|
MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$102,346.70
|
|
|
Service Code
|
MSDRG 034
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$102,346.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,346.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66,111.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88,996.79
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$83,099.24
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,795.88
|
| Rate for Payer: EPIC Health Plan Senior |
$42,811.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,811.76
|
| Rate for Payer: InnovAge PACE Commercial |
$64,217.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,811.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,367.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,367.76
|
| Rate for Payer: Multiplan WC |
$83,099.24
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$42,811.76
|
| Rate for Payer: Preferred Health Network WC |
$84,795.14
|
| Rate for Payer: Prime Health Services Medicare |
$45,380.47
|
| Rate for Payer: Prime Health Services WC |
$82,251.29
|
| 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: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$48,245.36
|
|
|
Service Code
|
MSDRG 036
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$48,245.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,245.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,164.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,952.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,172.28
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,286.33
|
| Rate for Payer: EPIC Health Plan Senior |
$20,952.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,952.84
|
| Rate for Payer: InnovAge PACE Commercial |
$31,429.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,952.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,076.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,076.81
|
| Rate for Payer: Multiplan WC |
$39,172.28
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,952.84
|
| Rate for Payer: Preferred Health Network WC |
$39,971.71
|
| Rate for Payer: Prime Health Services Medicare |
$22,210.01
|
| Rate for Payer: Prime Health Services WC |
$38,772.56
|
| 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: CELLULITIS WITH MCC
|
Facility
|
IP
|
$38,667.87
|
|
|
Service Code
|
MSDRG 602
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,667.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,667.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,977.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,624.11
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,395.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,062.31
|
| Rate for Payer: EPIC Health Plan Senior |
$17,083.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17,083.19
|
| Rate for Payer: InnovAge PACE Commercial |
$25,624.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,083.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,891.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,891.47
|
| Rate for Payer: Multiplan WC |
$31,395.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17,083.19
|
| Rate for Payer: Preferred Health Network WC |
$32,036.68
|
| Rate for Payer: Prime Health Services Medicare |
$18,108.18
|
| Rate for Payer: Prime Health Services WC |
$31,075.58
|
| 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: CELLULITIS WITHOUT MCC
|
Facility
|
IP
|
$23,181.78
|
|
|
Service Code
|
MSDRG 603
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$23,181.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,181.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,974.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,157.99
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,822.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,635.24
|
| Rate for Payer: EPIC Health Plan Senior |
$10,840.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,840.92
|
| Rate for Payer: InnovAge PACE Commercial |
$16,261.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,840.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,526.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,526.83
|
| Rate for Payer: Multiplan WC |
$18,822.18
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,840.92
|
| Rate for Payer: Preferred Health Network WC |
$19,206.31
|
| Rate for Payer: Prime Health Services Medicare |
$11,491.38
|
| Rate for Payer: Prime Health Services WC |
$18,630.12
|
| 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: CERVICAL SPINAL FUSION WITH CC
|
Facility
|
IP
|
$76,251.41
|
|
|
Service Code
|
MSDRG 472
|
| Min. Negotiated Rate |
$22,650.00 |
| Max. Negotiated Rate |
$76,251.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$76,251.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49,255.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66,305.32
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$61,911.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,562.21
|
| Rate for Payer: EPIC Health Plan Senior |
$32,268.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,268.30
|
| Rate for Payer: InnovAge PACE Commercial |
$48,402.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,268.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43,239.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,239.52
|
| Rate for Payer: Multiplan WC |
$61,911.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$32,268.30
|
| Rate for Payer: Preferred Health Network WC |
$63,174.96
|
| Rate for Payer: Prime Health Services Medicare |
$34,204.40
|
| Rate for Payer: Prime Health Services WC |
$61,279.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$30,096.00
|
| Rate for Payer: United Healthcare All Other HMO |
$42,113.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,721.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,650.00
|
|
|
MS-DRG 42.00: CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$127,839.28
|
|
|
Service Code
|
MSDRG 471
|
| Min. Negotiated Rate |
$24,564.00 |
| Max. Negotiated Rate |
$127,839.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$127,839.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$82,578.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111,164.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$103,797.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$71,700.75
|
| Rate for Payer: EPIC Health Plan Senior |
$53,111.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$53,111.67
|
| Rate for Payer: InnovAge PACE Commercial |
$79,667.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,111.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,169.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,169.64
|
| Rate for Payer: Multiplan WC |
$103,797.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$53,111.67
|
| Rate for Payer: Preferred Health Network WC |
$105,915.97
|
| Rate for Payer: Prime Health Services Medicare |
$56,298.37
|
| Rate for Payer: Prime Health Services WC |
$102,738.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$42,108.00
|
| Rate for Payer: United Healthcare All Other HMO |
