|
MS-DRG 42.00: SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$20,910.45
|
|
|
Service Code
|
MSDRG 948
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$20,910.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,910.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,507.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,182.93
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,978.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,685.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,619.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,619.11
|
| Rate for Payer: InnovAge PACE Commercial |
$17,428.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,619.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,569.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,569.61
|
| Rate for Payer: Multiplan WC |
$16,978.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,619.11
|
| Rate for Payer: Preferred Health Network WC |
$17,324.49
|
| Rate for Payer: Prime Health Services Medicare |
$12,316.26
|
| Rate for Payer: Prime Health Services WC |
$16,804.76
|
| 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
|
|
|
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 |
$16,155.18
|
| Rate for Payer: EPIC Health Plan Senior |
$11,966.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,966.80
|
| Rate for Payer: InnovAge PACE Commercial |
$17,950.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,966.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,035.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,035.51
|
| Rate for Payer: Multiplan WC |
$17,522.92
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,966.80
|
| Rate for Payer: Preferred Health Network WC |
$17,880.53
|
| Rate for Payer: Prime Health Services Medicare |
$12,684.81
|
| 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 |
$25,316.75
|
| Rate for Payer: EPIC Health Plan Senior |
$18,753.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18,753.15
|
| Rate for Payer: InnovAge PACE Commercial |
$28,129.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,753.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25,129.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25,129.22
|
| Rate for Payer: Multiplan WC |
$28,158.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18,753.15
|
| Rate for Payer: Preferred Health Network WC |
$28,733.14
|
| Rate for Payer: Prime Health Services Medicare |
$19,878.34
|
| 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 |
$12,523.33
|
| Rate for Payer: EPIC Health Plan Senior |
$9,276.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,276.54
|
| Rate for Payer: InnovAge PACE Commercial |
$13,914.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,276.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,430.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,430.56
|
| Rate for Payer: Multiplan WC |
$13,306.73
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,276.54
|
| Rate for Payer: Preferred Health Network WC |
$13,578.30
|
| Rate for Payer: Prime Health Services Medicare |
$9,833.13
|
| 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 |
$74,977.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$110,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$101,219.45
|
| Rate for Payer: EPIC Health Plan Senior |
$74,977.37
|
| 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 |
$74,977.37
|
| Rate for Payer: InnovAge PACE Commercial |
$112,466.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74,977.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$100,469.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$100,469.68
|
| 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 |
$74,977.37
|
| Rate for Payer: Preferred Health Network WC |
$118,646.04
|
| Rate for Payer: Prime Health Services Medicare |
$79,476.01
|
| 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 |
$108,877.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$110,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$146,984.91
|
| Rate for Payer: EPIC Health Plan Senior |
$108,877.71
|
| 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 |
$108,877.71
|
| Rate for Payer: InnovAge PACE Commercial |
$163,316.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$108,877.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$145,896.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$145,896.13
|
| 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 |
$108,877.71
|
| Rate for Payer: Preferred Health Network WC |
$172,858.93
|
| Rate for Payer: Prime Health Services Medicare |
$115,410.37
|
| 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 |
$66,511.31 |
| 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: Multiplan WC |
$83,601.42
|
| Rate for Payer: Preferred Health Network WC |
$85,307.57
|
| 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 |
$87,556.85 |
| 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: Multiplan WC |
$110,054.62
|
| Rate for Payer: Preferred Health Network WC |
$112,300.63
|
| 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 |
$52,465.09 |
| 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: Multiplan WC |
$65,946.01
|
| Rate for Payer: Preferred Health Network WC |
$67,291.85
|
| 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 |
$45,443.83
|
| Rate for Payer: EPIC Health Plan Senior |
$33,662.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,662.10
|
| Rate for Payer: InnovAge PACE Commercial |
$50,493.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,662.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45,107.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,107.21
|
| Rate for Payer: Multiplan WC |
$51,523.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$33,662.10
|
| Rate for Payer: Preferred Health Network WC |
$52,575.30
|
| Rate for Payer: Prime Health Services Medicare |
$35,681.83
|
| 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 |
$19,067.33
|
| Rate for Payer: EPIC Health Plan Senior |
$14,123.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,123.95
|
| Rate for Payer: InnovAge PACE Commercial |
$21,185.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,123.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,926.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,926.09
|
| Rate for Payer: Multiplan WC |
$20,903.56
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,123.95
|
| Rate for Payer: Preferred Health Network WC |
$21,330.16
|
| Rate for Payer: Prime Health Services Medicare |
$14,971.39
|
| 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 |
$31,880.97
|
| Rate for Payer: EPIC Health Plan Senior |
$23,615.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,615.53
|
| Rate for Payer: InnovAge PACE Commercial |
$35,423.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,615.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,644.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,644.81
|
| Rate for Payer: Multiplan WC |
$35,778.81
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,615.53
|
| Rate for Payer: Preferred Health Network WC |
$36,508.99
|
| Rate for Payer: Prime Health Services Medicare |
$25,032.46
|
| 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 |
$56,471.94
|
| Rate for Payer: EPIC Health Plan Senior |
$41,831.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,831.07
|
| Rate for Payer: InnovAge PACE Commercial |
$62,746.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,831.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,053.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,053.63
|
| Rate for Payer: Multiplan WC |
$64,326.21
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$41,831.07
|
| Rate for Payer: Preferred Health Network WC |
$65,638.99
|
| Rate for Payer: Prime Health Services Medicare |
$44,340.93
|
