|
MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA
|
Facility
|
IP
|
$16,425.69
|
|
|
Service Code
|
MSDRG 894
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$16,425.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,425.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,610.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,283.15
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,336.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,549.13
|
| Rate for Payer: EPIC Health Plan Senior |
$9,295.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,295.65
|
| Rate for Payer: InnovAge PACE Commercial |
$13,943.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,295.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,456.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,456.17
|
| Rate for Payer: Multiplan WC |
$13,336.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,295.65
|
| Rate for Payer: Preferred Health Network WC |
$13,608.83
|
| Rate for Payer: Prime Health Services Medicare |
$9,853.39
|
| Rate for Payer: Prime Health Services WC |
$13,200.57
|
| 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: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC
|
Facility
|
IP
|
$46,868.88
|
|
|
Service Code
|
MSDRG 896
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$46,868.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,868.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,275.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,755.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,054.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,841.39
|
| Rate for Payer: EPIC Health Plan Senior |
$25,067.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,067.70
|
| Rate for Payer: InnovAge PACE Commercial |
$37,601.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,067.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,590.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,590.72
|
| Rate for Payer: Multiplan WC |
$38,054.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25,067.70
|
| Rate for Payer: Preferred Health Network WC |
$38,831.28
|
| Rate for Payer: Prime Health Services Medicare |
$26,571.76
|
| Rate for Payer: Prime Health Services WC |
$37,666.34
|
| 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: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC
|
Facility
|
IP
|
$23,218.62
|
|
|
Service Code
|
MSDRG 897
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$23,218.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,218.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,998.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,190.03
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,852.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,300.17
|
| Rate for Payer: EPIC Health Plan Senior |
$12,814.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,814.94
|
| Rate for Payer: InnovAge PACE Commercial |
$19,222.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,814.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,172.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,172.02
|
| Rate for Payer: Multiplan WC |
$18,852.09
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,814.94
|
| Rate for Payer: Preferred Health Network WC |
$19,236.83
|
| Rate for Payer: Prime Health Services Medicare |
$13,583.84
|
| Rate for Payer: Prime Health Services WC |
$18,659.73
|
| 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: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY
|
Facility
|
IP
|
$38,107.28
|
|
|
Service Code
|
MSDRG 895
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,107.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,107.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,615.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,136.64
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,940.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,713.46
|
| Rate for Payer: EPIC Health Plan Senior |
$20,528.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,528.49
|
| Rate for Payer: InnovAge PACE Commercial |
$30,792.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,528.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,508.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,508.18
|
| Rate for Payer: Multiplan WC |
$30,940.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,528.49
|
| Rate for Payer: Preferred Health Network WC |
$31,572.22
|
| Rate for Payer: Prime Health Services Medicare |
$21,760.20
|
| Rate for Payer: Prime Health Services WC |
$30,625.05
|
| 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: ALLERGIC REACTIONS WITH MCC
|
Facility
|
IP
|
$45,739.79
|
|
|
Service Code
|
MSDRG 915
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$45,739.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,739.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,546.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,773.58
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,137.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,051.73
|
| Rate for Payer: EPIC Health Plan Senior |
$24,482.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,482.76
|
| Rate for Payer: InnovAge PACE Commercial |
$36,724.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,482.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,806.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,806.90
|
| Rate for Payer: Multiplan WC |
$37,137.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,482.76
|
| Rate for Payer: Preferred Health Network WC |
$37,895.82
|
| Rate for Payer: Prime Health Services Medicare |
$25,951.73
|
| Rate for Payer: Prime Health Services WC |
$36,758.95
|
| 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: ALLERGIC REACTIONS WITHOUT MCC
|
Facility
|
IP
|
$17,478.45
|
|
|
Service Code
|
MSDRG 916
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$17,478.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,478.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,290.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,198.59
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,191.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,285.43
|
| Rate for Payer: EPIC Health Plan Senior |
$9,841.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,841.06
|
| Rate for Payer: InnovAge PACE Commercial |
$14,761.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,841.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,187.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,187.02
|
| Rate for Payer: Multiplan WC |
$14,191.43
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,841.06
|
| Rate for Payer: Preferred Health Network WC |
$14,481.05
|
| Rate for Payer: Prime Health Services Medicare |
$10,431.52
|
| Rate for Payer: Prime Health Services WC |
$14,046.62
|
| 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: ALLOGENEIC BONE MARROW TRANSPLANT
|
Facility
|
IP
|
$344,826.27
|
|
|
Service Code
|
MSDRG 014
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$344,826.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$344,826.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$222,743.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$299,847.79
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$279,977.78
|
| Rate for Payer: Caremore Medicare Advantage |