$38,993.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,692.00
|
|
|
MS-DRG 42.00: CERVICAL SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$62,307.60
|
|
|
Service Code
|
MSDRG 473
|
| Min. Negotiated Rate |
$22,963.00 |
| Max. Negotiated Rate |
$62,307.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,307.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40,248.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54,180.32
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$50,589.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,956.57
|
| Rate for Payer: EPIC Health Plan Senior |
$26,634.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,634.50
|
| Rate for Payer: InnovAge PACE Commercial |
$39,951.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,634.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,690.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,690.23
|
| Rate for Payer: Multiplan WC |
$50,589.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26,634.50
|
| Rate for Payer: Preferred Health Network WC |
$51,622.40
|
| Rate for Payer: Prime Health Services Medicare |
$28,232.57
|
| Rate for Payer: Prime Health Services WC |
$50,073.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$42,292.00
|
| Rate for Payer: United Healthcare All Other HMO |
$32,996.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25,065.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,963.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH CC
|
Facility
|
IP
|
$27,945.51
|
|
|
Service Code
|
MSDRG 787
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$27,945.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,945.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,051.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,300.35
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,690.05
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,222.85
|
| Rate for Payer: EPIC Health Plan Senior |
$12,757.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,757.67
|
| Rate for Payer: InnovAge PACE Commercial |
$19,136.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,757.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,095.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,095.28
|
| Rate for Payer: Multiplan WC |
$22,690.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,757.67
|
| Rate for Payer: Preferred Health Network WC |
$23,153.11
|
| Rate for Payer: Prime Health Services Medicare |
$13,523.13
|
| Rate for Payer: Prime Health Services WC |
$22,458.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC
|
Facility
|
IP
|
$42,528.87
|
|
|
Service Code
|
MSDRG 786
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$42,528.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,528.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,471.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,981.49
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,530.84
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,168.28
|
| Rate for Payer: EPIC Health Plan Senior |
$18,643.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18,643.17
|
| Rate for Payer: InnovAge PACE Commercial |
$27,964.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,643.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,981.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,981.85
|
| Rate for Payer: Multiplan WC |
$34,530.84
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18,643.17
|
| Rate for Payer: Preferred Health Network WC |
$35,235.55
|
| Rate for Payer: Prime Health Services Medicare |
$19,761.76
|
| Rate for Payer: Prime Health Services WC |
$34,178.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$23,810.80
|
|
|
Service Code
|
MSDRG 788
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$23,810.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,810.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,380.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,704.96
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,332.91
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,976.93
|
| Rate for Payer: EPIC Health Plan Senior |
$11,094.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,094.02
|
| Rate for Payer: InnovAge PACE Commercial |
$16,641.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,094.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,865.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,865.99
|
| Rate for Payer: Multiplan WC |
$19,332.91
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,094.02
|
| Rate for Payer: Preferred Health Network WC |
$19,727.46
|
| Rate for Payer: Prime Health Services Medicare |
$11,759.66
|
| Rate for Payer: Prime Health Services WC |
$19,135.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH CC
|
Facility
|
IP
|
$28,503.48
|
|
|
Service Code
|
MSDRG 784
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$28,503.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,503.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,412.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,785.54
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,143.07
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,525.92
|
| Rate for Payer: EPIC Health Plan Senior |
$12,982.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,982.16
|
| Rate for Payer: InnovAge PACE Commercial |
$19,473.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,982.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,396.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,396.09
|
| Rate for Payer: Multiplan WC |
$23,143.07
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,982.16
|
| Rate for Payer: Preferred Health Network WC |
$23,615.38
|
| Rate for Payer: Prime Health Services Medicare |
$13,761.09
|
| Rate for Payer: Prime Health Services WC |
$22,906.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH MCC
|
Facility
|
IP
|
$48,482.23
|
|
|
Service Code
|
MSDRG 783
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$48,482.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,482.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,317.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,158.30
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,364.60
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,415.54
|
| Rate for Payer: EPIC Health Plan Senior |
$21,048.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,048.55
|
| Rate for Payer: InnovAge PACE Commercial |
$31,572.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,048.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,205.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,205.06
|
| Rate for Payer: Multiplan WC |
$39,364.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,048.55
|
| Rate for Payer: Preferred Health Network WC |
$40,167.96
|
| Rate for Payer: Prime Health Services Medicare |
$22,311.46
|
| Rate for Payer: Prime Health Services WC |
$38,962.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$22,989.65
|
|
|
Service Code
|
MSDRG 785
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$22,989.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,989.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,850.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,990.92