| 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 |
$22,089.90
|
| Rate for Payer: EPIC Health Plan Senior |
$16,362.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,362.89
|
| Rate for Payer: InnovAge PACE Commercial |
$24,544.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,362.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,926.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,926.27
|
| Rate for Payer: Multiplan WC |
$24,412.42
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,362.89
|
| Rate for Payer: Preferred Health Network WC |
$24,910.63
|
| Rate for Payer: Prime Health Services Medicare |
$17,344.66
|
| 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 |
$50,077.09
|
| Rate for Payer: EPIC Health Plan Senior |
$37,094.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,094.14
|
| Rate for Payer: InnovAge PACE Commercial |
$55,641.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,094.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,706.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49,706.15
|
| Rate for Payer: Multiplan WC |
$56,902.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$37,094.14
|
| Rate for Payer: Preferred Health Network WC |
$58,063.75
|
| Rate for Payer: Prime Health Services Medicare |
$39,319.79
|
| 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 |
$100,376.36
|
| Rate for Payer: EPIC Health Plan Senior |
$74,352.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$74,352.86
|
| Rate for Payer: InnovAge PACE Commercial |
$111,529.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74,352.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$99,632.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,632.83
|
| Rate for Payer: Multiplan WC |
$115,294.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$74,352.86
|
| Rate for Payer: Preferred Health Network WC |
$117,647.34
|
| Rate for Payer: Prime Health Services Medicare |
$78,814.03
|
| 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 |
$32,177.33
|
| Rate for Payer: EPIC Health Plan Senior |
$23,835.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,835.06
|
| Rate for Payer: InnovAge PACE Commercial |
$35,752.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,835.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,938.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,938.98
|
| Rate for Payer: Multiplan WC |
$36,122.86
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,835.06
|
| Rate for Payer: Preferred Health Network WC |
$36,860.06
|
| Rate for Payer: Prime Health Services Medicare |
$25,265.16
|
| 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 |
$64,842.00
|
| Rate for Payer: EPIC Health Plan Senior |
$48,031.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,031.11
|
| Rate for Payer: InnovAge PACE Commercial |
$72,046.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,031.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,361.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,361.69
|
| Rate for Payer: Multiplan WC |
$74,042.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$48,031.11
|
| Rate for Payer: Preferred Health Network WC |
$75,553.96
|
| Rate for Payer: Prime Health Services Medicare |
$50,912.98
|
| 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 |
$114,419.65
|
| Rate for Payer: EPIC Health Plan Senior |
$84,755.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$84,755.30
|
| Rate for Payer: InnovAge PACE Commercial |
$127,132.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84,755.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$113,572.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$113,572.10
|
| Rate for Payer: Multiplan WC |
$131,597.12
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$84,755.30
|
| Rate for Payer: Preferred Health Network WC |
$134,282.78
|
| Rate for Payer: Prime Health Services Medicare |
$89,840.62
|
| 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 |
$37,815.65
|
| Rate for Payer: EPIC Health Plan Senior |
$28,011.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,011.59
|
| Rate for Payer: InnovAge PACE Commercial |
$42,017.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,011.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,535.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,535.53
|
| Rate for Payer: Multiplan WC |
$42,668.31
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$28,011.59
|
| Rate for Payer: Preferred Health Network WC |
$43,539.09
|
| Rate for Payer: Prime Health Services Medicare |
$29,692.29
|
| 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 |
$36,271.25
|
| Rate for Payer: EPIC Health Plan Senior |
$26,867.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,867.59
|
| Rate for Payer: InnovAge PACE Commercial |
$40,301.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,867.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,002.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,002.57
|
| Rate for Payer: Multiplan WC |
$40,875.42
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26,867.59
|
| Rate for Payer: Preferred Health Network WC |
$41,709.61
|
| Rate for Payer: Prime Health Services Medicare |
$28,479.65
|
| 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 |
$69,942.76
|
| Rate for Payer: EPIC Health Plan Senior |
$51,809.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51,809.45
|
| Rate for Payer: InnovAge PACE Commercial |
$77,714.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51,809.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69,424.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69,424.66
|
| Rate for Payer: Multiplan WC |
$79,964.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$51,809.45
|
| Rate for Payer: Preferred Health Network WC |
$81,596.27
|
| Rate for Payer: Prime Health Services Medicare |
$54,918.02
|
| 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 |
$19,525.70
|
| Rate for Payer: EPIC Health Plan Senior |
$14,463.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,463.48
|
| Rate for Payer: InnovAge PACE Commercial |
$21,695.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,463.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,381.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,381.06
|
| Rate for Payer: Multiplan WC |
$21,435.66
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,463.48
|
| Rate for Payer: Preferred Health Network WC |
$21,873.12
|
| Rate for Payer: Prime Health Services Medicare |
$15,331.29
|
| 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 |
$72,135.14
|
| Rate for Payer: EPIC Health Plan Senior |
$53,433.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$53,433.44
|
| Rate for Payer: InnovAge PACE Commercial |
$80,150.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53,433.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71,600.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71,600.81
|
| Rate for Payer: Multiplan WC |
$82,509.44
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$53,433.44
|
| Rate for Payer: Preferred Health Network WC |
$84,193.31
|
| Rate for Payer: Prime Health Services Medicare |
$56,639.45
|
| 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 |
$31,400.53
|
| Rate for Payer: EPIC Health Plan Senior |
$23,259.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,259.65
|
| Rate for Payer: InnovAge PACE Commercial |
$34,889.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,259.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,167.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,167.93
|
| Rate for Payer: Multiplan WC |
$35,221.06
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,259.65
|
| Rate for Payer: Preferred Health Network WC |
$35,939.86
|
| Rate for Payer: Prime Health Services Medicare |
$24,655.23
|
| 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
|
|
