|
MS-DRG 42.00: MINOR BLADDER PROCEDURES WITH MCC
|
Facility
|
IP
|
$82,104.75
|
|
|
Service Code
|
MSDRG 662
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$82,104.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,104.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53,036.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71,395.17
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$66,664.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,485.77
|
| Rate for Payer: EPIC Health Plan Senior |
$43,322.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,322.79
|
| Rate for Payer: InnovAge PACE Commercial |
$64,984.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,322.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58,052.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,052.54
|
| Rate for Payer: Multiplan WC |
$66,664.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$43,322.79
|
| Rate for Payer: Preferred Health Network WC |
$68,024.51
|
| Rate for Payer: Prime Health Services Medicare |
$45,922.16
|
| Rate for Payer: Prime Health Services WC |
$65,983.77
|
| 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: MINOR BLADDER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$28,419.26
|
|
|
Service Code
|
MSDRG 664
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$28,419.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,419.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,357.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,712.30
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$23,074.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,937.54
|
| Rate for Payer: EPIC Health Plan Senior |
$15,509.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,509.29
|
| Rate for Payer: InnovAge PACE Commercial |
$23,263.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,509.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,782.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,782.45
|
| Rate for Payer: Multiplan WC |
$23,074.69
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,509.29
|
| Rate for Payer: Preferred Health Network WC |
$23,545.60
|
| Rate for Payer: Prime Health Services Medicare |
$16,439.85
|
| Rate for Payer: Prime Health Services WC |
$22,839.23
|
| 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: MINOR SKIN DISORDERS WITH MCC
|
Facility
|
IP
|
$42,381.49
|
|
|
Service Code
|
MSDRG 606
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,381.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,381.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,376.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,853.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,411.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,702.90
|
| Rate for Payer: EPIC Health Plan Senior |
$22,742.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,742.89
|
| Rate for Payer: InnovAge PACE Commercial |
$34,114.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,742.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,475.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,475.47
|
| Rate for Payer: Multiplan WC |
$34,411.17
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,742.89
|
| Rate for Payer: Preferred Health Network WC |
$35,113.44
|
| Rate for Payer: Prime Health Services Medicare |
$24,107.46
|
| Rate for Payer: Prime Health Services WC |
$34,060.04
|
| 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: MINOR SKIN DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$22,744.88
|
|
|
Service Code
|
MSDRG 607
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$22,744.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,744.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,692.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,778.08
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,467.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,968.84
|
| Rate for Payer: EPIC Health Plan Senior |
$12,569.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,569.51
|
| Rate for Payer: InnovAge PACE Commercial |
$18,854.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,569.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,843.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,843.14
|
| Rate for Payer: Multiplan WC |
$18,467.44
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,569.51
|
| Rate for Payer: Preferred Health Network WC |
$18,844.33
|
| Rate for Payer: Prime Health Services Medicare |
$13,323.68
|
| Rate for Payer: Prime Health Services WC |
$18,279.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$39,181.10
|
|
|
Service Code
|
MSDRG 345
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$39,181.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$39,181.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,309.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,070.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,812.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,464.52
|
| Rate for Payer: EPIC Health Plan Senior |
$21,084.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,084.83
|
| Rate for Payer: InnovAge PACE Commercial |
$31,627.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,084.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,253.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28,253.67
|
| Rate for Payer: Multiplan WC |
$31,812.64
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,084.83
|
| Rate for Payer: Preferred Health Network WC |
$32,461.88
|
| Rate for Payer: Prime Health Services Medicare |
$22,349.92
|
| Rate for Payer: Prime Health Services WC |
$31,488.02
|
| 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: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$70,916.55
|
|
|
Service Code
|
MSDRG 344
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$70,916.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70,916.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45,809.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61,666.33
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$57,579.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,660.60
|
| Rate for Payer: EPIC Health Plan Senior |
$37,526.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,526.37
|
| Rate for Payer: InnovAge PACE Commercial |
$56,289.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,526.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50,285.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,285.34
|
| Rate for Payer: Multiplan WC |