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,666.19
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,530.89
|
| Rate for Payer: EPIC Health Plan Senior |
$10,763.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,763.62
|
| Rate for Payer: InnovAge PACE Commercial |
$16,145.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,763.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,423.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,423.25
|
| Rate for Payer: Multiplan WC |
$18,666.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,763.62
|
| Rate for Payer: Preferred Health Network WC |
$19,047.13
|
| Rate for Payer: Prime Health Services Medicare |
$11,409.44
|
| Rate for Payer: Prime Health Services WC |
$18,475.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC
|
Facility
|
IP
|
$131,784.50
|
|
|
Service Code
|
MSDRG 837
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$131,784.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$131,784.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$85,127.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114,594.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$107,000.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$73,852.68
|
| Rate for Payer: EPIC Health Plan Senior |
$54,705.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$54,705.69
|
| Rate for Payer: InnovAge PACE Commercial |
$82,058.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54,705.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73,305.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73,305.62
|
| Rate for Payer: Multiplan WC |
$107,000.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$54,705.69
|
| Rate for Payer: Preferred Health Network WC |
$109,184.62
|
| Rate for Payer: Prime Health Services Medicare |
$57,988.03
|
| Rate for Payer: Prime Health Services WC |
$105,909.08
|
| 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: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT
|
Facility
|
IP
|
$53,380.20
|
|
|
Service Code
|
MSDRG 838
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$53,380.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$53,380.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34,481.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46,417.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$43,341.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,087.14
|
| Rate for Payer: EPIC Health Plan Senior |
$23,027.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,027.51
|
| Rate for Payer: InnovAge PACE Commercial |
$34,541.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,027.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,856.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,856.86
|
| Rate for Payer: Multiplan WC |
$43,341.44
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,027.51
|
| Rate for Payer: Preferred Health Network WC |
$44,225.96
|
| Rate for Payer: Prime Health Services Medicare |
$24,409.16
|
| Rate for Payer: Prime Health Services WC |
$42,899.18
|
| 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: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$36,067.56
|
|
|
Service Code
|
MSDRG 839
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,067.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,067.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,298.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,362.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,284.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,643.97
|
| Rate for Payer: EPIC Health Plan Senior |
$16,032.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,032.57
|
| Rate for Payer: InnovAge PACE Commercial |
$24,048.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,032.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,483.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,483.64
|
| Rate for Payer: Multiplan WC |
$29,284.64
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,032.57
|
| Rate for Payer: Preferred Health Network WC |
$29,882.29
|
| Rate for Payer: Prime Health Services Medicare |
$16,994.52
|
| Rate for Payer: Prime Health Services WC |
$28,985.82
|
| 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: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC
|
Facility
|
IP
|
$33,443.55
|
|
|
Service Code
|
MSDRG 847
|
| 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 |
$20,212.71
|
| Rate for Payer: EPIC Health Plan Senior |
$14,972.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,972.38
|
| Rate for Payer: InnovAge PACE Commercial |
$22,458.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,972.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,062.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,062.99
|
| Rate for Payer: Multiplan WC |
$27,154.11
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,972.38
|
| Rate for Payer: Preferred Health Network WC |
$27,708.28
|
| Rate for Payer: Prime Health Services Medicare |
$15,870.72
|
| 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: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$67,213.46
|
|
|
Service Code
|
MSDRG 846
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$67,213.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67,213.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43,417.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58,446.27
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$54,573.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,632.48
|
| Rate for Payer: EPIC Health Plan Senior |
$28,616.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,616.65
|
| Rate for Payer: InnovAge PACE Commercial |
$42,924.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,616.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,346.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,346.31
|
| Rate for Payer: Multiplan WC |
$54,573.21
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$28,616.65
|
| Rate for Payer: Preferred Health Network WC |
$55,686.95
|
| Rate for Payer: Prime Health Services Medicare |
$30,333.65
|
| Rate for Payer: Prime Health Services WC |
$54,016.34
|
| 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: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$21,552.63
|
|
|
Service Code
|
MSDRG 848
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$21,552.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,552.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,922.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,741.35
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,499.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,750.33
|
| Rate for Payer: EPIC Health Plan Senior |
$10,185.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,185.43
|
| Rate for Payer: InnovAge PACE Commercial |
$15,278.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,185.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,648.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,648.48
|
| Rate for Payer: Multiplan WC |
$17,499.41