$179,434.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$160,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$242,236.01
|
| Rate for Payer: EPIC Health Plan Senior |
$179,434.08
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$165,000.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$179,434.08
|
| Rate for Payer: InnovAge PACE Commercial |
$269,151.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$179,434.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$240,441.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$240,441.67
|
| Rate for Payer: Multiplan WC |
$279,977.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$179,434.08
|
| Rate for Payer: Preferred Health Network WC |
$285,691.61
|
| Rate for Payer: Prime Health Services Medicare |
$190,200.12
|
| Rate for Payer: Prime Health Services WC |
$277,120.86
|
| 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: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC
|
Facility
|
IP
|
$76,646.19
|
|
|
Service Code
|
MSDRG 240
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$76,646.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$76,646.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49,510.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66,648.61
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$62,232.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,667.99
|
| Rate for Payer: EPIC Health Plan Senior |
$40,494.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,494.81
|
| Rate for Payer: InnovAge PACE Commercial |
$60,742.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,494.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,263.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,263.05
|
| Rate for Payer: Multiplan WC |
$62,232.01
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,494.81
|
| Rate for Payer: Preferred Health Network WC |
$63,502.05
|
| Rate for Payer: Prime Health Services Medicare |
$42,924.50
|
| Rate for Payer: Prime Health Services WC |
$61,596.99
|
| 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: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC
|
Facility
|
IP
|
$132,566.17
|
|
|
Service Code
|
MSDRG 239
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$132,566.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$132,566.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$85,632.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115,274.49
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$107,635.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$93,779.03
|
| Rate for Payer: EPIC Health Plan Senior |
$69,465.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$69,465.95
|
| Rate for Payer: InnovAge PACE Commercial |
$104,198.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69,465.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93,084.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93,084.37
|
| Rate for Payer: Multiplan WC |
$107,635.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$69,465.95
|
| Rate for Payer: Preferred Health Network WC |
$109,832.24
|
| Rate for Payer: Prime Health Services Medicare |
$73,633.91
|
| Rate for Payer: Prime Health Services WC |
$106,537.27
|
| 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: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC
|
Facility
|
IP
|
$39,739.06
|
|
|
Service Code
|
MSDRG 241
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$39,739.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,739.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,669.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,555.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,265.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,854.76
|
| Rate for Payer: EPIC Health Plan Senior |
$21,373.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,373.90
|
| Rate for Payer: InnovAge PACE Commercial |
$32,060.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,373.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,641.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,641.03
|
| Rate for Payer: Multiplan WC |
$32,265.68
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,373.90
|
| Rate for Payer: Preferred Health Network WC |
$32,924.16
|
| Rate for Payer: Prime Health Services Medicare |
$22,656.33
|
| Rate for Payer: Prime Health Services WC |
$31,936.44
|
| 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: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$56,777.98
|
|
|
Service Code
|
MSDRG 475
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$56,777.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,777.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,676.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49,371.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$46,100.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,771.94
|
| Rate for Payer: EPIC Health Plan Senior |
$30,201.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,201.44
|
| Rate for Payer: InnovAge PACE Commercial |
$45,302.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,201.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,469.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,469.93
|
| Rate for Payer: Multiplan WC |
$46,100.24
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$30,201.44
|
| Rate for Payer: Preferred Health Network WC |
$47,041.06
|
| Rate for Payer: Prime Health Services Medicare |
$32,013.53
|
| Rate for Payer: Prime Health Services WC |
$45,629.83
|
| 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: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC
|
Facility
|
IP
|
$118,032.82
|
|
|
Service Code
|
MSDRG 474
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$118,032.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$118,032.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$76,244.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102,636.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$95,835.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$83,614.23
|
| Rate for Payer: EPIC Health Plan Senior |
$61,936.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$61,936.47
|
| Rate for Payer: InnovAge PACE Commercial |
$92,904.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61,936.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82,994.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82,994.87
|
| Rate for Payer: Multiplan WC |
$95,835.41
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$61,936.47
|
| Rate for Payer: Preferred Health Network WC |
$97,791.23
|
| Rate for Payer: Prime Health Services Medicare |
$65,652.66
|
| Rate for Payer: Prime Health Services WC |
$94,857.49
|
| 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: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$30,611.63
|
|
|
Service Code
|
MSDRG 476
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$30,611.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,611.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,773.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,618.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,854.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,470.94
|
| Rate for Payer: EPIC Health Plan Senior |
$16,645.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,645.14
|
| Rate for Payer: InnovAge PACE Commercial |
