|
MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH CC
|
Facility
|
IP
|
$21,581.58
|
|
|
Service Code
|
MSDRG 194
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$21,581.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,581.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,940.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,766.52
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,522.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,766.04
|
| Rate for Payer: EPIC Health Plan Senior |
$10,197.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,197.07
|
| Rate for Payer: InnovAge PACE Commercial |
$15,295.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,197.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,664.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,664.07
|
| Rate for Payer: Multiplan WC |
$17,522.92
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,197.07
|
| Rate for Payer: Preferred Health Network WC |
$17,880.53
|
| Rate for Payer: Prime Health Services Medicare |
$10,808.89
|
| Rate for Payer: Prime Health Services WC |
$17,344.11
|
| 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: SIMPLE PNEUMONIA AND PLEURISY WITH MCC
|
Facility
|
IP
|
$34,680.55
|
|
|
Service Code
|
MSDRG 193
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,680.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,680.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,402.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,156.88
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$28,158.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,887.43
|
| Rate for Payer: EPIC Health Plan Senior |
$15,472.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,472.17
|
| Rate for Payer: InnovAge PACE Commercial |
$23,208.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,472.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,732.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,732.71
|
| Rate for Payer: Multiplan WC |
$28,158.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,472.17
|
| Rate for Payer: Preferred Health Network WC |
$28,733.14
|
| Rate for Payer: Prime Health Services Medicare |
$16,400.50
|
| Rate for Payer: Prime Health Services WC |
$27,871.15
|
| 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: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC
|
Facility
|
IP
|
$16,388.84
|
|
|
Service Code
|
MSDRG 195
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$16,388.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,388.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,586.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,251.11
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$13,306.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,945.42
|
| Rate for Payer: EPIC Health Plan Senior |
$8,107.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,107.72
|
| Rate for Payer: InnovAge PACE Commercial |
$12,161.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,107.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,864.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,864.34
|
| Rate for Payer: Multiplan WC |
$13,306.73
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,107.72
|
| Rate for Payer: Preferred Health Network WC |
$13,578.30
|
| Rate for Payer: Prime Health Services Medicare |
$8,594.18
|
| Rate for Payer: Prime Health Services WC |
$13,170.95
|
| 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: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT
|
Facility
|
IP
|
$171,250.00
|
|
|
Service Code
|
MSDRG 008
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$171,250.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$143,204.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$171,250.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$92,504.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124,525.01
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$116,273.12
|
| Rate for Payer: Blue Distinction Transplant |
$138,317.00
|
| Rate for Payer: Blue Shield of California Transplant |
$102,000.00
|
| Rate for Payer: Caremore Medicare Advantage |
$59,319.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$110,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,081.62
|
| Rate for Payer: EPIC Health Plan Senior |
$59,319.72
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$90,300.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$96,050.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,319.72
|
| Rate for Payer: InnovAge PACE Commercial |
$88,979.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,319.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79,488.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,488.42
|
| Rate for Payer: Multiplan WC |
$116,273.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$153,846.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$59,319.72
|
| Rate for Payer: Preferred Health Network WC |
$118,646.04
|
| Rate for Payer: Prime Health Services Medicare |
$62,878.90
|
| Rate for Payer: Prime Health Services WC |
$115,086.66
|
| 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: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS
|
Facility
|
IP
|
$208,638.61
|
|
|
Service Code
|
MSDRG 019
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$208,638.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$171,250.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$208,638.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$134,772.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$181,424.19
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$169,401.75
|
| Rate for Payer: Blue Distinction Transplant |
$138,317.00
|
| Rate for Payer: Blue Shield of California Transplant |
$102,000.00
|
| Rate for Payer: Caremore Medicare Advantage |
$85,757.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$110,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$115,772.69
|
| Rate for Payer: EPIC Health Plan Senior |
$85,757.55
|
| Rate for Payer: Health Plan of Nevada (Sierra) Transplant |
$90,300.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$96,050.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$85,757.55
|
| Rate for Payer: InnovAge PACE Commercial |
$128,636.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85,757.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$114,915.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$114,915.12
|
| Rate for Payer: Multiplan WC |
$169,401.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Commercial |
$153,846.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$85,757.55
|
| Rate for Payer: Preferred Health Network WC |
$172,858.93
|
| Rate for Payer: Prime Health Services Medicare |
$90,903.00
|
| Rate for Payer: Prime Health Services WC |
$167,673.16
|
| 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: SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL
|
Facility
|
IP
|
$102,965.19
|
|
|
Service Code
|
MSDRG 402
|
| Min. Negotiated Rate |
$43,061.65 |
| Max. Negotiated Rate |
$102,965.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102,965.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66,511.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89,534.61
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$83,601.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,133.23
|
| Rate for Payer: EPIC Health Plan Senior |
$43,061.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,061.65
