|
MS-DRG 42.00: ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION
|
Facility
|
IP
|
$25,229.39
|
|
|
Service Code
|
MSDRG 880
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$25,229.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,229.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,297.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,938.52
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,484.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,706.53
|
| Rate for Payer: EPIC Health Plan Senior |
$13,856.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,856.69
|
| Rate for Payer: InnovAge PACE Commercial |
$20,785.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,856.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,567.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,567.96
|
| Rate for Payer: Multiplan WC |
$20,484.72
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,856.69
|
| Rate for Payer: Preferred Health Network WC |
$20,902.78
|
| Rate for Payer: Prime Health Services Medicare |
$14,688.09
|
| Rate for Payer: Prime Health Services WC |
$20,275.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH CC
|
Facility
|
IP
|
$41,497.17
|
|
|
Service Code
|
MSDRG 289
|
| Min. Negotiated Rate |
$22,284.71 |
| Max. Negotiated Rate |
$41,497.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,497.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,805.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,084.36
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,693.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,084.36
|
| Rate for Payer: EPIC Health Plan Senior |
$22,284.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,284.71
|
| Rate for Payer: InnovAge PACE Commercial |
$33,427.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,284.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,861.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,861.51
|
| Rate for Payer: Multiplan WC |
$33,693.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,284.71
|
| Rate for Payer: Preferred Health Network WC |
$34,380.77
|
| Rate for Payer: Prime Health Services Medicare |
$23,621.79
|
| Rate for Payer: Prime Health Services WC |
$33,349.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$33,040.00
|
| Rate for Payer: United Healthcare All Other HMO |
$39,155.00
|
| Rate for Payer: United Healthcare HMO Rider |
$29,741.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,248.00
|
|
|
MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC
|
Facility
|
IP
|
$71,890.35
|
|
|
Service Code
|
MSDRG 288
|
| Min. Negotiated Rate |
$34,413.00 |
| Max. Negotiated Rate |
$71,890.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71,890.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46,438.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62,513.11
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$58,370.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,341.70
|
| Rate for Payer: EPIC Health Plan Senior |
$38,030.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,030.89
|
| Rate for Payer: InnovAge PACE Commercial |
$57,046.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,030.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,961.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,961.39
|
| Rate for Payer: Multiplan WC |
$58,370.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$38,030.89
|
| Rate for Payer: Preferred Health Network WC |
$59,561.79
|
| Rate for Payer: Prime Health Services Medicare |
$40,312.74
|
| Rate for Payer: Prime Health Services WC |
$57,774.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$37,549.00
|
| Rate for Payer: United Healthcare All Other HMO |
$49,452.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,563.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,413.00
|
|
|
MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$33,480.00
|
|
|
Service Code
|
MSDRG 290
|
| Min. Negotiated Rate |
$14,134.84 |
| Max. Negotiated Rate |
$33,480.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,766.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,643.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,405.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,920.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,082.03
|
| Rate for Payer: EPIC Health Plan Senior |
$14,134.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,134.84
|
| Rate for Payer: InnovAge PACE Commercial |
$21,202.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,134.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,940.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,940.69
|
| Rate for Payer: Multiplan WC |
$20,920.66
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,134.84
|
| Rate for Payer: Preferred Health Network WC |
$21,347.61
|
| Rate for Payer: Prime Health Services Medicare |
$14,982.93
|
| Rate for Payer: Prime Health Services WC |
$20,707.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$33,040.00
|
| Rate for Payer: United Healthcare All Other HMO |
$33,480.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25,436.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23,302.00
|
|
|
MS-DRG 42.00: ACUTE LEUKEMIA WITH CC
|
Facility
|
IP
|
$56,214.75
|
|
|
Service Code
|
MSDRG 835
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$56,214.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,214.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,312.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48,882.21
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,642.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,378.01
|
| Rate for Payer: EPIC Health Plan Senior |
$29,909.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,909.64
|
| Rate for Payer: InnovAge PACE Commercial |
