|
APR-DRG 41.00: FRACTURE OF PELVIS OR DISLOCATION OF HIP
|
Facility
|
IP
|
$10,189.36
|
|
|
Service Code
|
APR-DRG 3412
|
| Min. Negotiated Rate |
$6,435.38 |
| Max. Negotiated Rate |
$10,189.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,435.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,668.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,189.36
|
|
|
APR-DRG 41.00: FRACTURE OF PELVIS OR DISLOCATION OF HIP
|
Facility
|
IP
|
$13,374.73
|
|
|
Service Code
|
APR-DRG 3413
|
| Min. Negotiated Rate |
$8,447.20 |
| Max. Negotiated Rate |
$13,374.73 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,447.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,066.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,374.73
|
|
|
APR-DRG 41.00: FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK
|
Facility
|
IP
|
$8,455.00
|
|
|
Service Code
|
APR-DRG 3421
|
| Min. Negotiated Rate |
$5,340.00 |
| Max. Negotiated Rate |
$8,455.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,340.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,363.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,455.00
|
|
|
APR-DRG 41.00: FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK
|
Facility
|
IP
|
$15,898.29
|
|
|
Service Code
|
APR-DRG 3423
|
| Min. Negotiated Rate |
$10,041.02 |
| Max. Negotiated Rate |
$15,898.29 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,041.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,965.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,898.29
|
|
|
APR-DRG 41.00: FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK
|
Facility
|
IP
|
$11,163.03
|
|
|
Service Code
|
APR-DRG 3422
|
| Min. Negotiated Rate |
$7,050.34 |
| Max. Negotiated Rate |
$11,163.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,050.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,401.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,163.03
|
|
|
APR-DRG 41.00: FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK
|
Facility
|
IP
|
$27,472.10
|
|
|
Service Code
|
APR-DRG 3424
|
| Min. Negotiated Rate |
$17,350.80 |
| Max. Negotiated Rate |
$27,472.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$17,350.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20,676.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27,472.10
|
|
|
APR-DRG 41.00: GASTRIC FUNDOPLICATION
|
Facility
|
IP
|
$18,790.79
|
|
|
Service Code
|
APR-DRG 2321
|
| Min. Negotiated Rate |
$11,867.87 |
| Max. Negotiated Rate |
$18,790.79 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,867.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,142.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,790.79
|
|
|
APR-DRG 41.00: GASTRIC FUNDOPLICATION
|
Facility
|
IP
|
$74,714.38
|
|
|
Service Code
|
APR-DRG 2324
|
| Min. Negotiated Rate |
$47,188.03 |
| Max. Negotiated Rate |
$74,714.38 |
| Rate for Payer: Adventist Health Medi-Cal |
$47,188.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$56,232.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74,714.38
|
|
|
APR-DRG 41.00: GASTRIC FUNDOPLICATION
|
Facility
|
IP
|
$22,367.92
|
|
|
Service Code
|
APR-DRG 2322
|
| Min. Negotiated Rate |
$14,127.11 |
| Max. Negotiated Rate |
$22,367.92 |
| Rate for Payer: Adventist Health Medi-Cal |
$14,127.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,834.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,367.92
|
|
|
APR-DRG 41.00: GASTRIC FUNDOPLICATION
|
Facility
|
IP
|
$31,096.77
|
|
|
Service Code
|
APR-DRG 2323
|
| Min. Negotiated Rate |
$19,640.06 |
| Max. Negotiated Rate |
$31,096.77 |
| Rate for Payer: Adventist Health Medi-Cal |
$19,640.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23,404.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31,096.77
|
|
|
APR-DRG 41.00: GASTROINTESTINAL VASCULAR INSUFFICIENCY
|
Facility
|
IP
|
$25,579.91
|
|
|
Service Code
|
APR-DRG 2464
|
| Min. Negotiated Rate |
$16,155.73 |
| Max. Negotiated Rate |
$25,579.91 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,155.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19,252.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,579.91
|
|
|
APR-DRG 41.00: GASTROINTESTINAL VASCULAR INSUFFICIENCY
|
Facility
|
IP
|
$9,852.75
|
|
|
Service Code
|
APR-DRG 2461
|
| Min. Negotiated Rate |
$6,222.79 |
| Max. Negotiated Rate |
$9,852.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,222.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,415.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,852.75
|
|
|
APR-DRG 41.00: GASTROINTESTINAL VASCULAR INSUFFICIENCY
|
Facility
|
IP
|
$12,361.11
|
|
|
Service Code
|
APR-DRG 2462
|
| Min. Negotiated Rate |
$7,807.02 |
| Max. Negotiated Rate |