$57,579.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$37,526.37
|
| Rate for Payer: Preferred Health Network WC |
$58,754.98
|
| Rate for Payer: Prime Health Services Medicare |
$39,777.95
|
| Rate for Payer: Prime Health Services WC |
$56,992.33
|
| 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: MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$32,775.05
|
|
|
Service Code
|
MSDRG 346
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$32,775.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,775.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,171.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,499.94
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$26,611.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,984.03
|
| Rate for Payer: EPIC Health Plan Senior |
$17,765.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17,765.95
|
| Rate for Payer: InnovAge PACE Commercial |
$26,648.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,765.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,806.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,806.37
|
| Rate for Payer: Multiplan WC |
$26,611.33
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17,765.95
|
| Rate for Payer: Preferred Health Network WC |
$27,154.42
|
| Rate for Payer: Prime Health Services Medicare |
$18,831.91
|
| Rate for Payer: Prime Health Services WC |
$26,339.79
|
| 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: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC
|
Facility
|
IP
|
$34,951.63
|
|
|
Service Code
|
MSDRG 640
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,951.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,951.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,577.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,392.61
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,378.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,506.36
|
| Rate for Payer: EPIC Health Plan Senior |
$18,893.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18,893.60
|
| Rate for Payer: InnovAge PACE Commercial |
$28,340.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,893.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,317.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,317.42
|
| Rate for Payer: Multiplan WC |
$28,378.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18,893.60
|
| Rate for Payer: Preferred Health Network WC |
$28,957.74
|
| Rate for Payer: Prime Health Services Medicare |
$20,027.22
|
| Rate for Payer: Prime Health Services WC |
$28,089.01
|
| 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: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC
|
Facility
|
IP
|
$20,565.67
|
|
|
Service Code
|
MSDRG 641
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$20,565.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,565.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,284.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,883.12
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,698.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,444.66
|
| Rate for Payer: EPIC Health Plan Senior |
$11,440.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,440.49
|
| Rate for Payer: InnovAge PACE Commercial |
$17,160.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,440.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,330.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,330.26
|
| Rate for Payer: Multiplan WC |
$16,698.06
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,440.49
|
| Rate for Payer: Preferred Health Network WC |
$17,038.84
|
| Rate for Payer: Prime Health Services Medicare |
$12,126.92
|
| Rate for Payer: Prime Health Services WC |
$16,527.67
|
| 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: MOUTH PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$36,809.75
|
|
|
Service Code
|
MSDRG 137
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$36,809.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36,809.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,777.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32,008.36
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,887.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,805.95
|
| Rate for Payer: EPIC Health Plan Senior |
$19,856.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19,856.26
|
| Rate for Payer: InnovAge PACE Commercial |
$29,784.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,856.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,607.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,607.39
|
| Rate for Payer: Multiplan WC |
$29,887.27
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19,856.26
|
| Rate for Payer: Preferred Health Network WC |
$30,497.21
|
| Rate for Payer: Prime Health Services Medicare |
$21,047.64
|
| Rate for Payer: Prime Health Services WC |
$29,582.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: MOUTH PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$21,410.51
|
|
|
Service Code
|
MSDRG 138
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$21,410.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,410.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,830.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,617.76
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,384.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,035.56
|
| Rate for Payer: EPIC Health Plan Senior |
$11,878.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,878.19
|
| Rate for Payer: InnovAge PACE Commercial |
$17,817.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,878.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,916.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,916.77
|
| Rate for Payer: Multiplan WC |
$17,384.01
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,878.19
|
| Rate for Payer: Preferred Health Network WC |
$17,738.79
|
| Rate for Payer: Prime Health Services Medicare |
$12,590.88
|
| Rate for Payer: Prime Health Services WC |
$17,206.63
|
| 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: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC
|
Facility
|
IP
|
$186,935.96
|
|
|
Service Code
|
MSDRG 427
|
| Min. Negotiated Rate |
$120,753.00 |
| Max. Negotiated Rate |
$186,935.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$186,935.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120,753.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162,552.39
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$151,780.54
|
