|
MS-DRG 29.00: CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC
|
Facility
|
IP
|
$13,987.00
|
|
|
Service Code
|
MSDRG 227
|
| Min. Negotiated Rate |
$11,000.00 |
| Max. Negotiated Rate |
$13,987.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$11,000.00
|
|
|
MS-DRG 29.00: CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC
|
Facility
|
IP
|
$48,447.54
|
|
|
Service Code
|
MSDRG 258
|
| Min. Negotiated Rate |
$8,850.00 |
| Max. Negotiated Rate |
$48,447.54 |
| Rate for Payer: Cigna of CA HMO/PPO |
$11,000.00
|
|
|
MS-DRG 29.00: CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC
|
Facility
|
IP
|
$30,353.32
|
|
|
Service Code
|
MSDRG 259
|
| Min. Negotiated Rate |
$8,850.00 |
| Max. Negotiated Rate |
$30,353.32 |
| Rate for Payer: Cigna of CA HMO/PPO |
$11,000.00
|
|
|
MS-DRG 29.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC
|
Facility
|
IP
|
$32,769.22
|
|
|
Service Code
|
MSDRG 261
|
| Min. Negotiated Rate |
$8,850.00 |
| Max. Negotiated Rate |
$32,769.22 |
| Rate for Payer: Cigna of CA HMO/PPO |
$11,000.00
|
|
|
MS-DRG 29.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC
|
Facility
|
IP
|
$58,820.89
|
|
|
Service Code
|
MSDRG 260
|
| Min. Negotiated Rate |
$8,850.00 |
| Max. Negotiated Rate |
$58,820.89 |
| Rate for Payer: Cigna of CA HMO/PPO |
$11,000.00
|
|
|
MS-DRG 29.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC
|
Facility
|
IP
|
$28,979.00
|
|
|
Service Code
|
MSDRG 262
|
| Min. Negotiated Rate |
$8,850.00 |
| Max. Negotiated Rate |
$28,979.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$11,000.00
|
|
|
MS-DRG 29.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC
|
Facility
|
IP
|
$111,520.00
|
|
|
Service Code
|
MSDRG 217
|
| Min. Negotiated Rate |
$28,410.00 |
| Max. Negotiated Rate |
$111,520.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$32,400.00
|
|
|
MS-DRG 29.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC
|
Facility
|
IP
|
$166,662.64
|
|
|
Service Code
|
MSDRG 216
|
| Min. Negotiated Rate |
$28,410.00 |
| Max. Negotiated Rate |
$166,662.64 |
| Rate for Payer: Cigna of CA HMO/PPO |
$32,400.00
|
|
|
MS-DRG 29.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC
|
Facility
|
IP
|
$102,737.10
|
|
|
Service Code
|
MSDRG 218
|
| Min. Negotiated Rate |
$28,410.00 |
| Max. Negotiated Rate |
$102,737.10 |
| Rate for Payer: Cigna of CA HMO/PPO |
$32,400.00
|
|
|
MS-DRG 29.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC
|
Facility
|
IP
|
$91,467.51
|
|
|
Service Code
|
MSDRG 220
|
| Min. Negotiated Rate |
$28,410.00 |
| Max. Negotiated Rate |
$91,467.51 |
| Rate for Payer: Cigna of CA HMO/PPO |
$32,400.00
|
|
|
MS-DRG 29.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC
|
Facility
|
IP
|
$133,617.12
|
|
|
Service Code
|
MSDRG 219
|
| Min. Negotiated Rate |
$28,410.00 |
| Max. Negotiated Rate |
$133,617.12 |
| Rate for Payer: Cigna of CA HMO/PPO |
$32,400.00
|
|
|
MS-DRG 29.00: CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC
|
Facility
|
IP
|
$86,939.00
|
|
|
Service Code
|
MSDRG 221
|
| Min. Negotiated Rate |
$28,410.00 |
| Max. Negotiated Rate |
$86,939.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$32,400.00
|
|
|
MS-DRG 29.00: CAROTID ARTERY STENT PROCEDURE W CC