$12,361.11 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,807.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,303.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,361.11
|
|
|
APR-DRG 41.00: GASTROINTESTINAL VASCULAR INSUFFICIENCY
|
Facility
|
IP
|
$17,239.00
|
|
|
Service Code
|
APR-DRG 2463
|
| Min. Negotiated Rate |
$10,887.79 |
| Max. Negotiated Rate |
$17,239.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,887.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,974.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,239.00
|
|
|
APR-DRG 41.00: GENDER RELATED PROCEDURES
|
Facility
|
IP
|
$45,374.79
|
|
|
Service Code
|
APR-DRG 8513
|
| Min. Negotiated Rate |
$28,657.76 |
| Max. Negotiated Rate |
$45,374.79 |
| Rate for Payer: Adventist Health Medi-Cal |
$28,657.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$34,150.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45,374.79
|
|
|
APR-DRG 41.00: GENDER RELATED PROCEDURES
|
Facility
|
IP
|
$26,774.17
|
|
|
Service Code
|
APR-DRG 8511
|
| Min. Negotiated Rate |
$16,910.00 |
| Max. Negotiated Rate |
$26,774.17 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,910.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20,151.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26,774.17
|
|
|
APR-DRG 41.00: GENDER RELATED PROCEDURES
|
Facility
|
IP
|
$139,697.71
|
|
|
Service Code
|
APR-DRG 8514
|
| Min. Negotiated Rate |
$88,230.13 |
| Max. Negotiated Rate |
$139,697.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$88,230.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$105,140.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$139,697.71
|
|
|
APR-DRG 41.00: GENDER RELATED PROCEDURES
|
Facility
|
IP
|
$30,832.42
|
|
|
Service Code
|
APR-DRG 8512
|
| Min. Negotiated Rate |
$19,473.11 |
| Max. Negotiated Rate |
$30,832.42 |
| Rate for Payer: Adventist Health Medi-Cal |
$19,473.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23,205.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,832.42
|
|
|
APR-DRG 41.00: HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$28,040.71
|
|
|
Service Code
|
APR-DRG 3163
|
| Min. Negotiated Rate |
$17,709.92 |
| Max. Negotiated Rate |
$28,040.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$17,709.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21,104.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,040.71
|
|
|
APR-DRG 41.00: HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$51,827.31
|
|
|
Service Code
|
APR-DRG 3164
|
| Min. Negotiated Rate |
$32,733.04 |
| Max. Negotiated Rate |
$51,827.31 |
| Rate for Payer: Adventist Health Medi-Cal |
$32,733.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39,006.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51,827.31
|
|
|
APR-DRG 41.00: HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$13,665.69
|
|
|
Service Code
|
APR-DRG 3161
|
| Min. Negotiated Rate |
$8,630.96 |
| Max. Negotiated Rate |
$13,665.69 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,630.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,285.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,665.69
|
|
|
APR-DRG 41.00: HAND AND WRIST PROCEDURES
|
Facility
|
IP
|
$18,235.50
|
|
|
Service Code
|
APR-DRG 3162
|
| Min. Negotiated Rate |
$11,517.16 |
| Max. Negotiated Rate |
$18,235.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,517.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,724.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,235.50
|
|
|
APR-DRG 41.00: HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE
|
Facility
|
IP
|
$22,135.91
|
|
|
Service Code
|
APR-DRG 0553
|
| Min. Negotiated Rate |
$13,980.58 |
| Max. Negotiated Rate |
$22,135.91 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,980.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,660.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,135.91
|
|
|
APR-DRG 41.00: HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE
|
Facility
|
IP
|
$39,785.68
|
|
|
Service Code
|
APR-DRG 0554
|
| Min. Negotiated Rate |
$25,127.80 |
| Max. Negotiated Rate |
$39,785.68 |
| Rate for Payer: Adventist Health Medi-Cal |
$25,127.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29,943.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39,785.68
|
|
|
APR-DRG 41.00: HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE
|
Facility
|
IP
|
$10,252.11
|
|
|
Service Code
|
APR-DRG 0551
|
| Min. Negotiated Rate |
$6,475.02 |
| Max. Negotiated Rate |
$10,252.11 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,475.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,716.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,252.11
|
|