|
MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$290,027.48
|
|
|
Service Code
|
MSDRG 002
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$290,027.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$272,940.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$290,027.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$187,345.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$252,196.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$235,484.52
|
| Rate for Payer: Blue Distinction Transplant |
$247,615.00
|
| Rate for Payer: Blue Shield of California Transplant |
$140,000.00
|
| Rate for Payer: Caremore Medicare Advantage |
$151,043.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$156,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$203,909.16
|
| Rate for Payer: EPIC Health Plan Senior |
$151,043.82
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$125,000.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$242,950.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$151,043.82
|
| Rate for Payer: InnovAge PACE Commercial |
$226,565.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$151,043.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$202,398.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$202,398.72
|
| Rate for Payer: Multiplan WC |
$235,484.52
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$264,401.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$151,043.82
|
| Rate for Payer: Preferred Health Network WC |
$240,290.33
|
| Rate for Payer: Prime Health Services Medicare |
$160,106.45
|
| Rate for Payer: Prime Health Services WC |
$233,081.62
|
| 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: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC
|
Facility
|
IP
|
$43,099.99
|
|
|
Service Code
|
MSDRG 421
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,099.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,099.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,840.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,478.11
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,994.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,205.41
|
| Rate for Payer: EPIC Health Plan Senior |
$23,115.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,115.12
|
| Rate for Payer: InnovAge PACE Commercial |
$34,672.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,115.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,974.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,974.26
|
| Rate for Payer: Multiplan WC |
$34,994.56
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,115.12
|
| Rate for Payer: Preferred Health Network WC |
$35,708.73
|
| Rate for Payer: Prime Health Services Medicare |
$24,502.03
|
| Rate for Payer: Prime Health Services WC |
$34,637.47
|
| 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: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$92,892.91
|
|
|
Service Code
|
MSDRG 420
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$92,892.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92,892.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60,005.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80,776.14
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$75,423.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$66,031.12
|
| Rate for Payer: EPIC Health Plan Senior |
$48,911.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,911.94
|
| Rate for Payer: InnovAge PACE Commercial |
$73,367.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,911.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65,542.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,542.00
|
| Rate for Payer: Multiplan WC |
$75,423.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$48,911.94
|
| Rate for Payer: Preferred Health Network WC |
$76,962.60
|
| Rate for Payer: Prime Health Services Medicare |
$51,846.66
|
| Rate for Payer: Prime Health Services WC |
$74,653.72
|
| 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: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$38,673.14
|
|
|
Service Code
|
MSDRG 422
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$38,673.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,673.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,981.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,628.69
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,400.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,109.23
|
| Rate for Payer: EPIC Health Plan Senior |
$20,821.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,821.65
|
| Rate for Payer: InnovAge PACE Commercial |
$31,232.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,821.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,901.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,901.01
|
| Rate for Payer: Multiplan WC |
$31,400.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,821.65
|
| Rate for Payer: Preferred Health Network WC |
$32,041.04
|
| Rate for Payer: Prime Health Services Medicare |
$22,070.95
|
| Rate for Payer: Prime Health Services WC |
$31,079.81
|
| 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: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC
|
Facility
|
IP
|
$44,771.25
|
|
|
Service Code
|
MSDRG 354
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$44,771.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,771.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,920.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,931.37
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,351.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,374.31
|
| Rate for Payer: EPIC Health Plan Senior |
$23,980.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,980.97
|
| Rate for Payer: InnovAge PACE Commercial |
$35,971.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,980.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,134.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,134.50
|
| Rate for Payer: Multiplan WC |
$36,351.51
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,980.97
|
| Rate for Payer: Preferred Health Network WC |
$37,093.38
|
| Rate for Payer: Prime Health Services Medicare |
$25,419.83
|
| Rate for Payer: Prime Health Services WC |
$35,980.58
|
| 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: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC
|
Facility
|
IP
|
$77,193.63
|
|
|
Service Code
|
MSDRG 353
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$77,193.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77,193.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49,863.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67,124.64
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$62,676.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,050.87
|
| Rate for Payer: EPIC Health Plan Senior |
$40,778.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,778.42
|
| Rate for Payer: InnovAge PACE Commercial |
$61,167.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,778.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,643.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,643.08
|
| Rate for Payer: Multiplan WC |
$62,676.49
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,778.42
|
| Rate for Payer: Preferred Health Network WC |
$63,955.60
|
| Rate for Payer: Prime Health Services Medicare |
$43,225.13
|
| Rate for Payer: Prime Health Services WC |
$62,036.93
|
| 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: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC
|
Facility
|
IP
|
