|
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 |
$40,298.85
|
| Rate for Payer: EPIC Health Plan Senior |
$29,851.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,851.00
|
| Rate for Payer: InnovAge PACE Commercial |
$44,776.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,851.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,000.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,000.34
|
| Rate for Payer: Multiplan WC |
$45,551.04
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$29,851.00
|
| Rate for Payer: Preferred Health Network WC |
$46,480.65
|
| Rate for Payer: Prime Health Services Medicare |
$31,642.06
|
| 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
|
|
|
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 |
$51,431.91
|
| Rate for Payer: EPIC Health Plan Senior |
$38,097.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,097.71
|
| Rate for Payer: InnovAge PACE Commercial |
$57,146.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,097.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,050.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,050.93
|
| Rate for Payer: Multiplan WC |
$58,475.27
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$38,097.71
|
| Rate for Payer: Preferred Health Network WC |
$59,668.64
|
| Rate for Payer: Prime Health Services Medicare |
$40,383.57
|
| 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 |
$31,663.76
|
| Rate for Payer: EPIC Health Plan Senior |
$23,454.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,454.64
|
| Rate for Payer: InnovAge PACE Commercial |
$35,181.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,454.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,429.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,429.22
|
| Rate for Payer: Multiplan WC |
$35,526.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,454.64
|
| Rate for Payer: Preferred Health Network WC |
$36,251.68
|
| Rate for Payer: Prime Health Services Medicare |
$24,861.92
|
| 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 |
$16,874.96
|
| Rate for Payer: EPIC Health Plan Senior |
$12,499.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,499.97
|
| Rate for Payer: InnovAge PACE Commercial |
$18,749.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,499.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,749.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,749.96
|
| Rate for Payer: Multiplan WC |
$18,358.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,499.97
|
| Rate for Payer: Preferred Health Network WC |
$18,733.13
|
| Rate for Payer: Prime Health Services Medicare |
$13,249.97
|
| 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 |
$21,732.76
|
| Rate for Payer: EPIC Health Plan Senior |
$16,098.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,098.34
|
| Rate for Payer: InnovAge PACE Commercial |
$24,147.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,098.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,571.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,571.78
|
| Rate for Payer: Multiplan WC |
$23,997.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,098.34
|
| Rate for Payer: Preferred Health Network WC |
$24,487.60
|
| Rate for Payer: Prime Health Services Medicare |
$17,064.24
|
| 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 |
$12,974.34
|
| Rate for Payer: EPIC Health Plan Senior |
$9,610.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,610.62
|
| Rate for Payer: InnovAge PACE Commercial |
$14,415.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,610.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,878.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,878.23
|
| Rate for Payer: Multiplan WC |
$13,830.29
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,610.62
|
| Rate for Payer: Preferred Health Network WC |
$14,112.54
|
| Rate for Payer: Prime Health Services Medicare |
$10,187.26
|
| 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 |
$41,802.78
|
| Rate for Payer: EPIC Health Plan Senior |
$30,965.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,965.02
|
| Rate for Payer: InnovAge PACE Commercial |
$46,447.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,965.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41,493.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41,493.13
|
| Rate for Payer: Multiplan WC |
$47,296.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$30,965.02
|
| Rate for Payer: Preferred Health Network WC |
$48,262.17
|
| Rate for Payer: Prime Health Services Medicare |
$32,822.92
|
| 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 |
$21,119.79
|
| Rate for Payer: EPIC Health Plan Senior |
$15,644.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,644.29
|
| Rate for Payer: InnovAge PACE Commercial |
$23,466.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,644.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,963.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,963.35
|
| Rate for Payer: Multiplan WC |
$23,286.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,644.29
|
| Rate for Payer: Preferred Health Network WC |
$23,761.48
|
| Rate for Payer: Prime Health Services Medicare |
$16,582.95
|
| 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 |
$20,753.47
|
| Rate for Payer: EPIC Health Plan Senior |
$15,372.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,372.94
|
| Rate for Payer: InnovAge PACE Commercial |
$23,059.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,372.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,599.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,599.74
|
| Rate for Payer: Multiplan WC |
$22,861.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,372.94
|
| Rate for Payer: Preferred Health Network WC |
$23,327.55
|
| Rate for Payer: Prime Health Services Medicare |
$16,295.32
|
| 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 |
$37,123.50
|
| Rate for Payer: EPIC Health Plan Senior |
$27,498.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,498.89
|
| Rate for Payer: InnovAge PACE Commercial |
$41,248.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,498.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,848.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,848.51
|
| Rate for Payer: Multiplan WC |
$41,864.82
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$27,498.89
|
| Rate for Payer: Preferred Health Network WC |
$42,719.20
|
| Rate for Payer: Prime Health Services Medicare |
$29,148.82
|
| 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 |
$13,881.86
|
| Rate for Payer: EPIC Health Plan Senior |
$10,282.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,282.86
|
| Rate for Payer: InnovAge PACE Commercial |
$15,424.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,282.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,779.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,779.03
|
| Rate for Payer: Multiplan WC |
$14,883.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,282.86
|
| Rate for Payer: Preferred Health Network WC |
$15,187.55
|
| Rate for Payer: Prime Health Services Medicare |
$10,899.83
|
| 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 |
$29,556.09
|
| Rate for Payer: EPIC Health Plan Senior |
$21,893.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,893.40
|
| Rate for Payer: InnovAge PACE Commercial |
$32,840.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,893.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,337.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,337.16
