|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH MCC
|
Facility
|
IP
|
$72,019.31
|
|
|
Service Code
|
MSDRG 411
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$72,019.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72,019.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46,521.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62,625.25
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$58,475.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,253.81
|
| Rate for Payer: EPIC Health Plan Senior |
$30,558.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,558.38
|
| Rate for Payer: InnovAge PACE Commercial |
$45,837.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,558.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,948.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,948.23
|
| Rate for Payer: Multiplan WC |
$58,475.27
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$30,558.38
|
| Rate for Payer: Preferred Health Network WC |
$59,668.64
|
| Rate for Payer: Prime Health Services Medicare |
$32,391.88
|
| Rate for Payer: Prime Health Services WC |
$57,878.58
|
| 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. WITHOUT CC/MCC
|
Facility
|
IP
|
$43,755.34
|
|
|
Service Code
|
MSDRG 413
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,755.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,755.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,264.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,047.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,526.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,837.26
|
| Rate for Payer: EPIC Health Plan Senior |
$19,138.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19,138.71
|
| Rate for Payer: InnovAge PACE Commercial |
$28,708.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,138.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,645.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,645.87
|
| Rate for Payer: Multiplan WC |
$35,526.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19,138.71
|
| Rate for Payer: Preferred Health Network WC |
$36,251.68
|
| Rate for Payer: Prime Health Services Medicare |
$20,287.03
|
| Rate for Payer: Prime Health Services WC |
$35,164.13
|
| 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
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC
|
Facility
|
IP
|
$22,610.65
|
|
|
Service Code
|
MSDRG 191
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$22,610.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,610.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,605.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,661.36
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,358.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,325.03
|
| Rate for Payer: EPIC Health Plan Senior |
$10,611.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,611.13
|
| Rate for Payer: InnovAge PACE Commercial |
$15,916.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,611.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,218.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,218.91
|
| Rate for Payer: Multiplan WC |
$18,358.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,611.13
|
| Rate for Payer: Preferred Health Network WC |
$18,733.13
|
| Rate for Payer: Prime Health Services Medicare |
$11,247.80
|
| Rate for Payer: Prime Health Services WC |
$18,171.14
|
| 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: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC
|
Facility
|
IP
|
$29,556.24
|
|
|
Service Code
|
MSDRG 190
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$29,556.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29,556.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,092.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,700.98
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,997.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,097.78
|
| Rate for Payer: EPIC Health Plan Senior |
$13,405.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,405.76
|
| Rate for Payer: InnovAge PACE Commercial |
$20,108.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,405.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,963.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,963.72
|
| Rate for Payer: Multiplan WC |
$23,997.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,405.76
|
| Rate for Payer: Preferred Health Network WC |
$24,487.60
|
| Rate for Payer: Prime Health Services Medicare |
$14,210.11
|
| Rate for Payer: Prime Health Services WC |
$23,752.97
|
| 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: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$17,033.66
|
|
|
Service Code
|
MSDRG 192
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$17,033.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,033.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,003.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,811.82
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,830.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,295.69
|
| Rate for Payer: EPIC Health Plan Senior |
$8,367.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,367.18
|
| Rate for Payer: InnovAge PACE Commercial |
$12,550.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,367.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,212.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,212.02
|
| Rate for Payer: Multiplan WC |
$13,830.29
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,367.18
|
| Rate for Payer: Preferred Health Network WC |
$14,112.54
|
| Rate for Payer: Prime Health Services Medicare |
$8,869.21
|
| Rate for Payer: Prime Health Services WC |
$13,689.16
|
| 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: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$58,251.84
|
|
|
Service Code
|
MSDRG 286
|
| Min. Negotiated Rate |
$4,504.00 |
| Max. Negotiated Rate |
$58,251.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,251.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37,628.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50,653.58
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$47,296.93
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,744.36
|
| Rate for Payer: EPIC Health Plan Senior |
$24,995.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,995.82
|
| Rate for Payer: InnovAge PACE Commercial |
$37,493.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,995.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,494.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,494.40
|
| Rate for Payer: Multiplan WC |
$47,296.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,995.82
|
| Rate for Payer: Preferred Health Network WC |
$48,262.17
|
| Rate for Payer: Prime Health Services Medicare |
$26,495.57
|
| Rate for Payer: Prime Health Services WC |
$46,814.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$20,829.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,011.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,202.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,927.00
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$28,679.81
|
|
|
Service Code
|
MSDRG 287
|
| Min. Negotiated Rate |
$4,504.00 |
| Max. Negotiated Rate |