| Rate for Payer: Multiplan WC |
$151,780.54
|
| Rate for Payer: Preferred Health Network WC |
$154,878.10
|
| Rate for Payer: Prime Health Services WC |
$150,231.76
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$275,702.05
|
|
|
Service Code
|
MSDRG 426
|
| Min. Negotiated Rate |
$178,092.28 |
| Max. Negotiated Rate |
$275,702.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$275,702.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$178,092.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$239,740.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$223,853.16
|
| Rate for Payer: Multiplan WC |
$223,853.16
|
| Rate for Payer: Preferred Health Network WC |
$228,421.59
|
| Rate for Payer: Prime Health Services WC |
$221,568.94
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC
|
Facility
|
IP
|
$144,862.41
|
|
|
Service Code
|
MSDRG 428
|
| Min. Negotiated Rate |
$93,575.20 |
| Max. Negotiated Rate |
$144,862.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$144,862.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93,575.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125,966.83
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$117,619.38
|
| Rate for Payer: Multiplan WC |
$117,619.38
|
| Rate for Payer: Preferred Health Network WC |
$120,019.78
|
| Rate for Payer: Prime Health Services WC |
$116,419.19
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$176,461.00
|
|
|
Service Code
|
MSDRG 447
|
| Min. Negotiated Rate |
$113,986.60 |
| Max. Negotiated Rate |
$176,461.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$176,461.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$113,986.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153,443.76
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$143,275.51
|
| Rate for Payer: Multiplan WC |
$143,275.51
|
| Rate for Payer: Preferred Health Network WC |
$146,199.50
|
| Rate for Payer: Prime Health Services WC |
$141,813.52
|
|
|
MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$107,473.64
|
|
|
Service Code
|
MSDRG 448
|
| Min. Negotiated Rate |
$69,423.58 |
| Max. Negotiated Rate |
$107,473.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107,473.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69,423.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$93,454.98
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$87,262.00
|
| Rate for Payer: Multiplan WC |
$87,262.00
|
| Rate for Payer: Preferred Health Network WC |
$89,042.86
|
| Rate for Payer: Prime Health Services WC |
$86,371.57
|
|
|
MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC
|
Facility
|
IP
|
$32,203.93
|
|
|
Service Code
|
MSDRG 059
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$32,203.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,203.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,802.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,003.31
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$26,147.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,584.58
|
| Rate for Payer: EPIC Health Plan Senior |
$17,470.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17,470.06
|
| Rate for Payer: InnovAge PACE Commercial |
$26,205.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,470.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23,409.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23,409.88
|
| Rate for Payer: Multiplan WC |
$26,147.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17,470.06
|
| Rate for Payer: Preferred Health Network WC |
$26,681.24
|
| Rate for Payer: Prime Health Services Medicare |
$18,518.26
|
| Rate for Payer: Prime Health Services WC |
$25,880.80
|
| 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: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC
|
Facility
|
IP
|
$48,582.24
|
|
|
Service Code
|
MSDRG 058
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$48,582.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,582.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,382.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42,245.27
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$39,445.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,039.76
|
| Rate for Payer: EPIC Health Plan Senior |
$25,955.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,955.38
|
| Rate for Payer: InnovAge PACE Commercial |
$38,933.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,955.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34,780.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,780.21
|
| Rate for Payer: Multiplan WC |
$39,445.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25,955.38
|
| Rate for Payer: Preferred Health Network WC |
$40,250.82
|
| Rate for Payer: Prime Health Services Medicare |
$27,512.70
|
| Rate for Payer: Prime Health Services WC |
$39,043.30
|
| 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: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC
|
Facility
|
IP
|
$23,487.08
|
|
|
Service Code
|
MSDRG 060
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$23,487.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,487.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,171.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,423.47
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$19,070.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,487.93
|
| Rate for Payer: EPIC Health Plan Senior |
$12,954.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,954.02
|
| Rate for Payer: InnovAge PACE Commercial |
$19,431.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,954.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,358.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,358.39
|
| Rate for Payer: Multiplan WC |
$19,070.06
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,954.02
|
| Rate for Payer: Preferred Health Network WC |
$19,459.25
|
| Rate for Payer: Prime Health Services Medicare |
$13,731.26
|
| Rate for Payer: Prime Health Services WC |
$18,875.47
|
| 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: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$62,110.21
|
|
|
Service Code
|
MSDRG 827
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$62,110.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62,110.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40,120.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54,008.67
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$50,429.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,501.39
|
| Rate for Payer: EPIC Health Plan Senior |