$35,088.49
|
|
|
Service Code
|
MSDRG 355
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$35,088.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35,088.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,665.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,511.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,489.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,602.09
|
| Rate for Payer: EPIC Health Plan Senior |
$18,964.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18,964.51
|
| Rate for Payer: InnovAge PACE Commercial |
$28,446.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,964.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,412.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,412.44
|
| Rate for Payer: Multiplan WC |
$28,489.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18,964.51
|
| Rate for Payer: Preferred Health Network WC |
$29,071.12
|
| Rate for Payer: Prime Health Services Medicare |
$20,102.38
|
| Rate for Payer: Prime Health Services WC |
$28,198.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$74,534.00
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$21,830.00 |
| Max. Negotiated Rate |
$74,534.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,609.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35,275.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47,486.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$44,339.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,255.14
|
| Rate for Payer: EPIC Health Plan Senior |
$29,077.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,077.88
|
| Rate for Payer: InnovAge PACE Commercial |
$43,616.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,077.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$38,964.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,964.36
|
| Rate for Payer: Multiplan WC |
$44,339.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$29,077.88
|
| Rate for Payer: Preferred Health Network WC |
$45,244.28
|
| Rate for Payer: Prime Health Services Medicare |
$30,822.55
|
| Rate for Payer: Prime Health Services WC |
$43,886.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$74,534.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31,364.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,828.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,830.00
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
|
IP
|
$77,404.18
|
|
|
Service Code
|
MSDRG 480
|
| Min. Negotiated Rate |
$24,564.00 |
| Max. Negotiated Rate |
$77,404.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77,404.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49,999.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67,307.73
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$62,847.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,198.15
|
| Rate for Payer: EPIC Health Plan Senior |
$40,887.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,887.52
|
| Rate for Payer: InnovAge PACE Commercial |
$61,331.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,887.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,789.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,789.28
|
| Rate for Payer: Multiplan WC |
$62,847.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,887.52
|
| Rate for Payer: Preferred Health Network WC |
$64,130.05
|
| Rate for Payer: Prime Health Services Medicare |
$43,340.77
|
| Rate for Payer: Prime Health Services WC |
$62,206.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$56,679.00
|
| Rate for Payer: United Healthcare All Other HMO |
$40,772.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30,970.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,371.00
|
|
|
MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
|
IP
|
$60,760.00
|
|
|
Service Code
|
MSDRG 482
|
| Min. Negotiated Rate |
$18,472.00 |
| Max. Negotiated Rate |
$60,760.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,752.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,970.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,306.35
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,900.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,262.92
|
| Rate for Payer: EPIC Health Plan Senior |
$22,416.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,416.98
|
| Rate for Payer: InnovAge PACE Commercial |
$33,625.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,416.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,038.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,038.75
|
| Rate for Payer: Multiplan WC |
$33,900.43
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,416.98
|
| Rate for Payer: Preferred Health Network WC |
$34,592.28
|
| Rate for Payer: Prime Health Services Medicare |
$23,762.00
|
| Rate for Payer: Prime Health Services WC |
$33,554.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,760.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,545.00
|
| Rate for Payer: United Healthcare HMO Rider |
$20,163.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18,472.00
|
|
|
MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
|
IP
|
$76,711.99
|
|
|
Service Code
|
MSDRG 521
|
| Min. Negotiated Rate |
$40,528.90 |
| Max. Negotiated Rate |
$76,711.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$76,711.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$49,552.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66,705.82
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$62,285.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$54,714.01
|
| Rate for Payer: EPIC Health Plan Senior |
$40,528.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,528.90
|
| Rate for Payer: InnovAge PACE Commercial |
$60,793.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,528.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,308.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,308.73
|
| Rate for Payer: Multiplan WC |
$62,285.43
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40,528.90
|
| Rate for Payer: Preferred Health Network WC |
$63,556.56
|
| Rate for Payer: Prime Health Services Medicare |
$42,960.63
|
| Rate for Payer: Prime Health Services WC |
$61,649.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$59,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$57,548.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,441.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,540.00
|
|
|
MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
|
IP
|
$75,160.00
|
|
|
Service Code
|
MSDRG 522
|
| Min. Negotiated Rate |
$29,530.58 |
| Max. Negotiated Rate |
$75,160.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,483.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35,839.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48,245.98
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$45,048.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,866.28
|
| Rate for Payer: EPIC Health Plan Senior |
$29,530.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,530.58
|
| Rate for Payer: InnovAge PACE Commercial |
$44,295.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,530.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,570.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,570.98
|
| Rate for Payer: Multiplan WC |
$45,048.87
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$29,530.58
|
| Rate for Payer: Preferred Health Network WC |
$45,968.23
|
| Rate for Payer: Prime Health Services Medicare |
$31,302.41
|
| Rate for Payer: Prime Health Services WC |