|
| Rate for Payer: InnovAge PACE Commercial |
$64,592.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,061.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57,702.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57,702.61
|
| Rate for Payer: Multiplan WC |
$83,601.42
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$43,061.65
|
| Rate for Payer: Preferred Health Network WC |
$85,307.57
|
| Rate for Payer: Prime Health Services Medicare |
$45,645.35
|
| Rate for Payer: Prime Health Services WC |
$82,748.34
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE
|
Facility
|
IP
|
$135,545.48
|
|
|
Service Code
|
MSDRG 450
|
| Min. Negotiated Rate |
$56,225.28 |
| Max. Negotiated Rate |
$135,545.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$135,545.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87,556.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$117,865.19
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$110,054.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$75,904.13
|
| Rate for Payer: EPIC Health Plan Senior |
$56,225.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$56,225.28
|
| Rate for Payer: InnovAge PACE Commercial |
$84,337.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56,225.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75,341.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75,341.88
|
| Rate for Payer: Multiplan WC |
$110,054.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$56,225.28
|
| Rate for Payer: Preferred Health Network WC |
$112,300.63
|
| Rate for Payer: Prime Health Services Medicare |
$59,598.80
|
| Rate for Payer: Prime Health Services WC |
$108,931.61
|
|
|
MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$81,220.43
|
|
|
Service Code
|
MSDRG 451
|
| Min. Negotiated Rate |
$34,275.96 |
| Max. Negotiated Rate |
$81,220.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$81,220.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52,465.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70,626.20
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$65,946.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,272.55
|
| Rate for Payer: EPIC Health Plan Senior |
$34,275.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,275.96
|
| Rate for Payer: InnovAge PACE Commercial |
$51,413.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,275.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,929.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,929.79
|
| Rate for Payer: Multiplan WC |
$65,946.01
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$34,275.96
|
| Rate for Payer: Preferred Health Network WC |
$67,291.85
|
| Rate for Payer: Prime Health Services Medicare |
$36,332.52
|
| Rate for Payer: Prime Health Services WC |
$65,273.09
|
|
|
MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$63,457.74
|
|
|
Service Code
|
MSDRG 135
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$63,457.74 |
| Rate for Payer: Aetna of CA HMO/PPO |
$63,457.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40,991.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55,180.43
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$51,523.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,583.92
|
| Rate for Payer: EPIC Health Plan Senior |
$27,099.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,099.20
|
| Rate for Payer: InnovAge PACE Commercial |
$40,648.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,099.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,312.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,312.93
|
| Rate for Payer: Multiplan WC |
$51,523.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$27,099.20
|
| Rate for Payer: Preferred Health Network WC |
$52,575.30
|
| Rate for Payer: Prime Health Services Medicare |
$28,725.15
|
| Rate for Payer: Prime Health Services WC |
$50,998.04
|
| 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: SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$25,745.25
|
|
|
Service Code
|
MSDRG 136
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$25,745.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,745.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,630.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,387.09
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$20,903.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,027.69
|
| Rate for Payer: EPIC Health Plan Senior |
$11,872.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,872.36
|
| Rate for Payer: InnovAge PACE Commercial |
$17,808.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,872.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,908.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,908.96
|
| Rate for Payer: Multiplan WC |
$20,903.56
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,872.36
|
| Rate for Payer: Preferred Health Network WC |
$21,330.16
|
| Rate for Payer: Prime Health Services Medicare |
$12,584.70
|
| Rate for Payer: Prime Health Services WC |
$20,690.26
|
| 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: SKIN DEBRIDEMENT WITH CC
|
Facility
|
IP
|
$44,065.90
|
|
|
Service Code
|
MSDRG 571
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$44,065.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,065.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,464.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,318.03
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,778.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,006.64
|
| Rate for Payer: EPIC Health Plan Senior |
$19,264.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19,264.18
|
| Rate for Payer: InnovAge PACE Commercial |
$28,896.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,264.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,814.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,814.00
|
| Rate for Payer: Multiplan WC |
$35,778.81
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19,264.18
|
| Rate for Payer: Preferred Health Network WC |
$36,508.99
|
| Rate for Payer: Prime Health Services Medicare |
$20,420.03
|
| Rate for Payer: Prime Health Services WC |
$35,413.72
|
| 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: SKIN DEBRIDEMENT WITH MCC
|
Facility
|
IP
|
$79,225.45
|
|
|
Service Code
|
MSDRG 570
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$79,225.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$79,225.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$51,176.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68,891.44
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$64,326.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,184.39
|
| Rate for Payer: EPIC Health Plan Senior |
$33,469.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,469.92
|
| Rate for Payer: InnovAge PACE Commercial |
$50,204.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,469.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44,849.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44,849.69
|
| Rate for Payer: Multiplan WC |
$64,326.21
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$33,469.92
|
| Rate for Payer: Preferred Health Network WC |
$65,638.99
|
| Rate for Payer: Prime Health Services Medicare |
$35,478.12
|
| Rate for Payer: Prime Health Services WC |
$63,669.82
|
| 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: SKIN DEBRIDEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$30,066.83
|
|
|
Service Code
|