|
| Rate for Payer: Multiplan WC |
$33,079.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,893.40
|
| Rate for Payer: Preferred Health Network WC |
$33,754.95
|
| Rate for Payer: Prime Health Services Medicare |
$23,207.00
|
| 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 |
$141,798.54 |
| 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: Multiplan WC |
$178,233.73
|
| Rate for Payer: Preferred Health Network WC |
$181,871.15
|
| 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 |
$93,003.97 |
| 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: Multiplan WC |
$116,901.38
|
| Rate for Payer: Preferred Health Network WC |
$119,287.12
|
| 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 |
$21,108.75
|
| Rate for Payer: EPIC Health Plan Senior |
$15,636.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,636.11
|
| Rate for Payer: InnovAge PACE Commercial |
$23,454.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,636.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,952.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,952.39
|
| Rate for Payer: Multiplan WC |
$23,273.43
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,636.11
|
| Rate for Payer: Preferred Health Network WC |
$23,748.40
|
| Rate for Payer: Prime Health Services Medicare |
$16,574.28
|
| 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 |
$36,482.93
|
| Rate for Payer: EPIC Health Plan Senior |
$27,024.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,024.39
|
| Rate for Payer: InnovAge PACE Commercial |
$40,536.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,024.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,212.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,212.68
|
| Rate for Payer: Multiplan WC |
$41,121.16
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$27,024.39
|
| Rate for Payer: Preferred Health Network WC |
$41,960.37
|
| Rate for Payer: Prime Health Services Medicare |
$28,645.85
|
| 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 |
$14,853.78
|
| Rate for Payer: EPIC Health Plan Senior |
$11,002.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,002.80
|
| Rate for Payer: InnovAge PACE Commercial |
$16,504.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,002.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,743.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,743.75
|
| Rate for Payer: Multiplan WC |
$16,012.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,002.80
|
| Rate for Payer: Preferred Health Network WC |
$16,338.88
|
| Rate for Payer: Prime Health Services Medicare |
$11,662.97
|
| 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 |
$19,761.29
|
| Rate for Payer: EPIC Health Plan Senior |
$14,637.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,637.99
|
| Rate for Payer: InnovAge PACE Commercial |
$21,956.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,637.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,614.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,614.91
|
| Rate for Payer: Multiplan WC |
$21,709.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,637.99
|
| Rate for Payer: Preferred Health Network WC |
$22,152.23
|
| Rate for Payer: Prime Health Services Medicare |
$15,516.27
|
| 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 |
$34,629.25
|
| Rate for Payer: EPIC Health Plan Senior |
$25,651.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,651.30
|
| Rate for Payer: InnovAge PACE Commercial |
$38,476.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,651.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,372.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,372.74
|
| Rate for Payer: Multiplan WC |
$38,969.26
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25,651.30
|
| Rate for Payer: Preferred Health Network WC |
$39,764.55
|
| Rate for Payer: Prime Health Services Medicare |
$27,190.38
|
| 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 |
$13,719.83
|
| Rate for Payer: EPIC Health Plan Senior |
$10,162.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,162.84
|
| Rate for Payer: InnovAge PACE Commercial |
$15,244.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,162.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,618.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,618.21
|
| Rate for Payer: Multiplan WC |
$14,695.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,162.84
|
| Rate for Payer: Preferred Health Network WC |
$14,995.66
|
| Rate for Payer: Prime Health Services Medicare |
$10,772.61
|
| 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 |
$201,593.46
|
| Rate for Payer: EPIC Health Plan Senior |
$149,328.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$149,328.49
|
| Rate for Payer: InnovAge PACE Commercial |
$223,992.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149,328.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$200,100.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$200,100.18
|
| Rate for Payer: Multiplan WC |
$232,796.26
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$149,328.49
|
| Rate for Payer: Preferred Health Network WC |
$237,547.20
|
| Rate for Payer: Prime Health Services Medicare |
$158,288.20
|
| 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 |
$105,174.99 |
| 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: Multiplan WC |
$132,199.74
|
| Rate for Payer: Preferred Health Network WC |
$134,897.69
|
| 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 |
$20,795.82
|
| Rate for Payer: EPIC Health Plan Senior |
$15,404.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,404.31
|
| Rate for Payer: InnovAge PACE Commercial |
$23,106.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,404.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,641.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,641.78
|
| Rate for Payer: Multiplan WC |
$22,910.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,404.31
|
| Rate for Payer: Preferred Health Network WC |
$23,377.70
|
| Rate for Payer: Prime Health Services Medicare |
$16,328.57
|
| 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 |
$27,028.69
|
| Rate for Payer: EPIC Health Plan Senior |
$20,021.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,021.25
|
| Rate for Payer: InnovAge PACE Commercial |
$30,031.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,021.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,828.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,828.47
|
| Rate for Payer: Multiplan WC |
$30,145.83
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,021.25
|
| Rate for Payer: Preferred Health Network WC |
$30,761.05
|
| Rate for Payer: Prime Health Services Medicare |
$21,222.53
|
| 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 |
$16,841.80
|
| Rate for Payer: EPIC Health Plan Senior |
$12,475.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,475.41
|
| Rate for Payer: InnovAge PACE Commercial |
$18,713.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,475.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,717.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,717.05
|
| Rate for Payer: Multiplan WC |
$18,320.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,475.41
|
| Rate for Payer: Preferred Health Network WC |
$18,693.88
|
| Rate for Payer: Prime Health Services Medicare |
$13,223.93
|
| 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
|
|