$44,589.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$75,160.00
|
| Rate for Payer: United Healthcare All Other HMO |
$47,209.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,860.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,854.00
|
|
|
MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$166,449.25
|
|
|
Service Code
|
MSDRG 969
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$166,449.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$166,449.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$107,519.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144,737.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$135,146.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$117,477.19
|
| Rate for Payer: EPIC Health Plan Senior |
$87,020.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$87,020.14
|
| Rate for Payer: InnovAge PACE Commercial |
$130,530.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$87,020.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$116,606.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$116,606.99
|
| Rate for Payer: Multiplan WC |
$135,146.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$87,020.14
|
| Rate for Payer: Preferred Health Network WC |
$137,904.68
|
| Rate for Payer: Prime Health Services Medicare |
$92,241.35
|
| Rate for Payer: Prime Health Services WC |
$133,767.54
|
| 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: HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC
|
Facility
|
IP
|
$69,832.20
|
|
|
Service Code
|
MSDRG 970
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$69,832.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69,832.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45,108.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60,723.42
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,699.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$49,902.22
|
| Rate for Payer: EPIC Health Plan Senior |
$36,964.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$36,964.61
|
| Rate for Payer: InnovAge PACE Commercial |
$55,446.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,964.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,532.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,532.58
|
| Rate for Payer: Multiplan WC |
$56,699.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$36,964.61
|
| Rate for Payer: Preferred Health Network WC |
$57,856.60
|
| Rate for Payer: Prime Health Services Medicare |
$39,182.49
|
| Rate for Payer: Prime Health Services WC |
$56,120.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH CC
|
Facility
|
IP
|
$37,409.83
|
|
|
Service Code
|
MSDRG 975
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,409.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,409.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,165.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,530.16
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,374.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,225.65
|
| Rate for Payer: EPIC Health Plan Senior |
$20,167.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,167.15
|
| Rate for Payer: InnovAge PACE Commercial |
$30,250.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,167.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,023.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,023.98
|
| Rate for Payer: Multiplan WC |
$30,374.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,167.15
|
| Rate for Payer: Preferred Health Network WC |
$30,994.37
|
| Rate for Payer: Prime Health Services Medicare |
$21,377.18
|
| Rate for Payer: Prime Health Services WC |
$30,064.54
|
| 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: HIV WITH MAJOR RELATED CONDITION WITH MCC
|
Facility
|
IP
|
$78,593.80
|
|
|
Service Code
|
MSDRG 974
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$78,593.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78,593.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50,768.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68,342.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$63,813.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,030.16
|
| Rate for Payer: EPIC Health Plan Senior |
$41,503.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,503.82
|
| Rate for Payer: InnovAge PACE Commercial |
$62,255.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,503.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,615.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,615.12
|
| Rate for Payer: Multiplan WC |
$63,813.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$41,503.82
|
| Rate for Payer: Preferred Health Network WC |
$65,115.66
|
| Rate for Payer: Prime Health Services Medicare |
$43,994.05
|
| Rate for Payer: Prime Health Services WC |
$63,162.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC
|
Facility
|
IP
|
$26,397.96
|
|
|
Service Code
|
MSDRG 976
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$26,397.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,397.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,052.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,954.66
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,433.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,523.83
|
| Rate for Payer: EPIC Health Plan Senior |
$14,462.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,462.10
|
| Rate for Payer: InnovAge PACE Commercial |
$21,693.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,462.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,379.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,379.21
|
| Rate for Payer: Multiplan WC |
$21,433.52
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,462.10
|
| Rate for Payer: Preferred Health Network WC |
$21,870.94
|
| Rate for Payer: Prime Health Services Medicare |
$15,329.83
|
| Rate for Payer: Prime Health Services WC |
$21,214.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: HIV WITH OR WITHOUT OTHER RELATED CONDITION
|
Facility
|
IP
|
$37,949.37
|
|
|
Service Code
|
MSDRG 977
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,949.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,949.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,513.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,999.32
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$30,812.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,603.02
|
| Rate for Payer: EPIC Health Plan Senior |
$20,446.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,446.68
|
| Rate for Payer: InnovAge PACE Commercial |
$30,670.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,446.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,398.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,398.55
|
| Rate for Payer: Multiplan WC |
$30,812.56
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,446.68
|
| Rate for Payer: Preferred Health Network WC |
$31,441.39
|
| Rate for Payer: Prime Health Services Medicare |
$21,673.48
|
| Rate for Payer: Prime Health Services WC |
$30,498.15
|
| 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: HYPERTENSION WITH MCC
|
Facility
|
IP
|
$30,919.56
|
|
|
Service Code
|
MSDRG 304
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$30,919.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,919.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,972.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,886.47
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$25,104.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,686.29
|
