|
UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$32,653.98
|
|
|
Service Code
|
MSDRG 743
|
| Min. Negotiated Rate |
$18,013.39 |
| Max. Negotiated Rate |
$32,653.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,653.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,093.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29,531.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,722.09
|
| Rate for Payer: EPIC Health Plan Senior |
$19,814.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18,013.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,218.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24,137.94
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18,013.39
|
| Rate for Payer: Prime Health Services Medicare |
$19,094.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$24,996.00
|
| Rate for Payer: United Healthcare All Other HMO |
$24,996.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,398.00
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY
|
Facility
|
IP
|
$72,482.64
|
|
|
Service Code
|
APR-DRG 5124
|
| Min. Negotiated Rate |
$45,778.51 |
| Max. Negotiated Rate |
$72,482.64 |
| Rate for Payer: Adventist Health Medi-Cal |
$45,778.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$54,552.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72,482.64
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY
|
Facility
|
IP
|
$24,536.87
|
|
|
Service Code
|
APR-DRG 5122
|
| Min. Negotiated Rate |
$15,496.97 |
| Max. Negotiated Rate |
$24,536.87 |
| Rate for Payer: Adventist Health Medi-Cal |
$15,496.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18,467.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24,536.87
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY
|
Facility
|
IP
|
$20,907.30
|
|
|
Service Code
|
APR-DRG 5121
|
| Min. Negotiated Rate |
$13,204.61 |
| Max. Negotiated Rate |
$20,907.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,204.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,735.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20,907.30
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY
|
Facility
|
IP
|
$38,908.11
|
|
|
Service Code
|
APR-DRG 5123
|
| Min. Negotiated Rate |
$24,573.54 |
| Max. Negotiated Rate |
$38,908.11 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,573.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29,283.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38,908.11
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$47,626.86
|
|
|
Service Code
|
MSDRG 740
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$47,626.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47,626.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,765.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43,072.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,668.49
|
| Rate for Payer: EPIC Health Plan Senior |
$28,445.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,859.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36,203.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$34,651.98
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25,859.69
|
| Rate for Payer: Prime Health Services Medicare |
$27,411.27
|
| 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
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$92,808.69
|
|
|
Service Code
|
MSDRG 739
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$92,808.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92,808.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59,950.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83,932.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$83,020.97
|
| Rate for Payer: EPIC Health Plan Senior |
$55,347.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,315.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70,442.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$67,423.09
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$50,315.74
|
| Rate for Payer: Prime Health Services Medicare |
$53,334.68
|
| 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
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$37,533.53
|
|
|
Service Code
|
MSDRG 741
|
| Min. Negotiated Rate |
$20,570.44 |
| Max. Negotiated Rate |
$37,533.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37,533.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,245.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33,944.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,941.23
|
| Rate for Payer: EPIC Health Plan Senior |
$22,627.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20,570.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28,798.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27,564.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20,570.44
|
| Rate for Payer: Prime Health Services Medicare |
$21,804.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$24,996.00
|
| Rate for Payer: United Healthcare All Other HMO |
$24,996.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,398.00
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY
|
Facility
|
IP
|
$72,839.16
|
|
|
Service Code
|
APR-DRG 5114
|
| Min. Negotiated Rate |
$46,003.68 |
| Max. Negotiated Rate |
$72,839.16 |
| Rate for Payer: Adventist Health Medi-Cal |
$46,003.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$54,821.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72,839.16
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY
|
Facility
|
IP
|
$26,319.43
|
|
|
Service Code
|
APR-DRG 5112
|
| Min. Negotiated Rate |
$16,622.80 |
| Max. Negotiated Rate |
$26,319.43 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,622.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19,808.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$26,319.43
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY
|
Facility
|
IP
|
$21,618.29
|
|
|
Service Code
|
APR-DRG 5111
|
| Min. Negotiated Rate |
$13,653.66 |
| Max. Negotiated Rate |
$21,618.29 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,653.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,270.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21,618.29
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY
|
Facility
|
IP
|
$38,873.87
|
|
|
Service Code
|
APR-DRG 5113
|
| Min. Negotiated Rate |
$24,551.92 |
| Max. Negotiated Rate |
$38,873.87 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,551.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29,257.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38,873.87
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC
|
Facility
|
IP
|
$54,232.93
|
|
|
Service Code
|
MSDRG 737