|
Facility
|
IP
|
$39,283.01
|
|
|
Service Code
|
MSDRG 035
|
| Min. Negotiated Rate |
$14,752.00 |
| Max. Negotiated Rate |
$39,283.01 |
| Rate for Payer: Cigna of CA HMO/PPO |
$24,300.00
|
|
|
MS-DRG 29.00: CAROTID ARTERY STENT PROCEDURE W MCC
|
Facility
|
IP
|
$67,153.07
|
|
|
Service Code
|
MSDRG 034
|
| Min. Negotiated Rate |
$14,752.00 |
| Max. Negotiated Rate |
$67,153.07 |
| Rate for Payer: Cigna of CA HMO/PPO |
$24,300.00
|
|
|
MS-DRG 29.00: CAROTID ARTERY STENT PROCEDURE W/O CC/MCC
|
Facility
|
IP
|
$31,655.38
|
|
|
Service Code
|
MSDRG 036
|
| Min. Negotiated Rate |
$14,752.00 |
| Max. Negotiated Rate |
$31,655.38 |
| Rate for Payer: Cigna of CA HMO/PPO |
$24,300.00
|
|
|
MS-DRG 29.00: CERVICAL SPINAL FUSION W CC
|
Facility
|
IP
|
$50,031.09
|
|
|
Service Code
|
MSDRG 472
|
| Min. Negotiated Rate |
$3,928.00 |
| Max. Negotiated Rate |
$50,031.09 |
| Rate for Payer: Cigna of CA HMO/PPO |
$21,600.00
|
|
|
MS-DRG 29.00: CERVICAL SPINAL FUSION W MCC
|
Facility
|
IP
|
$83,879.61
|
|
|
Service Code
|
MSDRG 471
|
| Min. Negotiated Rate |
$3,928.00 |
| Max. Negotiated Rate |
$83,879.61 |
| Rate for Payer: Cigna of CA HMO/PPO |
$21,600.00
|
|
|
MS-DRG 29.00: CERVICAL SPINAL FUSION W/O CC/MCC
|
Facility
|
IP
|
$40,882.09
|
|
|
Service Code
|
MSDRG 473
|
| Min. Negotiated Rate |
$3,928.00 |
| Max. Negotiated Rate |
$40,882.09 |
| Rate for Payer: Cigna of CA HMO/PPO |
$21,600.00
|
|
|
MS-DRG 29.00: CESAREAN SECTION W CC/MCC
|
Facility
|
IP
|
$7,435.00
|
|
|
Service Code
|
MSDRG 765
|
| Min. Negotiated Rate |
$7,435.00 |
| Max. Negotiated Rate |
$7,435.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$7,435.00
|
|
|
MS-DRG 29.00: CESAREAN SECTION W/O CC/MCC
|
Facility
|
IP
|
$7,435.00
|
|
|
Service Code
|
MSDRG 766
|
| Min. Negotiated Rate |
$7,435.00 |
| Max. Negotiated Rate |
$7,435.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$7,435.00
|
|
|
MS-DRG 29.00: CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC
|
Facility
|
IP
|
$38,220.97
|
|
|
Service Code
|
MSDRG 286
|
| Min. Negotiated Rate |
$8,633.00 |
| Max. Negotiated Rate |
$38,220.97 |
| Rate for Payer: Cigna of CA HMO/PPO |
$11,000.00
|
|
|
MS-DRG 29.00: CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC
|
Facility
|
IP
|
$18,817.78
|
|
|
Service Code
|
MSDRG 287
|
| Min. Negotiated Rate |
$8,633.00 |
| Max. Negotiated Rate |
$18,817.78 |
| Rate for Payer: Cigna of CA HMO/PPO |
$11,000.00
|
|
|
MS-DRG 29.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC
|
Facility
|
IP
|
$28,410.00
|
|
|
Service Code
|
MSDRG 454
|
| Min. Negotiated Rate |
$21,600.00 |
| Max. Negotiated Rate |
$28,410.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$21,600.00
|
|
|
MS-DRG 29.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC
|
Facility
|
IP
|
$28,410.00
|
|
|
Service Code
|
MSDRG 453
|
| Min. Negotiated Rate |
$21,600.00 |
| Max. Negotiated Rate |
$28,410.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$21,600.00
|
|
|
MS-DRG 29.00: COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC
|
Facility
|
IP
|
$28,410.00
|
|
|
Service Code
|
MSDRG 455
|
| Min. Negotiated Rate |
$21,600.00 |
| Max. Negotiated Rate |
$28,410.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$21,600.00
|
|