$44,864.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,909.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,078.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,078.92
|
| Rate for Payer: Multiplan WC |
$45,642.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$29,909.64
|
| Rate for Payer: Preferred Health Network WC |
$46,574.42
|
| Rate for Payer: Prime Health Services Medicare |
$31,704.22
|
| Rate for Payer: Prime Health Services WC |
$45,177.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: ACUTE LEUKEMIA WITH MCC
|
Facility
|
IP
|
$145,473.01
|
|
|
Service Code
|
MSDRG 834
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$145,473.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$145,473.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93,969.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126,497.79
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$118,115.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$102,806.20
|
| Rate for Payer: EPIC Health Plan Senior |
$76,152.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$76,152.74
|
| Rate for Payer: InnovAge PACE Commercial |
$114,229.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76,152.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102,044.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102,044.67
|
| Rate for Payer: Multiplan WC |
$118,115.16
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$76,152.74
|
| Rate for Payer: Preferred Health Network WC |
$120,525.67
|
| Rate for Payer: Prime Health Services Medicare |
$80,721.90
|
| Rate for Payer: Prime Health Services WC |
$116,909.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: ACUTE LEUKEMIA WITH OTHER PROCEDURES
|
Facility
|
IP
|
$242,448.00
|
|
|
Service Code
|
MSDRG 850
|
| Min. Negotiated Rate |
$156,611.51 |
| Max. Negotiated Rate |
$242,448.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$242,448.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$156,611.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$210,823.54
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$196,852.90
|
| Rate for Payer: Multiplan WC |
$196,852.90
|
| Rate for Payer: Preferred Health Network WC |
$200,870.31
|
| Rate for Payer: Prime Health Services WC |
$194,844.20
|
|
|
MS-DRG 42.00: ACUTE LEUKEMIA WITHOUT CC/MCC
|
Facility
|
IP
|
$33,443.55
|
|
|
Service Code
|
MSDRG 836
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$33,443.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,443.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,603.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,081.24
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$27,154.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,451.59
|
| Rate for Payer: EPIC Health Plan Senior |
$18,112.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18,112.29
|
| Rate for Payer: InnovAge PACE Commercial |
$27,168.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,112.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,270.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,270.47
|
| Rate for Payer: Multiplan WC |
$27,154.11
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18,112.29
|
| Rate for Payer: Preferred Health Network WC |
$27,708.28
|
| Rate for Payer: Prime Health Services Medicare |
$19,199.03
|
| Rate for Payer: Prime Health Services WC |
$26,877.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITH CC/MCC
|
Facility
|
IP
|
$30,614.26
|
|
|
Service Code
|
MSDRG 121
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$30,614.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,614.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,775.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,621.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,856.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,472.75
|
| Rate for Payer: EPIC Health Plan Senior |
$16,646.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,646.48
|
| Rate for Payer: InnovAge PACE Commercial |
$24,969.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,646.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,306.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,306.28
|
| Rate for Payer: Multiplan WC |
$24,856.91
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,646.48
|
| Rate for Payer: Preferred Health Network WC |
$25,364.19
|
| Rate for Payer: Prime Health Services Medicare |
$17,645.27
|
| Rate for Payer: Prime Health Services WC |
$24,603.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$17,852.18
|
|
|
Service Code
|
MSDRG 122
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$17,852.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,852.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,531.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,523.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,494.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,546.82
|
| Rate for Payer: EPIC Health Plan Senior |
$10,034.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,034.68
|
| Rate for Payer: InnovAge PACE Commercial |
$15,052.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,034.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,446.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,446.47
|
| Rate for Payer: Multiplan WC |
$14,494.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,034.68
|
| Rate for Payer: Preferred Health Network WC |
$14,790.69
|
| Rate for Payer: Prime Health Services Medicare |
$10,636.76
|
| Rate for Payer: Prime Health Services WC |
$14,346.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC
|
Facility
|
IP
|
$26,466.00
|
|
|
Service Code
|
MSDRG 281
|
| Min. Negotiated Rate |
$13,354.92 |
| Max. Negotiated Rate |
$26,466.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,260.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,671.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,096.31
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,698.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,029.14