MSDRG 572
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$30,066.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,066.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,421.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,144.97
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$24,412.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,375.12
|
| Rate for Payer: EPIC Health Plan Senior |
$13,611.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,611.20
|
| Rate for Payer: InnovAge PACE Commercial |
$20,416.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,611.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,239.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,239.01
|
| Rate for Payer: Multiplan WC |
$24,412.42
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,611.20
|
| Rate for Payer: Preferred Health Network WC |
$24,910.63
|
| Rate for Payer: Prime Health Services Medicare |
$14,427.87
|
| Rate for Payer: Prime Health Services WC |
$24,163.31
|
| 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: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$70,082.23
|
|
|
Service Code
|
MSDRG 577
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$70,082.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70,082.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45,270.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60,940.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$56,902.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,197.24
|
| Rate for Payer: EPIC Health Plan Senior |
$29,775.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,775.73
|
| Rate for Payer: InnovAge PACE Commercial |
$44,663.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,775.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39,899.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,899.48
|
| Rate for Payer: Multiplan WC |
$56,902.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$29,775.73
|
| Rate for Payer: Preferred Health Network WC |
$58,063.75
|
| Rate for Payer: Prime Health Services Medicare |
$31,562.27
|
| Rate for Payer: Prime Health Services WC |
$56,321.84
|
| 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: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$141,998.90
|
|
|
Service Code
|
MSDRG 576
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$141,998.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$141,998.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$91,725.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$123,476.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$115,294.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$79,424.12
|
| Rate for Payer: EPIC Health Plan Senior |
$58,832.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58,832.68
|
| Rate for Payer: InnovAge PACE Commercial |
$88,249.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,832.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78,835.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78,835.79
|
| Rate for Payer: Multiplan WC |
$115,294.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$58,832.68
|
| Rate for Payer: Preferred Health Network WC |
$117,647.34
|
| Rate for Payer: Prime Health Services Medicare |
$62,362.64
|
| Rate for Payer: Prime Health Services WC |
$114,117.92
|
| 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: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$44,489.64
|
|
|
Service Code
|
MSDRG 578
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$44,489.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,489.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,738.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38,686.49
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,122.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,237.76
|
| Rate for Payer: EPIC Health Plan Senior |
$19,435.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19,435.38
|
| Rate for Payer: InnovAge PACE Commercial |
$29,153.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,435.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,043.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,043.41
|
| Rate for Payer: Multiplan WC |
$36,122.86
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19,435.38
|
| Rate for Payer: Preferred Health Network WC |
$36,860.06
|
| Rate for Payer: Prime Health Services Medicare |
$20,601.50
|
| Rate for Payer: Prime Health Services WC |
$35,754.26
|
| 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: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC
|
Facility
|
IP
|
$91,192.70
|
|
|
Service Code
|
MSDRG 574
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$91,192.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$91,192.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58,906.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79,297.70
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$74,042.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,711.94
|
| Rate for Payer: EPIC Health Plan Senior |
$38,305.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,305.14
|
| Rate for Payer: InnovAge PACE Commercial |
$57,457.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,305.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,328.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,328.89
|
| Rate for Payer: Multiplan WC |
$74,042.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$38,305.14
|
| Rate for Payer: Preferred Health Network WC |
$75,553.96
|
| Rate for Payer: Prime Health Services Medicare |
$40,603.45
|
| Rate for Payer: Prime Health Services WC |
$73,287.34
|
| 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: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC
|
Facility
|
IP
|
$162,077.67
|
|
|
Service Code
|
MSDRG 573
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$162,077.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$162,077.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104,695.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140,936.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$131,597.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$90,376.07
|
| Rate for Payer: EPIC Health Plan Senior |
$66,945.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$66,945.24
|
| Rate for Payer: InnovAge PACE Commercial |
$100,417.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66,945.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$89,706.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$89,706.62
|
| Rate for Payer: Multiplan WC |
$131,597.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$66,945.24
|
| Rate for Payer: Preferred Health Network WC |
$134,282.78
|
| Rate for Payer: Prime Health Services Medicare |
$70,961.95
|
| Rate for Payer: Prime Health Services WC |
$130,254.30
|
| 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: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$52,551.15
|
|
|
Service Code
|
MSDRG 575
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$52,551.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,551.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33,945.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,696.48
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$42,668.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,634.92
|
| Rate for Payer: EPIC Health Plan Senior |
$22,692.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,692.53
|
| Rate for Payer: InnovAge PACE Commercial |