$24,967.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,645.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,304.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,304.49
|
| Rate for Payer: Multiplan WC |
$24,854.76
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,645.14
|
| Rate for Payer: Preferred Health Network WC |
$25,362.00
|
| Rate for Payer: Prime Health Services Medicare |
$17,643.85
|
| Rate for Payer: Prime Health Services WC |
$24,601.14
|
| 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: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$50,837.78
|
|
|
Service Code
|
MSDRG 617
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$50,837.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,837.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,839.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,206.60
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,277.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,617.32
|
| Rate for Payer: EPIC Health Plan Senior |
$27,123.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,123.94
|
| Rate for Payer: InnovAge PACE Commercial |
$40,685.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,123.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,346.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,346.08
|
| Rate for Payer: Multiplan WC |
$41,277.16
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$27,123.94
|
| Rate for Payer: Preferred Health Network WC |
$42,119.55
|
| Rate for Payer: Prime Health Services Medicare |
$28,751.38
|
| Rate for Payer: Prime Health Services WC |
$40,855.96
|
| 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: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$101,722.93
|
|
|
Service Code
|
MSDRG 616
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$101,722.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101,722.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65,708.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88,454.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$82,592.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$72,206.94
|
| Rate for Payer: EPIC Health Plan Senior |
$53,486.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$53,486.62
|
| Rate for Payer: InnovAge PACE Commercial |
$80,229.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,486.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,672.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,672.07
|
| Rate for Payer: Multiplan WC |
$82,592.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$53,486.62
|
| Rate for Payer: Preferred Health Network WC |
$84,278.35
|
| Rate for Payer: Prime Health Services Medicare |
$56,695.82
|
| Rate for Payer: Prime Health Services WC |
$81,750.00
|
| 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: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$32,769.79
|
|
|
Service Code
|
MSDRG 618
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$32,769.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,769.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,167.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,495.36
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$26,607.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,889.37
|
| Rate for Payer: EPIC Health Plan Senior |
$16,955.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,955.09
|
| Rate for Payer: InnovAge PACE Commercial |
$25,432.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,955.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,719.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,719.82
|
| Rate for Payer: Multiplan WC |
$26,607.06
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,955.09
|
| Rate for Payer: Preferred Health Network WC |
$27,150.06
|
| Rate for Payer: Prime Health Services Medicare |
$17,972.40
|
| Rate for Payer: Prime Health Services WC |
$26,335.56
|
| 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: ANAL AND STOMAL PROCEDURES WITH CC
|
Facility
|
IP
|
$33,132.99
|
|
|
Service Code
|
MSDRG 348
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$33,132.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,132.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,402.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,811.19
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$26,901.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,234.36
|
| Rate for Payer: EPIC Health Plan Senior |
$17,951.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17,951.38
|
| Rate for Payer: InnovAge PACE Commercial |
$26,927.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,951.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,054.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,054.85
|
| Rate for Payer: Multiplan WC |
$26,901.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17,951.38
|
| Rate for Payer: Preferred Health Network WC |
$27,450.97
|
| Rate for Payer: Prime Health Services Medicare |
$19,028.46
|
| Rate for Payer: Prime Health Services WC |
$26,627.44
|
| 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: ANAL AND STOMAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$62,291.81
|
|
|
Service Code
|
MSDRG 347
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$62,291.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,291.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40,237.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54,166.58
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$50,577.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,628.39
|
| Rate for Payer: EPIC Health Plan Senior |
$33,058.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,058.07
|
| Rate for Payer: InnovAge PACE Commercial |
$49,587.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,058.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,297.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,297.81
|
| Rate for Payer: Multiplan WC |
$50,577.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$33,058.07
|
| Rate for Payer: Preferred Health Network WC |
$51,609.31
|
| Rate for Payer: Prime Health Services Medicare |
$35,041.55
|
| Rate for Payer: Prime Health Services WC |
$50,061.03
|
| 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: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$23,184.41
|
|
|
Service Code
|
MSDRG 349
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$23,184.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,184.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,976.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,160.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,824.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,276.26
|
| Rate for Payer: EPIC Health Plan Senior |
$12,797.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,797.23
|
| Rate for Payer: InnovAge PACE Commercial |
$19,195.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,797.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,148.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,148.29
|
| Rate for Payer: Multiplan WC |
$18,824.32
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,797.23
|
| Rate for Payer: Preferred Health Network WC |
$19,208.49
|
| Rate for Payer: Prime Health Services Medicare |
$13,565.06
|
| Rate for Payer: Prime Health Services WC |
$18,632.24
|