$32,963.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,963.99
|
| Rate for Payer: InnovAge PACE Commercial |
$49,445.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,963.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,171.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,171.75
|
| Rate for Payer: Multiplan WC |
$50,429.68
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$32,963.99
|
| Rate for Payer: Preferred Health Network WC |
$51,458.86
|
| Rate for Payer: Prime Health Services Medicare |
$34,941.83
|
| Rate for Payer: Prime Health Services WC |
$49,915.09
|
| 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: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$125,686.38
|
|
|
Service Code
|
MSDRG 826
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$125,686.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$125,686.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$81,188.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109,292.09
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$102,049.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$88,967.20
|
| Rate for Payer: EPIC Health Plan Senior |
$65,901.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$65,901.63
|
| Rate for Payer: InnovAge PACE Commercial |
$98,852.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65,901.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88,308.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$88,308.18
|
| Rate for Payer: Multiplan WC |
$102,049.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$65,901.63
|
| Rate for Payer: Preferred Health Network WC |
$104,132.28
|
| Rate for Payer: Prime Health Services Medicare |
$69,855.73
|
| Rate for Payer: Prime Health Services WC |
$101,008.31
|
| 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: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$42,186.73
|
|
|
Service Code
|
MSDRG 828
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$42,186.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42,186.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27,250.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,683.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$34,253.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,566.66
|
| Rate for Payer: EPIC Health Plan Senior |
$22,641.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,641.97
|
| Rate for Payer: InnovAge PACE Commercial |
$33,962.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,641.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,340.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,340.24
|
| Rate for Payer: Multiplan WC |
$34,253.03
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,641.97
|
| Rate for Payer: Preferred Health Network WC |
$34,952.07
|
| Rate for Payer: Prime Health Services Medicare |
$24,000.49
|
| Rate for Payer: Prime Health Services WC |
$33,903.51
|
| 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: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$81,162.53
|
|
|
Service Code
|
MSDRG 829
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$81,162.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81,162.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52,427.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70,575.85
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$65,898.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,826.75
|
| Rate for Payer: EPIC Health Plan Senior |
$42,834.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,834.63
|
| Rate for Payer: InnovAge PACE Commercial |
$64,251.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,834.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,398.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,398.40
|
| Rate for Payer: Multiplan WC |
$65,898.99
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$42,834.63
|
| Rate for Payer: Preferred Health Network WC |
$67,243.87
|
| Rate for Payer: Prime Health Services Medicare |
$45,404.71
|
| Rate for Payer: Prime Health Services WC |
$65,226.55
|
| 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: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$38,491.54
|
|
|
Service Code
|
MSDRG 830
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$38,491.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,491.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,863.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,470.78
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,252.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,982.21
|
| Rate for Payer: EPIC Health Plan Senior |
$20,727.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,727.56
|
| Rate for Payer: InnovAge PACE Commercial |
$31,091.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,727.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,774.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,774.93
|
| Rate for Payer: Multiplan WC |
$31,252.77
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,727.56
|
| Rate for Payer: Preferred Health Network WC |
$31,890.58
|
| Rate for Payer: Prime Health Services Medicare |
$21,971.21
|
| Rate for Payer: Prime Health Services WC |
$30,933.86
|
| 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: NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY
|
Facility
|
IP
|
$47,442.63
|
|
|
Service Code
|
MSDRG 789
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$47,442.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,442.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,646.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,254.30
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,520.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,242.68
|
| Rate for Payer: EPIC Health Plan Senior |
$25,364.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,364.95
|
| Rate for Payer: InnovAge PACE Commercial |
$38,047.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,364.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33,989.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,989.03
|
| Rate for Payer: Multiplan WC |
$38,520.51
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25,364.95
|
| Rate for Payer: Preferred Health Network WC |
$39,306.64
|
| Rate for Payer: Prime Health Services Medicare |
$26,886.85
|
| Rate for Payer: Prime Health Services WC |
$38,127.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,809.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,601.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