$34,038.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,692.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,407.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,407.99
|
| Rate for Payer: Multiplan WC |
$42,668.31
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,692.53
|
| Rate for Payer: Preferred Health Network WC |
$43,539.09
|
| Rate for Payer: Prime Health Services Medicare |
$24,054.08
|
| Rate for Payer: Prime Health Services WC |
$42,232.92
|
| 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: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC
|
Facility
|
IP
|
$50,342.98
|
|
|
Service Code
|
MSDRG 623
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$50,342.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,342.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,519.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43,776.34
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$40,875.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,430.49
|
| Rate for Payer: EPIC Health Plan Senior |
$21,800.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,800.36
|
| Rate for Payer: InnovAge PACE Commercial |
$32,700.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,800.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,212.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,212.48
|
| Rate for Payer: Multiplan WC |
$40,875.42
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,800.36
|
| Rate for Payer: Preferred Health Network WC |
$41,709.61
|
| Rate for Payer: Prime Health Services Medicare |
$23,108.38
|
| Rate for Payer: Prime Health Services WC |
$40,458.32
|
| 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: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC
|
Facility
|
IP
|
$98,485.70
|
|
|
Service Code
|
MSDRG 622
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$98,485.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98,485.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$63,617.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85,639.41
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$79,964.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,689.89
|
| Rate for Payer: EPIC Health Plan Senior |
$41,251.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,251.77
|
| Rate for Payer: InnovAge PACE Commercial |
$61,877.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,251.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55,277.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,277.37
|
| Rate for Payer: Multiplan WC |
$79,964.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$41,251.77
|
| Rate for Payer: Preferred Health Network WC |
$81,596.27
|
| Rate for Payer: Prime Health Services Medicare |
$43,726.88
|
| Rate for Payer: Prime Health Services WC |
$79,148.38
|
| 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: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$26,400.59
|
|
|
Service Code
|
MSDRG 624
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$26,400.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,400.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,053.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,956.95
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,435.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,383.68
|
| Rate for Payer: EPIC Health Plan Senior |
$12,136.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,136.06
|
| Rate for Payer: InnovAge PACE Commercial |
$18,204.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,136.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,262.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,262.32
|
| Rate for Payer: Multiplan WC |
$21,435.66
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,136.06
|
| Rate for Payer: Preferred Health Network WC |
$21,873.12
|
| Rate for Payer: Prime Health Services Medicare |
$12,864.22
|
| Rate for Payer: Prime Health Services WC |
$21,216.93
|
| 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: SKIN GRAFTS FOR INJURIES WITH CC/MCC
|
Facility
|
IP
|
$101,620.29
|
|
|
Service Code
|
MSDRG 904
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$101,620.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$101,620.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65,642.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88,365.13
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$82,509.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,399.65
|
| Rate for Payer: EPIC Health Plan Senior |
$42,518.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,518.26
|
| Rate for Payer: InnovAge PACE Commercial |
$63,777.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,518.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,974.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,974.47
|
| Rate for Payer: Multiplan WC |
$82,509.44
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$42,518.26
|
| Rate for Payer: Preferred Health Network WC |
$84,193.31
|
| Rate for Payer: Prime Health Services Medicare |
$45,069.36
|
| Rate for Payer: Prime Health Services WC |
$81,667.51
|
| 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: SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$43,378.98
|
|
|
Service Code
|
MSDRG 905
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$43,378.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43,378.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28,021.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37,720.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$35,221.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,631.96
|
| Rate for Payer: EPIC Health Plan Senior |
$18,986.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18,986.64
|
| Rate for Payer: InnovAge PACE Commercial |
$28,479.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,986.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,442.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,442.10
|
| Rate for Payer: Multiplan WC |
$35,221.06
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18,986.64
|
| Rate for Payer: Preferred Health Network WC |
$35,939.86
|
| Rate for Payer: Prime Health Services Medicare |
$20,125.84
|
| Rate for Payer: Prime Health Services WC |
$34,861.66
|
| 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: SKIN ULCERS WITH CC
|
Facility
|
IP
|
$32,180.24
|
|
|
Service Code
|
MSDRG 593
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$32,180.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,180.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20,787.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,982.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$26,128.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,523.63
|
| Rate for Payer: EPIC Health Plan Senior |
$14,461.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,461.95
|
| Rate for Payer: InnovAge PACE Commercial |
$21,692.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,461.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,379.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,379.01
|
| Rate for Payer: Multiplan WC |
$26,128.38
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,461.95
|
| Rate for Payer: Preferred Health Network WC |
$26,661.61
|
| Rate for Payer: Prime Health Services Medicare |
$15,329.67
|
| Rate for Payer: Prime Health Services WC |
$25,861.76
|
| 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
|
|