|
| Rate for Payer: EPIC Health Plan Senior |
$13,354.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,354.92
|
| Rate for Payer: InnovAge PACE Commercial |
$20,032.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,354.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,895.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,895.59
|
| Rate for Payer: Multiplan WC |
$19,698.32
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,354.92
|
| Rate for Payer: Preferred Health Network WC |
$20,100.33
|
| Rate for Payer: Prime Health Services Medicare |
$14,156.22
|
| Rate for Payer: Prime Health Services WC |
$19,497.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$26,466.00
|
| Rate for Payer: United Healthcare All Other HMO |
$22,273.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,920.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,502.00
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC
|
Facility
|
IP
|
$43,200.01
|
|
|
Service Code
|
MSDRG 280
|
| Min. Negotiated Rate |
$20,535.00 |
| Max. Negotiated Rate |
$43,200.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,200.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,905.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,565.08
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,075.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,275.37
|
| Rate for Payer: EPIC Health Plan Senior |
$23,166.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,166.94
|
| Rate for Payer: InnovAge PACE Commercial |
$34,750.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,166.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,043.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,043.70
|
| Rate for Payer: Multiplan WC |
$35,075.76
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,166.94
|
| Rate for Payer: Preferred Health Network WC |
$35,791.59
|
| Rate for Payer: Prime Health Services Medicare |
$24,556.96
|
| Rate for Payer: Prime Health Services WC |
$34,717.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,038.00
|
| Rate for Payer: United Healthcare All Other HMO |
$29,511.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,413.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,535.00
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC
|
Facility
|
IP
|
$28,087.00
|
|
|
Service Code
|
MSDRG 282
|
| Min. Negotiated Rate |
$10,672.83 |
| Max. Negotiated Rate |
$28,087.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,083.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,327.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,594.64
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,494.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,408.32
|
| Rate for Payer: EPIC Health Plan Senior |
$10,672.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,672.83
|
| Rate for Payer: InnovAge PACE Commercial |
$16,009.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,672.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,301.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,301.59
|
| Rate for Payer: Multiplan WC |
$15,494.97
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,672.83
|
| Rate for Payer: Preferred Health Network WC |
$15,811.19
|
| Rate for Payer: Prime Health Services Medicare |
$11,313.20
|
| Rate for Payer: Prime Health Services WC |
$15,336.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,087.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,018.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,685.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,537.00
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC
|
Facility
|
IP
|
$28,275.00
|
|
|
Service Code
|
MSDRG 284
|
| Min. Negotiated Rate |
$10,889.62 |
| Max. Negotiated Rate |
$28,275.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,502.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,597.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,958.53
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,834.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,700.99
|
| Rate for Payer: EPIC Health Plan Senior |
$10,889.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,889.62
|
| Rate for Payer: InnovAge PACE Commercial |
$16,334.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,889.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,592.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,592.09
|
| Rate for Payer: Multiplan WC |
$15,834.73
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,889.62
|
| Rate for Payer: Preferred Health Network WC |
$16,157.89
|
| Rate for Payer: Prime Health Services Medicare |
$11,543.00
|
| Rate for Payer: Prime Health Services WC |
$15,673.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$28,275.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,489.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,558.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,254.00
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC
|
Facility
|
IP
|
$51,464.17
|
|
|
Service Code
|
MSDRG 283
|
| Min. Negotiated Rate |
$18,641.00 |
| Max. Negotiated Rate |
$51,464.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,464.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,243.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,751.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,785.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,055.42
|
| Rate for Payer: EPIC Health Plan Senior |
$27,448.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,448.46
|
| Rate for Payer: InnovAge PACE Commercial |
$41,172.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,448.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,780.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,780.94
|
| Rate for Payer: Multiplan WC |
$41,785.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$27,448.46
