DRG 939: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC
|
Facility
IP
|
$84,623.48
|
|
|
Service Code
|
MS-DRG 939
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$84,623.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$84,623.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52,653.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64,676.74
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$65,249.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,814.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$44,306.89
|
| Rate for Payer: IEHP Medicare Advantage |
$44,306.89
|
| Rate for Payer: Innovage PACE Commercial |
$66,460.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$44,306.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59,371.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59,371.23
|
| Rate for Payer: Multiplan WC |
$65,249.86
|
| Rate for Payer: Preferred Health Network WC |
$66,581.49
|
| Rate for Payer: Prime Health Services Medicare |
$46,965.30
|
| Rate for Payer: Prime Health Services WC |
$62,954.50
|
| 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 940: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC
|
Facility
IP
|
$57,022.75
|
|
|
Service Code
|
MS-DRG 940
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$57,022.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57,022.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37,458.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46,011.51
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$46,419.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,723.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$30,165.87
|
| Rate for Payer: IEHP Medicare Advantage |
$30,165.87
|
| Rate for Payer: Innovage PACE Commercial |
$45,248.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,165.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,422.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,422.27
|
| Rate for Payer: Multiplan WC |
$46,419.24
|
| Rate for Payer: Preferred Health Network WC |
$47,366.57
|
| Rate for Payer: Prime Health Services Medicare |
$31,975.82
|
| Rate for Payer: Prime Health Services WC |
$44,786.31
|
| 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 941: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC
|
Facility
IP
|
$48,848.06
|
|
|
Service Code
|
MS-DRG 941
|
| Min. Negotiated Rate |
$7,235.00 |
| Max. Negotiated Rate |
$48,848.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,848.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,087.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,414.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,763.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,069.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$25,977.62
|
| Rate for Payer: IEHP Medicare Advantage |
$25,977.62
|
| Rate for Payer: Innovage PACE Commercial |
$38,966.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,977.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,810.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,810.01
|
| Rate for Payer: Multiplan WC |
$39,763.84
|
| Rate for Payer: Preferred Health Network WC |
$40,575.35
|
| Rate for Payer: Prime Health Services Medicare |
$27,536.28
|
| Rate for Payer: Prime Health Services WC |
$38,365.03
|
| 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 945: REHABILITATION WITH CC/MCC
|
Facility
IP
|
$39,728.53
|
|
|
Service Code
|
MS-DRG 945
|
| Min. Negotiated Rate |
$2,739.00 |
| Max. Negotiated Rate |
$39,728.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,728.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,589.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,433.09
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,711.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,762.16
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,305.30
|
| Rate for Payer: IEHP Medicare Advantage |
$21,305.30
|
| Rate for Payer: Innovage PACE Commercial |
$31,957.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,305.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,549.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,549.10
|
| Rate for Payer: Multiplan WC |
$31,711.63
|
| Rate for Payer: Preferred Health Network WC |
$32,358.81
|
| Rate for Payer: Prime Health Services Medicare |
$22,583.62
|
| Rate for Payer: Prime Health Services WC |
$30,596.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,770.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,196.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,995.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,739.00
|
|
|
INPATIENT MS-DRG 946: REHABILITATION WITHOUT CC/MCC
|
Facility
IP
|
$26,653.25
|
|
|
Service Code
|
MS-DRG 946
|
| Min. Negotiated Rate |
$2,739.00 |
| Max. Negotiated Rate |
$26,653.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,653.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,085.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,443.26
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,651.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,718.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14,606.28
|
| Rate for Payer: IEHP Medicare Advantage |
$14,606.28
|
| Rate for Payer: Innovage PACE Commercial |
$21,909.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,606.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,572.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,572.42
|
| Rate for Payer: Multiplan WC |
$23,651.00
|
| Rate for Payer: Preferred Health Network WC |
$24,133.67
|
| Rate for Payer: Prime Health Services Medicare |
$15,482.66
|
| Rate for Payer: Prime Health Services WC |
$22,819.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,770.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,196.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,995.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,739.00
|
|