$28,679.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,679.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,525.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,938.87
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,286.25
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,621.71
|
| Rate for Payer: EPIC Health Plan Senior |
$13,053.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,053.12
|
| Rate for Payer: InnovAge PACE Commercial |
$19,579.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,053.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,491.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,491.18
|
| Rate for Payer: Multiplan WC |
$23,286.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,053.12
|
| Rate for Payer: Preferred Health Network WC |
$23,761.48
|
| Rate for Payer: Prime Health Services Medicare |
$13,836.31
|
| Rate for Payer: Prime Health Services WC |
$23,048.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,003.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,364.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,707.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,475.00
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$28,156.07
|
|
|
Service Code
|
MSDRG 433
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$28,156.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,156.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,187.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,483.44
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,861.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,337.21
|
| Rate for Payer: EPIC Health Plan Senior |
$12,842.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,842.38
|
| Rate for Payer: InnovAge PACE Commercial |
$19,263.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,842.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,208.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,208.79
|
| Rate for Payer: Multiplan WC |
$22,861.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,842.38
|
| Rate for Payer: Preferred Health Network WC |
$23,327.55
|
| Rate for Payer: Prime Health Services Medicare |
$13,612.92
|
| Rate for Payer: Prime Health Services WC |
$22,627.72
|
| 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: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$51,561.55
|
|
|
Service Code
|
MSDRG 432
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$51,561.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$51,561.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,306.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,835.96
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,864.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,095.15
|
| Rate for Payer: EPIC Health Plan Senior |
$22,292.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,292.70
|
| Rate for Payer: InnovAge PACE Commercial |
$33,439.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,292.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,872.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,872.22
|
| Rate for Payer: Multiplan WC |
$41,864.82
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,292.70
|
| Rate for Payer: Preferred Health Network WC |
$42,719.20
|
| Rate for Payer: Prime Health Services Medicare |
$23,630.26
|
| Rate for Payer: Prime Health Services WC |
$41,437.62
|
| 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: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$18,331.18
|
|
|
Service Code
|
MSDRG 434
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$18,331.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,331.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,841.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,940.10
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,883.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,000.49
|
| Rate for Payer: EPIC Health Plan Senior |
$8,889.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,889.25
|
| Rate for Payer: InnovAge PACE Commercial |
$13,333.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,889.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,911.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,911.59
|
| Rate for Payer: Multiplan WC |
$14,883.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,889.25
|
| Rate for Payer: Preferred Health Network WC |
$15,187.55
|
| Rate for Payer: Prime Health Services Medicare |
$9,422.60
|
| Rate for Payer: Prime Health Services WC |
$14,731.92
|
| 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: COAGULATION DISORDERS
|
Facility
|
IP
|
$40,741.81
|
|
|
Service Code
|
MSDRG 813
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$40,741.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,741.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,317.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,427.53
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,079.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,193.54
|
| Rate for Payer: EPIC Health Plan Senior |
$17,921.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17,921.14
|
| Rate for Payer: InnovAge PACE Commercial |
$26,881.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,921.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,014.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,014.33
|
| Rate for Payer: Multiplan WC |
$33,079.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17,921.14
|
| Rate for Payer: Preferred Health Network WC |
$33,754.95
|
| Rate for Payer: Prime Health Services Medicare |
$18,996.41
|
| Rate for Payer: Prime Health Services WC |
$32,742.30
|
| 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: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$219,516.25
|
|
|
Service Code
|
MSDRG 429
|
| Min. Negotiated Rate |
$90,152.51 |
| Max. Negotiated Rate |
$219,516.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$219,516.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$141,798.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190,882.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$178,233.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$121,705.89
|
| Rate for Payer: EPIC Health Plan Senior |
$90,152.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$90,152.51
|
| Rate for Payer: InnovAge PACE Commercial |
$135,228.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90,152.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$120,804.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$120,804.36
|
| Rate for Payer: Multiplan WC |
$178,233.73
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$90,152.51
|
| Rate for Payer: Preferred Health Network WC |
$181,871.15
|
| Rate for Payer: Prime Health Services Medicare |
$95,561.66
|
| Rate for Payer: Prime Health Services WC |
$176,415.02
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC
|
Facility
|
IP
|
$143,978.09
|
|
|
Service Code
|
MSDRG 430
|
| Min. Negotiated Rate |
$59,632.35 |
| Max. Negotiated Rate |
$143,978.09 |
| Rate for Payer: Aetna of CA HMO/PPO |
$143,978.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93,003.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125,197.86
