|
APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$38,125.48
|
|
|
Service Code
|
APR-DRG 2824
|
| Min. Negotiated Rate |
$24,079.25 |
| Max. Negotiated Rate |
$38,125.48 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,079.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28,694.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38,125.48
|
|
|
APR-DRG 41.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$8,726.95
|
|
|
Service Code
|
APR-DRG 2821
|
| Min. Negotiated Rate |
$5,511.76 |
| Max. Negotiated Rate |
$8,726.95 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,511.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,568.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,726.95
|
|
|
APR-DRG 41.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
|
IP
|
$16,430.78
|
|
|
Service Code
|
APR-DRG 7523
|
| Min. Negotiated Rate |
$10,377.34 |
| Max. Negotiated Rate |
$16,430.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,377.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,366.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,430.78
|
|
|
APR-DRG 41.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
|
IP
|
$4,661.10
|
|
|
Service Code
|
APR-DRG 7521
|
| Min. Negotiated Rate |
$2,943.85 |
| Max. Negotiated Rate |
$4,661.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,943.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,508.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,661.10
|
|
|
APR-DRG 41.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
|
IP
|
$6,608.45
|
|
|
Service Code
|
APR-DRG 7522
|
| Min. Negotiated Rate |
$4,173.76 |
| Max. Negotiated Rate |
$6,608.45 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,173.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,973.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,608.45
|
|
|
APR-DRG 41.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
|
IP
|
$59,966.62
|
|
|
Service Code
|
APR-DRG 7524
|
| Min. Negotiated Rate |
$37,873.66 |
| Max. Negotiated Rate |
$59,966.62 |
| Rate for Payer: Adventist Health Medi-Cal |
$37,873.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$45,132.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59,966.62
|
|
|
APR-DRG 41.00: DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$11,250.51
|
|
|
Service Code
|
APR-DRG 2442
|
| Min. Negotiated Rate |
$7,105.58 |
| Max. Negotiated Rate |
$11,250.51 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,105.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,467.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,250.51
|
|
|
APR-DRG 41.00: DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$29,843.53
|
|
|
Service Code
|
APR-DRG 2444
|
| Min. Negotiated Rate |
$18,848.54 |
| Max. Negotiated Rate |
$29,843.53 |
| Rate for Payer: Adventist Health Medi-Cal |
$18,848.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,461.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,843.53
|
|
|
APR-DRG 41.00: DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$8,593.83
|
|
|
Service Code
|
APR-DRG 2441
|
| Min. Negotiated Rate |
$5,427.68 |
| Max. Negotiated Rate |
$8,593.83 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,427.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,467.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,593.83
|
|
|
APR-DRG 41.00: DIVERTICULITIS AND DIVERTICULOSIS
|
Facility
|
IP
|
$17,020.31
|
|
|
Service Code
|
APR-DRG 2443
|
| Min. Negotiated Rate |
$10,749.67 |
| Max. Negotiated Rate |
$17,020.31 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,749.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,810.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,020.31
|
|
|
APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK
|
Facility
|
IP
|
$75,764.13
|
|
|
Service Code
|
APR-DRG 3043
|
| Min. Negotiated Rate |
$47,851.03 |
| Max. Negotiated Rate |
$75,764.13 |
| Rate for Payer: Adventist Health Medi-Cal |
$47,851.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57,022.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$75,764.13
|
|
|
APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK
|
Facility
|
IP
|
$46,048.00
|
|
|
Service Code
|
APR-DRG 3041
|
| Min. Negotiated Rate |
$29,082.95 |
| Max. Negotiated Rate |
$46,048.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$29,082.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34,657.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46,048.00
|
|
|
APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK
|
Facility
|
IP
|
$54,484.00
|
|
|
Service Code
|
APR-DRG 3042
|
| Min. Negotiated Rate |
$34,410.95 |
| Max. Negotiated Rate |
$54,484.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$34,410.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41,006.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54,484.00
|
|
|
APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK
|
Facility
|
IP
|
$116,447.41
|
|
|
Service Code
|
APR-DRG 3044
|
| Min. Negotiated Rate |
$73,545.73 |
| Max. Negotiated Rate |
$116,447.41 |
| Rate for Payer: Adventist Health Medi-Cal |
$73,545.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87,642.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116,447.41
|
|
|
APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK
|
Facility
|
IP
|
$79,539.02
|
|
|
Service Code
|
APR-DRG 3032
|
| Min. Negotiated Rate |
$50,235.17 |
| Max. Negotiated Rate |
$79,539.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$50,235.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59,863.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79,539.02
|
|
|
APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK
|
Facility
|
IP
|
$109,610.75
|
|
|
Service Code
|
APR-DRG 3033
|
| Min. Negotiated Rate |
$69,227.84 |
| Max. Negotiated Rate |
$109,610.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$69,227.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$82,496.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109,610.75
|
|
|
APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK
|
Facility
|
IP
|
$160,321.75
|
|
|
Service Code
|
APR-DRG 3034
|
| Min. Negotiated Rate |
$101,255.84 |
| Max. Negotiated Rate |
$160,321.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$101,255.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$120,663.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160,321.75
|
|
|
APR-DRG 41.00: DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK
|
Facility
|
IP
|
$66,828.00
|
|
|
Service Code
|
APR-DRG 3031
|
| Min. Negotiated Rate |
$42,207.16 |
| Max. Negotiated Rate |
$66,828.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$42,207.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$50,296.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66,828.00
|
|
|
APR-DRG 41.00: DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
|
Facility
|
IP
|
$6,404.96
|
|
|
Service Code
|
APR-DRG 7702
|
| Min. Negotiated Rate |
$4,045.24 |
| Max. Negotiated Rate |
$6,404.96 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,045.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,820.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,404.96
|
|
|
APR-DRG 41.00: DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
|
Facility
|
IP
|
$21,476.00
|
|
|
Service Code
|
APR-DRG 7704
|
| Min. Negotiated Rate |
$13,563.79 |
| Max. Negotiated Rate |
$21,476.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,563.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,163.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21,476.00
|
|
|
APR-DRG 41.00: DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
|
Facility
|
IP
|
$9,999.19
|
|
|
Service Code
|
APR-DRG 7703
|
| Min. Negotiated Rate |
$6,315.28 |
| Max. Negotiated Rate |
$9,999.19 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,315.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,525.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,999.19
|
|
|
APR-DRG 41.00: DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
|
Facility
|
IP
|
$4,284.56
|
|
|
Service Code
|
APR-DRG 7701
|
| Min. Negotiated Rate |
$2,706.04 |
| Max. Negotiated Rate |
$4,284.56 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,706.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,224.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,284.56
|
|
|
APR-DRG 41.00: EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES
|
Facility
|
IP
|
$33,966.43
|
|
|
Service Code
|
APR-DRG 1104
|
| Min. Negotiated Rate |
$21,452.48 |
| Max. Negotiated Rate |
$33,966.43 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,452.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25,564.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33,966.43
|
|
|
APR-DRG 41.00: EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES
|
Facility
|
IP
|
$19,606.63
|
|
|
Service Code
|
APR-DRG 1103
|
| Min. Negotiated Rate |
$12,383.14 |
| Max. Negotiated Rate |
$19,606.63 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,383.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,756.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,606.63
|
|
|
APR-DRG 41.00: EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES
|
Facility
|
IP
|
$11,900.90
|
|
|
Service Code
|
APR-DRG 1101
|
| Min. Negotiated Rate |
$7,516.36 |
| Max. Negotiated Rate |
$11,900.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,516.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,956.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,900.90
|
|