| Rate for Payer: EPIC Health Plan Senior |
$16,804.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,804.66
|
| Rate for Payer: InnovAge PACE Commercial |
$25,206.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,804.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,518.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,518.24
|
| Rate for Payer: Multiplan WC |
$25,104.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,804.66
|
| Rate for Payer: Preferred Health Network WC |
$25,617.13
|
| Rate for Payer: Prime Health Services Medicare |
$17,812.94
|
| Rate for Payer: Prime Health Services WC |
$24,848.62
|
| 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: HYPERTENSION WITHOUT MCC
|
Facility
|
IP
|
$19,757.67
|
|
|
Service Code
|
MSDRG 305
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$19,757.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,757.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,762.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,180.52
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,042.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,879.55
|
| Rate for Payer: EPIC Health Plan Senior |
$11,021.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,021.89
|
| Rate for Payer: InnovAge PACE Commercial |
$16,532.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,021.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,769.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,769.33
|
| Rate for Payer: Multiplan WC |
$16,042.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,021.89
|
| Rate for Payer: Preferred Health Network WC |
$16,369.41
|
| Rate for Payer: Prime Health Services Medicare |
$11,683.20
|
| Rate for Payer: Prime Health Services WC |
$15,878.33
|
| 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: HYPERTENSIVE ENCEPHALOPATHY WITH CC
|
Facility
|
IP
|
$26,263.73
|
|
|
Service Code
|
MSDRG 078
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$26,263.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,263.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,965.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,837.94
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,324.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,429.94
|
| Rate for Payer: EPIC Health Plan Senior |
$14,392.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,392.55
|
| Rate for Payer: InnovAge PACE Commercial |
$21,588.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,392.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,286.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,286.02
|
| Rate for Payer: Multiplan WC |
$21,324.54
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,392.55
|
| Rate for Payer: Preferred Health Network WC |
$21,759.73
|
| Rate for Payer: Prime Health Services Medicare |
$15,256.10
|
| Rate for Payer: Prime Health Services WC |
$21,106.94
|
| 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: HYPERTENSIVE ENCEPHALOPATHY WITH MCC
|
Facility
|
IP
|
$40,697.07
|
|
|
Service Code
|
MSDRG 077
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$40,697.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,697.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,288.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,388.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,043.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,524.78
|
| Rate for Payer: EPIC Health Plan Senior |
$21,870.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,870.21
|
| Rate for Payer: InnovAge PACE Commercial |
$32,805.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,870.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,306.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,306.08
|
| Rate for Payer: Multiplan WC |
$33,043.52
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,870.21
|
| Rate for Payer: Preferred Health Network WC |
$33,717.88
|
| Rate for Payer: Prime Health Services Medicare |
$23,182.42
|
| Rate for Payer: Prime Health Services WC |
$32,706.34
|
| 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: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC
|
Facility
|
IP
|
$17,546.88
|
|
|
Service Code
|
MSDRG 079
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$17,546.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,546.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,334.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,258.10
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$14,246.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,333.29
|
| Rate for Payer: EPIC Health Plan Senior |
$9,876.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,876.51
|
| Rate for Payer: InnovAge PACE Commercial |
$14,814.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,876.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,234.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,234.52
|
| Rate for Payer: Multiplan WC |
$14,246.99
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,876.51
|
| Rate for Payer: Preferred Health Network WC |
$14,537.74
|
| Rate for Payer: Prime Health Services Medicare |
$10,469.10
|
| Rate for Payer: Prime Health Services WC |
$14,101.61
|
| 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: INBORN AND OTHER DISORDERS OF METABOLISM
|
Facility
|
IP
|
$32,664.51
|
|
|
Service Code
|
MSDRG 642
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$32,664.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,664.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,099.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,403.81
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$26,521.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,906.74
|
| Rate for Payer: EPIC Health Plan Senior |
$17,708.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17,708.70
|
| Rate for Payer: InnovAge PACE Commercial |
$26,563.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,708.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,729.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,729.66
|
| Rate for Payer: Multiplan WC |
$26,521.58
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17,708.70
|
| Rate for Payer: Preferred Health Network WC |
$27,062.84
|
| Rate for Payer: Prime Health Services Medicare |
$18,771.22
|
| Rate for Payer: Prime Health Services WC |
$26,250.95
|
| 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: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$26,826.96
|
|
|
Service Code
|
MSDRG 758
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$26,826.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,826.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,329.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,327.70
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,781.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,823.89
|
| Rate for Payer: EPIC Health Plan Senior |
$14,684.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,684.36
|
| Rate for Payer: InnovAge PACE Commercial |
$22,026.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,684.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,677.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,677.04
|
| Rate for Payer: Multiplan WC |
$21,781.84
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,684.36
|
| Rate for Payer: Preferred Health Network WC |
$22,226.37
|
| Rate for Payer: Prime Health Services Medicare |
$15,565.42
|
| Rate for Payer: Prime Health Services WC |
$21,559.58
|
| 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
|
|