|
| Rate for Payer: Preferred Health Network WC |
$42,638.52
|
| Rate for Payer: Prime Health Services Medicare |
$29,095.37
|
| Rate for Payer: Prime Health Services WC |
$41,359.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,007.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,787.00
|
| Rate for Payer: United Healthcare HMO Rider |
$20,346.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18,641.00
|
|
|
MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC
|
Facility
|
IP
|
$27,865.00
|
|
|
Service Code
|
MSDRG 285
|
| Min. Negotiated Rate |
$8,440.71 |
| Max. Negotiated Rate |
$27,865.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,775.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,544.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,848.20
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,996.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,394.96
|
| Rate for Payer: EPIC Health Plan Senior |
$8,440.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,440.71
|
| Rate for Payer: InnovAge PACE Commercial |
$12,661.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,440.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,310.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,310.55
|
| Rate for Payer: Multiplan WC |
$11,996.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,440.71
|
| Rate for Payer: Preferred Health Network WC |
$12,241.62
|
| Rate for Payer: Prime Health Services Medicare |
$8,947.15
|
| Rate for Payer: Prime Health Services WC |
$11,874.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,865.00
|
| Rate for Payer: United Healthcare All Other HMO |
$17,683.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,432.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,305.00
|
|
|
MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$59,981.00
|
|
|
Service Code
|
MSDRG 614
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$59,981.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,981.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38,745.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52,157.19
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$48,700.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,012.17
|
| Rate for Payer: EPIC Health Plan Senior |
$31,860.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,860.87
|
| Rate for Payer: InnovAge PACE Commercial |
$47,791.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,860.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,693.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,693.57
|
| Rate for Payer: Multiplan WC |
$48,700.89
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$31,860.87
|
| Rate for Payer: Preferred Health Network WC |
$49,694.79
|
| Rate for Payer: Prime Health Services Medicare |
$33,772.52
|
| Rate for Payer: Prime Health Services WC |
$48,203.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$37,715.13
|
|
|
Service Code
|
MSDRG 615
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$37,715.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,715.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,362.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,795.64
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,622.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,439.17
|
| Rate for Payer: EPIC Health Plan Senior |
$20,325.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,325.31
|
| Rate for Payer: InnovAge PACE Commercial |
$30,487.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,325.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,235.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,235.92
|
| Rate for Payer: Multiplan WC |
$30,622.37
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,325.31
|
| Rate for Payer: Preferred Health Network WC |
$31,247.32
|
| Rate for Payer: Prime Health Services Medicare |
$21,544.83
|
| Rate for Payer: Prime Health Services WC |
$30,309.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC
|
Facility
|
IP
|
$29,969.45
|
|
|
Service Code
|
MSDRG 560
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$29,969.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,969.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,359.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,060.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,333.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,021.75
|
| Rate for Payer: EPIC Health Plan Senior |
$16,312.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,312.41
|
| Rate for Payer: InnovAge PACE Commercial |
$24,468.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,312.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,858.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,858.63
|
| Rate for Payer: Multiplan WC |
$24,333.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,312.41
|
| Rate for Payer: Preferred Health Network WC |
$24,829.95
|
| Rate for Payer: Prime Health Services Medicare |
$17,291.15
|
| Rate for Payer: Prime Health Services WC |
$24,085.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$48,855.96
|
|
|
Service Code
|
MSDRG 559
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$48,855.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,855.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,558.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,483.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,668.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,231.19
|
| Rate for Payer: EPIC Health Plan Senior |
$26,097.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,097.18
|
| Rate for Payer: InnovAge PACE Commercial |
$39,145.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,097.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,970.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,970.22
|
| Rate for Payer: Multiplan WC |