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$116,901.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,503.67
|
| Rate for Payer: EPIC Health Plan Senior |
$59,632.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,632.35
|
| Rate for Payer: InnovAge PACE Commercial |
$89,448.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,632.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79,907.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,907.35
|
| Rate for Payer: Multiplan WC |
$116,901.38
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$59,632.35
|
| Rate for Payer: Preferred Health Network WC |
$119,287.12
|
| Rate for Payer: Prime Health Services Medicare |
$63,210.29
|
| Rate for Payer: Prime Health Services WC |
$115,708.51
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC
|
Facility
|
IP
|
$28,664.02
|
|
|
Service Code
|
MSDRG 381
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$28,664.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,664.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,515.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,925.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,273.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,613.13
|
| Rate for Payer: EPIC Health Plan Senior |
$13,046.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,046.76
|
| Rate for Payer: InnovAge PACE Commercial |
$19,570.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,046.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,482.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,482.66
|
| Rate for Payer: Multiplan WC |
$23,273.43
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,046.76
|
| Rate for Payer: Preferred Health Network WC |
$23,748.40
|
| Rate for Payer: Prime Health Services Medicare |
$13,829.57
|
| Rate for Payer: Prime Health Services WC |
$23,035.95
|
| 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: COMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$50,645.65
|
|
|
Service Code
|
MSDRG 380
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$50,645.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,645.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,715.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,039.53
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$41,121.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,595.58
|
| Rate for Payer: EPIC Health Plan Senior |
$21,922.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,922.65
|
| Rate for Payer: InnovAge PACE Commercial |
$32,883.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,922.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,376.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,376.35
|
| Rate for Payer: Multiplan WC |
$41,121.16
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,922.65
|
| Rate for Payer: Preferred Health Network WC |
$41,960.37
|
| Rate for Payer: Prime Health Services Medicare |
$23,238.01
|
| Rate for Payer: Prime Health Services WC |
$40,701.56
|
| 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: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC
|
Facility
|
IP
|
$19,720.83
|
|
|
Service Code
|
MSDRG 382
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$19,720.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,720.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,738.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,148.48
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,755.33
|
| Rate for Payer: EPIC Health Plan Senior |
$9,448.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,448.39
|
| Rate for Payer: InnovAge PACE Commercial |
$14,172.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,448.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,660.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,660.84
|
| Rate for Payer: Multiplan WC |
$16,012.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,448.39
|
| Rate for Payer: Preferred Health Network WC |
$16,338.88
|
| Rate for Payer: Prime Health Services Medicare |
$10,015.29
|
| Rate for Payer: Prime Health Services WC |
$15,848.71
|
| 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: COMPLICATIONS OF TREATMENT WITH CC
|
Facility
|
IP
|
$26,737.47
|
|
|
Service Code
|
MSDRG 920
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$26,737.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,737.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,271.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,249.89
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,709.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,566.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12,271.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,271.60
|
| Rate for Payer: InnovAge PACE Commercial |
$18,407.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,271.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,443.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,443.94
|
| Rate for Payer: Multiplan WC |
$21,709.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,271.60
|
| Rate for Payer: Preferred Health Network WC |
$22,152.23
|
| Rate for Payer: Prime Health Services Medicare |
$13,007.90
|
| Rate for Payer: Prime Health Services WC |
$21,487.66
|
| 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: COMPLICATIONS OF TREATMENT WITH MCC
|
Facility
|
IP
|
$47,995.33
|
|
|
Service Code
|
MSDRG 919
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$47,995.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,995.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,003.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,734.91
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,969.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,149.94
|
| Rate for Payer: EPIC Health Plan Senior |
$20,851.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,851.81
|
| Rate for Payer: InnovAge PACE Commercial |
$31,277.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,851.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,941.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,941.43
|
| Rate for Payer: Multiplan WC |
$38,969.26
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,851.81
|
| Rate for Payer: Preferred Health Network WC |
$39,764.55
|
| Rate for Payer: Prime Health Services Medicare |
$22,102.92
|
| Rate for Payer: Prime Health Services WC |
$38,571.61
|
| 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: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$18,099.58
|
|
|
Service Code
|
MSDRG 921
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$18,099.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,099.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,691.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,738.70
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,695.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,874.67
|
| Rate for Payer: EPIC Health Plan Senior |
$8,796.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,796.05
|
| Rate for Payer: InnovAge PACE Commercial |
$13,194.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,796.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,786.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,786.71
