|
ANASTROZOLE 1 MG TABLET [16205]
|
Facility
IP
|
$1.09
|
|
|
Service Code
|
CPT S0170
|
| Hospital Charge Code |
1711729
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$0.82
|
| Rate for Payer: Blue Shield of California Commercial |
$0.45
|
| Rate for Payer: Blue Shield of California Commercial |
$0.14
|
| Rate for Payer: Blue Shield of California EPN |
$0.32
|
| Rate for Payer: Blue Shield of California EPN |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.58
|
| Rate for Payer: Cash Price |
$0.27
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cash Price |
$0.27
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Central Health Plan Commercial |
$0.48
|
| Rate for Payer: Central Health Plan Commercial |
$0.15
|
| Rate for Payer: Central Health Plan Commercial |
$0.87
|
| Rate for Payer: Cigna of CA HMO |
$0.13
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA HMO |
$0.42
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.13
|
| Rate for Payer: Cigna of CA PPO |
$0.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.44
|
| Rate for Payer: Galaxy Health WC |
$0.16
|
| Rate for Payer: Galaxy Health WC |
$0.51
|
| Rate for Payer: Galaxy Health WC |
$0.93
|
| Rate for Payer: Global Benefits Group Commercial |
$0.11
|
| Rate for Payer: Global Benefits Group Commercial |
$0.36
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$0.82
|
| Rate for Payer: Multiplan Commercial |
$0.14
|
| Rate for Payer: Networks By Design Commercial |
$0.39
|
| Rate for Payer: Networks By Design Commercial |
$0.12
|
| Rate for Payer: Networks By Design Commercial |
$0.71
|
| Rate for Payer: Prime Health Services Commercial |
$0.16
|
| Rate for Payer: Prime Health Services Commercial |
$0.51
|
| Rate for Payer: Prime Health Services Commercial |
$0.93
|
|
|
ANGINA PECTORIS
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
TRIS-DRG 311
|
| Min. Negotiated Rate |
$34,005.88 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 1981
|
| Min. Negotiated Rate |
$4,686.42 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,686.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$5,584.65
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 1983
|
| Min. Negotiated Rate |
$7,389.17 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,389.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$8,805.43
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 1982
|
| Min. Negotiated Rate |
$5,600.40 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,600.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$6,673.81
|
|
|
ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 1984
|
| Min. Negotiated Rate |
$12,847.32 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,847.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$15,309.72
|
|
|
ANGIOTENSIN II 2.5 MG/ML INTRAVENOUS SOLUTION [220829]
|
Facility
OP
|
$1,800.00
|
|
|
Service Code
|
CPT C9399
|
| Hospital Charge Code |
NDG220829
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$360.00 |
| Max. Negotiated Rate |
$1,620.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,093.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,530.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$990.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$990.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$871.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,063.44
|
| Rate for Payer: BCBS Transplant Transplant |
$1,080.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,132.20
|
| Rate for Payer: Blue Shield of California EPN |
$880.20
|
| Rate for Payer: Cash Price |
$810.00
|
| Rate for Payer: Cash Price |
$810.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,440.00
|
| Rate for Payer: Cigna of CA HMO |
$1,260.00
|
| Rate for Payer: Cigna of CA PPO |
$1,260.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,530.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$720.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$720.00
|
| Rate for Payer: Galaxy Health WC |
$1,530.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,080.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,620.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,350.00
|
| Rate for Payer: IEHP medi-cal |
$630.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,200.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$360.00
|
| Rate for Payer: Multiplan Commercial |
$1,350.00
|
| Rate for Payer: Networks By Design Commercial |
$900.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,530.00
|
| Rate for Payer: Riverside University Health MISP |
$720.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,080.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,080.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$900.00
|
| Rate for Payer: United Healthcare All Other HMO |
$900.00
|
| Rate for Payer: United Healthcare HMO Rider |
$900.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$900.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,530.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,530.00
|
|
|
ANGIOTENSIN II 2.5 MG/ML INTRAVENOUS SOLUTION [220829]
|
Facility
IP
|
$1,800.00
|
|
|
Service Code
|
CPT C9399
|
| Hospital Charge Code |
NDG220829
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$360.00 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,350.00
|
| Rate for Payer: Blue Shield of California EPN |
$961.20
|
| Rate for Payer: Cash Price |
$810.00
|
| Rate for Payer: Cash Price |
$810.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,440.00
|
| Rate for Payer: Cigna of CA HMO |
$1,260.00
|
| Rate for Payer: Cigna of CA PPO |
$1,260.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$720.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$720.00
|
| Rate for Payer: Galaxy Health WC |
$1,530.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,080.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,620.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,200.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$360.00
|
| Rate for Payer: Multiplan Commercial |
$1,350.00
|
| Rate for Payer: Networks By Design Commercial |
$900.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,530.00
|
|
|
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION [88093]
|
Facility
OP
|
$229.07
|
|
|
Service Code
|
CPT J0348
|
| Hospital Charge Code |
1753552
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$206.16 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$194.71
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$125.99