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$54,232.93 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54,232.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35,032.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49,046.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,380.47
|
| Rate for Payer: EPIC Health Plan Senior |
$32,253.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,321.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41,050.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$39,290.81
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$29,321.50
|
| Rate for Payer: Prime Health Services Medicare |
$31,080.79
|
| 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
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC
|
Facility
|
IP
|
$94,077.27
|
|
|
Service Code
|
MSDRG 736
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$94,077.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$94,077.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60,770.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85,080.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$82,832.08
|
| Rate for Payer: EPIC Health Plan Senior |
$55,221.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$50,201.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70,281.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$67,269.69
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$50,201.26
|
| Rate for Payer: Prime Health Services Medicare |
$53,213.34
|
| 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
|
|
|
UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$38,649.45
|
|
|
Service Code
|
MSDRG 738
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$38,649.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,649.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24,965.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,953.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,906.13
|
| Rate for Payer: EPIC Health Plan Senior |
$23,270.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,155.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29,617.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28,348.01
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,155.23
|
| Rate for Payer: Prime Health Services Medicare |
$22,424.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$45,718.73
|
|
|
Service Code
|
MSDRG 746
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$45,718.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,718.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,532.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,346.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$41,018.60
|
| Rate for Payer: EPIC Health Plan Senior |
$27,345.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,859.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,803.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,312.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,859.76
|
| Rate for Payer: Prime Health Services Medicare |
$26,351.35
|
| 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
|
|
|
VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$22,094.80
|
|
|
Service Code
|
MSDRG 747
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$22,094.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,094.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14,272.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,981.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,051.72
|
| Rate for Payer: EPIC Health Plan Senior |
$14,034.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,758.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,862.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17,096.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12,758.62
|
| Rate for Payer: Prime Health Services Medicare |
$13,524.14
|
| 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
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$10,043.36
|
|
|
Service Code
|
APR-DRG 5603
|
| Min. Negotiated Rate |
$6,343.18 |
| Max. Negotiated Rate |
$10,043.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,343.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,558.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,043.36
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$18,579.19
|
|
|
Service Code
|
APR-DRG 5604
|
| Min. Negotiated Rate |
$11,734.22 |
| Max. Negotiated Rate |
$18,579.19 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,734.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,983.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18,579.19
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$7,118.75
|
|
|
Service Code
|
APR-DRG 5602
|
| Min. Negotiated Rate |
$4,496.05 |
| Max. Negotiated Rate |
$7,118.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,496.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,357.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,118.75
|
|
|
VAGINAL DELIVERY
|
Facility
|
IP
|
$6,132.80
|
|
|
Service Code
|
APR-DRG 5601
|
| Min. Negotiated Rate |
$3,873.35 |
| Max. Negotiated Rate |
$6,132.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,873.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,615.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,132.80
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$41,244.36
|
|
|
Service Code
|
APR-DRG 5424
|
| Min. Negotiated Rate |
$26,049.07 |
| Max. Negotiated Rate |
$41,244.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$26,049.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31,041.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41,244.36
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$14,044.74
|
|
|
Service Code
|
APR-DRG 5423
|
| Min. Negotiated Rate |
$8,870.36 |
| Max. Negotiated Rate |
$14,044.74 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,870.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,570.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14,044.74
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$7,094.37
|
|
|
Service Code
|
APR-DRG 5421
|
| Min. Negotiated Rate |
$4,480.66 |
| Max. Negotiated Rate |
$7,094.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,480.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,339.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,094.37
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$8,248.72
|
|
|
Service Code
|
APR-DRG 5422
|
| Min. Negotiated Rate |
$5,209.72 |
| Max. Negotiated Rate |
$8,248.72 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,209.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,208.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,248.72
|
|