|
| Rate for Payer: Multiplan WC |
$14,695.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,796.05
|
| Rate for Payer: Preferred Health Network WC |
$14,995.66
|
| Rate for Payer: Prime Health Services Medicare |
$9,323.81
|
| Rate for Payer: Prime Health Services WC |
$14,545.79
|
| 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: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES
|
Facility
|
IP
|
$286,716.55
|
|
|
Service Code
|
MSDRG 212
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$286,716.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$286,716.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$185,207.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$249,317.80
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$232,796.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$158,370.61
|
| Rate for Payer: EPIC Health Plan Senior |
$117,311.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$117,311.56
|
| Rate for Payer: InnovAge PACE Commercial |
$175,967.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$117,311.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$157,197.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$157,197.49
|
| Rate for Payer: Multiplan WC |
$232,796.26
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$117,311.56
|
| Rate for Payer: Preferred Health Network WC |
$237,547.20
|
| Rate for Payer: Prime Health Services Medicare |
$124,350.25
|
| Rate for Payer: Prime Health Services WC |
$230,420.78
|
| 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: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION
|
Facility
|
IP
|
$162,819.86
|
|
|
Service Code
|
MSDRG 317
|
| Min. Negotiated Rate |
$67,245.11 |
| Max. Negotiated Rate |
$162,819.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$162,819.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105,174.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141,581.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$132,199.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$90,780.90
|
| Rate for Payer: EPIC Health Plan Senior |
$67,245.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67,245.11
|
| Rate for Payer: InnovAge PACE Commercial |
$100,867.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67,245.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90,108.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90,108.45
|
| Rate for Payer: Multiplan WC |
$132,199.74
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$67,245.11
|
| Rate for Payer: Preferred Health Network WC |
$134,897.69
|
| Rate for Payer: Prime Health Services Medicare |
$71,279.82
|
| Rate for Payer: Prime Health Services WC |
$130,850.76
|
|
|
MS-DRG 42.00: CONCUSSION WITH CC
|
Facility
|
IP
|
$28,216.60
|
|
|
Service Code
|
MSDRG 089
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$28,216.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,216.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,226.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,536.08
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,910.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,370.10
|
| Rate for Payer: EPIC Health Plan Senior |
$12,866.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,866.74
|
| Rate for Payer: InnovAge PACE Commercial |
$19,300.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,866.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,241.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,241.43
|
| Rate for Payer: Multiplan WC |
$22,910.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,866.74
|
| Rate for Payer: Preferred Health Network WC |
$23,377.70
|
| Rate for Payer: Prime Health Services Medicare |
$13,638.74
|
| Rate for Payer: Prime Health Services WC |
$22,676.37
|
| 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: CONCUSSION WITH MCC
|
Facility
|
IP
|
$37,128.21
|
|
|
Service Code
|
MSDRG 088
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,128.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,128.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,983.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,285.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,145.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,222.50
|
| Rate for Payer: EPIC Health Plan Senior |
$16,461.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,461.11
|
| Rate for Payer: InnovAge PACE Commercial |
$24,691.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,461.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,057.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,057.89
|
| Rate for Payer: Multiplan WC |
$30,145.83
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,461.11
|
| Rate for Payer: Preferred Health Network WC |
$30,761.05
|
| Rate for Payer: Prime Health Services Medicare |
$17,448.78
|
| Rate for Payer: Prime Health Services WC |
$29,838.22
|
| 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: CONCUSSION WITHOUT CC/MCC
|
Facility
|
IP
|
$22,563.28
|
|
|
Service Code
|
MSDRG 090
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$22,563.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,563.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,574.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,620.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,320.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,299.29
|
| Rate for Payer: EPIC Health Plan Senior |
$10,592.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,592.07
|
| Rate for Payer: InnovAge PACE Commercial |
$15,888.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,592.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,193.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,193.37
|
| Rate for Payer: Multiplan WC |
$18,320.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,592.07
|
| Rate for Payer: Preferred Health Network WC |
$18,693.88
|
| Rate for Payer: Prime Health Services Medicare |
$11,227.59
|
| Rate for Payer: Prime Health Services WC |
$18,133.06
|
| 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: CONNECTIVE TISSUE DISORDERS WITH CC
|
Facility
|
IP
|
$30,469.51
|
|
|
Service Code
|
MSDRG 546
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$30,469.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,469.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,682.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,495.12
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,739.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,593.85
|
| Rate for Payer: EPIC Health Plan Senior |
$13,773.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,773.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,659.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,773.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,456.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,456.11
|
| Rate for Payer: Multiplan WC |
$24,739.37
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,773.22
|
| Rate for Payer: Preferred Health Network WC |
$25,244.26
|
| Rate for Payer: Prime Health Services Medicare |
$14,599.61
|
| Rate for Payer: Prime Health Services WC |
$24,486.93
|
| 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
|
|