$39,668.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26,097.18
|
| Rate for Payer: Preferred Health Network WC |
$40,477.59
|
| Rate for Payer: Prime Health Services Medicare |
$27,663.01
|
| Rate for Payer: Prime Health Services WC |
$39,263.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$21,518.41
|
|
|
Service Code
|
MSDRG 561
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$21,518.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,518.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,900.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,711.59
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,471.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,111.05
|
| Rate for Payer: EPIC Health Plan Senior |
$11,934.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,934.11
|
| Rate for Payer: InnovAge PACE Commercial |
$17,901.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,934.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,991.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,991.71
|
| Rate for Payer: Multiplan WC |
$17,471.64
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,934.11
|
| Rate for Payer: Preferred Health Network WC |
$17,828.20
|
| Rate for Payer: Prime Health Services Medicare |
$12,650.16
|
| Rate for Payer: Prime Health Services WC |
$17,293.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: AFTERCARE WITH CC/MCC
|
Facility
|
IP
|
$28,398.20
|
|
|
Service Code
|
MSDRG 949
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$28,398.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,398.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,344.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,693.99
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,057.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,922.81
|
| Rate for Payer: EPIC Health Plan Senior |
$15,498.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,498.38
|
| Rate for Payer: InnovAge PACE Commercial |
$23,247.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,498.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,767.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,767.83
|
| Rate for Payer: Multiplan WC |
$23,057.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,498.38
|
| Rate for Payer: Preferred Health Network WC |
$23,528.16
|
| Rate for Payer: Prime Health Services Medicare |
$16,428.28
|
| Rate for Payer: Prime Health Services WC |
$22,822.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: AFTERCARE WITHOUT CC/MCC
|
Facility
|
IP
|
$15,425.57
|
|
|
Service Code
|
MSDRG 950
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$15,425.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,425.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,964.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,413.48
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$12,524.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,849.62
|
| Rate for Payer: EPIC Health Plan Senior |
$8,777.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,777.50
|
| Rate for Payer: InnovAge PACE Commercial |
$13,166.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,777.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,761.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,761.85
|
| Rate for Payer: Multiplan WC |
$12,524.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,777.50
|
| Rate for Payer: Preferred Health Network WC |
$12,780.22
|
| Rate for Payer: Prime Health Services Medicare |
$9,304.15
|
| Rate for Payer: Prime Health Services WC |
$12,396.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: AICD GENERATOR PROCEDURES
|
Facility
|
IP
|
$128,615.69
|
|
|
Service Code
|
MSDRG 245
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$128,615.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$128,615.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$83,080.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111,839.30
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$104,428.05
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$91,015.99
|
| Rate for Payer: EPIC Health Plan Senior |
$67,419.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67,419.25
|
| Rate for Payer: InnovAge PACE Commercial |
$101,128.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,419.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90,341.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,341.79
|
| Rate for Payer: Multiplan WC |
$104,428.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$67,419.25
|
| Rate for Payer: Preferred Health Network WC |
$106,559.23
|
| Rate for Payer: Prime Health Services Medicare |
$71,464.40
|
| Rate for Payer: Prime Health Services WC |
$103,362.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: AICD LEAD PROCEDURES
|
Facility
|
IP
|
$93,885.14
|
|
|
Service Code
|
MSDRG 265
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$93,885.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$93,885.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60,645.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81,638.94
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$76,228.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,725.11
|
| Rate for Payer: EPIC Health Plan Senior |
$49,426.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$49,426.01
|
| Rate for Payer: InnovAge PACE Commercial |
$74,139.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,426.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66,230.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66,230.85
|
| Rate for Payer: Multiplan WC |
$76,228.98
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$49,426.01
|
| Rate for Payer: Preferred Health Network WC |
$77,784.67
|
| Rate for Payer: Prime Health Services Medicare |
$52,391.57
|
| Rate for Payer: Prime Health Services WC |
$75,451.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