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,185.43
|
| Rate for Payer: Preferred Health Network WC |
$17,856.54
|
| Rate for Payer: Prime Health Services Medicare |
$10,796.56
|
| Rate for Payer: Prime Health Services WC |
$17,320.84
|
| 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: CHEST PAIN
|
Facility
|
IP
|
$18,775.97
|
|
|
Service Code
|
MSDRG 313
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$18,775.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,775.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,128.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,326.87
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$15,244.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,242.08
|
| Rate for Payer: EPIC Health Plan Senior |
$9,068.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,068.21
|
| Rate for Payer: InnovAge PACE Commercial |
$13,602.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,068.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,151.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,151.40
|
| Rate for Payer: Multiplan WC |
$15,244.94
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,068.21
|
| Rate for Payer: Preferred Health Network WC |
$15,556.06
|
| Rate for Payer: Prime Health Services Medicare |
$9,612.30
|
| Rate for Payer: Prime Health Services WC |
$15,089.38
|
| 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: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$992,563.18
|
|
|
Service Code
|
MSDRG 018
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$992,563.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$992,563.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$641,155.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$863,095.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$805,900.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$543,522.78
|
| Rate for Payer: EPIC Health Plan Senior |
$402,609.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$402,609.47
|
| Rate for Payer: InnovAge PACE Commercial |
$603,914.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$402,609.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$539,496.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$539,496.69
|
| Rate for Payer: Multiplan WC |
$805,900.42
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$402,609.47
|
| Rate for Payer: Preferred Health Network WC |
$822,347.37
|
| Rate for Payer: Prime Health Services Medicare |
$426,766.04
|
| Rate for Payer: Prime Health Services WC |
$797,676.95
|
| 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: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$52,061.61
|
|
|
Service Code
|
MSDRG 415
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$52,061.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,061.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,629.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,270.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,270.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,367.91
|
| Rate for Payer: EPIC Health Plan Senior |
$22,494.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,494.75
|
| Rate for Payer: InnovAge PACE Commercial |
$33,742.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,494.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,142.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,142.97
|
| Rate for Payer: Multiplan WC |
$42,270.84
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,494.75
|
| Rate for Payer: Preferred Health Network WC |
$43,133.51
|
| Rate for Payer: Prime Health Services Medicare |
$23,844.44
|
| Rate for Payer: Prime Health Services WC |
$41,839.50
|
| 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: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$92,216.51
|
|
|
Service Code
|
MSDRG 414
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$92,216.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92,216.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59,568.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80,187.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$74,874.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,270.37
|
| Rate for Payer: EPIC Health Plan Senior |
$38,718.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,718.79
|
| Rate for Payer: InnovAge PACE Commercial |
$58,078.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,718.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,883.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,883.18
|
| Rate for Payer: Multiplan WC |
$74,874.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$38,718.79
|
| Rate for Payer: Preferred Health Network WC |
$76,402.19
|
| Rate for Payer: Prime Health Services Medicare |
$41,041.92
|
| Rate for Payer: Prime Health Services WC |
$74,110.12
|
| 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: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$36,062.29
|
|
|
Service Code
|
MSDRG 416
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$36,062.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,062.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,294.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,358.40
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,280.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,641.08
|
| Rate for Payer: EPIC Health Plan Senior |
$16,030.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,030.43
|
| Rate for Payer: InnovAge PACE Commercial |
$24,045.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,030.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,480.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,480.78
|
| Rate for Payer: Multiplan WC |
$29,280.37
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,030.43
|
| Rate for Payer: Preferred Health Network WC |
$29,877.93
|
| Rate for Payer: Prime Health Services Medicare |
$16,992.26
|
| Rate for Payer: Prime Health Services WC |
$28,981.59
|
| 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: CHOLECYSTECTOMY WITH C.D.E. WITH CC
|
Facility
|
IP
|
$56,101.58
|
|
|
Service Code
|
MSDRG 412
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$56,101.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$56,101.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,239.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48,783.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,551.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,571.50
|
| Rate for Payer: EPIC Health Plan Senior |
$24,127.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,127.04
|
| Rate for Payer: InnovAge PACE Commercial |
$36,190.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,127.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,330.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,330.23
|
| Rate for Payer: Multiplan WC |
$45,551.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,127.04
|
| Rate for Payer: Preferred Health Network WC |
$46,480.65
|
| Rate for Payer: Prime Health Services Medicare |
$25,574.66
|
| Rate for Payer: Prime Health Services WC |
$45,086.23
|
| 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
|
|