| 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: ANGINA PECTORIS
|
Facility
|
IP
|
$18,378.56
|
|
|
Service Code
|
MSDRG 311
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$18,378.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,378.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,871.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,981.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,922.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,914.96
|
| Rate for Payer: EPIC Health Plan Senior |
$10,307.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,307.38
|
| Rate for Payer: InnovAge PACE Commercial |
$15,461.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,307.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,811.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,811.89
|
| Rate for Payer: Multiplan WC |
$14,922.26
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,307.38
|
| Rate for Payer: Preferred Health Network WC |
$15,226.80
|
| Rate for Payer: Prime Health Services Medicare |
$10,925.82
|
| Rate for Payer: Prime Health Services WC |
$14,770.00
|
| 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: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC
|
Facility
|
IP
|
$175,484.56
|
|
|
Service Code
|
MSDRG 268
|
| Min. Negotiated Rate |
$25,661.00 |
| Max. Negotiated Rate |
$175,484.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$175,484.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$113,355.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152,594.69
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$142,482.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$123,796.61
|
| Rate for Payer: EPIC Health Plan Senior |
$91,701.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$91,701.19
|
| Rate for Payer: InnovAge PACE Commercial |
$137,551.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$91,701.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$122,879.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$122,879.59
|
| Rate for Payer: Multiplan WC |
$142,482.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$91,701.19
|
| Rate for Payer: Preferred Health Network WC |
$145,390.51
|
| Rate for Payer: Prime Health Services Medicare |
$97,203.26
|
| Rate for Payer: Prime Health Services WC |
$141,028.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$127,168.00
|
| Rate for Payer: United Healthcare All Other HMO |
$111,805.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,927.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,806.00
|
|
|
MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC
|
Facility
|
IP
|
$109,505.46
|
|
|
Service Code
|
MSDRG 269
|
| Min. Negotiated Rate |
$25,661.00 |
| Max. Negotiated Rate |
$109,505.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$109,505.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70,736.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95,221.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$88,911.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$77,650.12
|
| Rate for Payer: EPIC Health Plan Senior |
$57,518.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$57,518.61
|
| Rate for Payer: InnovAge PACE Commercial |
$86,277.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,518.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77,074.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77,074.94
|
| Rate for Payer: Multiplan WC |
$88,911.72
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$57,518.61
|
| Rate for Payer: Preferred Health Network WC |
$90,726.24
|
| Rate for Payer: Prime Health Services Medicare |
$60,969.73
|
| Rate for Payer: Prime Health Services WC |
$88,004.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$79,046.00
|
| Rate for Payer: United Healthcare All Other HMO |
$69,501.00
|
| Rate for Payer: United Healthcare HMO Rider |
$52,792.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48,365.00
|
|
|
MS-DRG 42.00: APPENDIX PROCEDURES WITH CC
|
Facility
|
IP
|
$39,825.91
|
|
|
Service Code
|
MSDRG 398
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$39,825.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,825.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,725.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,631.10
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$32,336.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,915.47
|
| Rate for Payer: EPIC Health Plan Senior |
$21,418.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,418.87
|
| Rate for Payer: InnovAge PACE Commercial |
$32,128.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,418.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,701.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,701.29
|
| Rate for Payer: Multiplan WC |
$32,336.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,418.87
|
| Rate for Payer: Preferred Health Network WC |
$32,996.12
|
| Rate for Payer: Prime Health Services Medicare |
$22,704.00
|
| Rate for Payer: Prime Health Services WC |
$32,006.24
|
| 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: APPENDIX PROCEDURES WITH MCC
|
Facility
|
IP
|
$65,213.22
|
|
|
Service Code
|
MSDRG 397
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$65,213.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$65,213.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42,125.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56,706.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$52,949.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,671.65
|
| Rate for Payer: EPIC Health Plan Senior |
$34,571.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,571.59
|
| Rate for Payer: InnovAge PACE Commercial |
$51,857.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,571.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,325.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,325.93
|
| Rate for Payer: Multiplan WC |
$52,949.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$34,571.59
|
| Rate for Payer: Preferred Health Network WC |
$54,029.73
|
| Rate for Payer: Prime Health Services Medicare |
$36,645.89
|
| Rate for Payer: Prime Health Services WC |
$52,408.84
|
| 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: APPENDIX PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$29,577.29
|
|
|
Service Code
|
MSDRG 399
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$29,577.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,577.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,105.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,719.29
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,014.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,747.51
|
| Rate for Payer: EPIC Health Plan Senior |
$16,109.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,109.27
|
| Rate for Payer: InnovAge PACE Commercial |
$24,163.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,109.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,586.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,586.42
|
| Rate for Payer: Multiplan WC |
$24,014.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,109.27
|
| Rate for Payer: Preferred Health Network WC |
$24,505.05
|
| Rate for Payer: Prime Health Services Medicare |
$17,075.83
|
| Rate for Payer: Prime Health Services WC |
$23,769.90
|
| 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
|
|