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$125.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.07
|
| Rate for Payer: BCBS Transplant Transplant |
$137.44
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$103.08
|
| Rate for Payer: Cash Price |
$103.08
|
| Rate for Payer: Central Health Plan Commercial |
$183.26
|
| Rate for Payer: Cigna of CA HMO |
$160.35
|
| Rate for Payer: Cigna of CA PPO |
$160.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$194.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.63
|
| Rate for Payer: Galaxy Health WC |
$194.71
|
| Rate for Payer: Global Benefits Group Commercial |
$137.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$206.16
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$171.80
|
| Rate for Payer: IEHP medi-cal |
$0.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.81
|
| Rate for Payer: Multiplan Commercial |
$171.80
|
| Rate for Payer: Networks By Design Commercial |
$114.54
|
| Rate for Payer: Prime Health Services Commercial |
$194.71
|
| Rate for Payer: Riverside University Health MISP |
$91.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$137.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$137.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.54
|
| Rate for Payer: United Healthcare All Other HMO |
$114.54
|
| Rate for Payer: United Healthcare HMO Rider |
$114.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$194.71
|
| Rate for Payer: Vantage Medical Group Senior |
$194.71
|
|
|
ANIDULAFUNGIN 100 MG INTRAVENOUS SOLUTION [88093]
|
Facility
IP
|
$229.07
|
|
|
Service Code
|
CPT J0348
|
| Hospital Charge Code |
1753552
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$45.81 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$171.80
|
| Rate for Payer: Blue Shield of California EPN |
$122.32
|
| Rate for Payer: Cash Price |
$103.08
|
| Rate for Payer: Cash Price |
$103.08
|
| Rate for Payer: Central Health Plan Commercial |
$183.26
|
| Rate for Payer: Cigna of CA HMO |
$160.35
|
| Rate for Payer: Cigna of CA PPO |
$160.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.63
|
| Rate for Payer: Galaxy Health WC |
$194.71
|
| Rate for Payer: Global Benefits Group Commercial |
$137.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$206.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.81
|
| Rate for Payer: Multiplan Commercial |
$171.80
|
| Rate for Payer: Networks By Design Commercial |
$114.54
|
| Rate for Payer: Prime Health Services Commercial |
$194.71
|
|
|
Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 45990
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,508.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,508.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$3,508.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,262.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,736.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,508.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,508.15
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,753.37
|
| Rate for Payer: IEHP medi-cal |
$5,788.45
|
| Rate for Payer: IEHP Medicare Advantage |
$3,508.15
|
| Rate for Payer: Innovage PACE Commercial |
$5,262.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,508.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,700.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,700.92
|
| Rate for Payer: Prime Health Services Medicare |
$3,718.64
|
| Rate for Payer: Riverside University Health MISP |
$3,858.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,508.15
|
|
|
Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 46600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
Anoscopy; with biopsy, single or multiple
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 46606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,474.42 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 0591
|
| Min. Negotiated Rate |
$5,145.65 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,145.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$6,131.90
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 0592
|
| Min. Negotiated Rate |
$8,452.13 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,452.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$10,072.12
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 0593
|
| Min. Negotiated Rate |
$11,923.25 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,923.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$14,208.54
|
|
|
ANOXIC AND OTHER SEVERE BRAIN DAMAGE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 0594
|
| Min. Negotiated Rate |
$16,502.14 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,502.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$19,665.05
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 5472
|
| Min. Negotiated Rate |
$8,459.96 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,459.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$10,081.46
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 5474
|
| Min. Negotiated Rate |
$24,702.13 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,702.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$29,436.71
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 5471
|
| Min. Negotiated Rate |
$6,050.68 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,050.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$7,210.39
|
|
|
ANTEPARTUM WITH O.R. PROCEDURE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 5473
|
| Min. Negotiated Rate |
$12,570.66 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,570.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$14,980.04
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 5664
|
| Min. Negotiated Rate |
$11,293.32 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,293.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$13,457.87
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 5663
|
| Min. Negotiated Rate |
$4,628.17 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,628.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$5,515.24
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 5662
|
| Min. Negotiated Rate |
$3,179.90 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,179.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$3,789.39
|
|
|
ANTEPARTUM WITHOUT O.R. PROCEDURE
|
Facility
IP
|
$34,005.88
|
|
|
Service Code
|
APR-DRG 5661
|
| Min. Negotiated Rate |
$2,363.36 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,363.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: IEHP medi-cal |
$2,816.34
|
|
