|
OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES
|
Facility
IP
|
$6,277.79
|
|
|
Service Code
|
APR-DRG 1432
|
| Min. Negotiated Rate |
$6,277.79 |
| Max. Negotiated Rate |
$6,277.79 |
| Rate for Payer: IEHP Medi-Cal |
$6,277.79
|
|
|
OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES
|
Facility
IP
|
$8,981.92
|
|
|
Service Code
|
APR-DRG 1433
|
| Min. Negotiated Rate |
$8,981.92 |
| Max. Negotiated Rate |
$8,981.92 |
| Rate for Payer: IEHP Medi-Cal |
$8,981.92
|
|
|
OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES
|
Facility
IP
|
$4,430.27
|
|
|
Service Code
|
APR-DRG 1431
|
| Min. Negotiated Rate |
$4,430.27 |
| Max. Negotiated Rate |
$4,430.27 |
| Rate for Payer: IEHP Medi-Cal |
$4,430.27
|
|
|
OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES
|
Facility
IP
|
$13,834.03
|
|
|
Service Code
|
APR-DRG 1434
|
| Min. Negotiated Rate |
$13,834.03 |
| Max. Negotiated Rate |
$13,834.03 |
| Rate for Payer: IEHP Medi-Cal |
$13,834.03
|
|
|
OTHER SIGNIFICANT HIP AND FEMUR SURGERY
|
Facility
IP
|
$12,039.24
|
|
|
Service Code
|
APR-DRG 3091
|
| Min. Negotiated Rate |
$12,039.24 |
| Max. Negotiated Rate |
$12,039.24 |
| Rate for Payer: IEHP Medi-Cal |
$12,039.24
|
|
|
OTHER SIGNIFICANT HIP AND FEMUR SURGERY
|
Facility
IP
|
$36,426.13
|
|
|
Service Code
|
APR-DRG 3094
|
| Min. Negotiated Rate |
$36,426.13 |
| Max. Negotiated Rate |
$36,426.13 |
| Rate for Payer: IEHP Medi-Cal |
$36,426.13
|
|
|
OTHER SIGNIFICANT HIP AND FEMUR SURGERY
|
Facility
IP
|
$16,011.85
|
|
|
Service Code
|
APR-DRG 3092
|
| Min. Negotiated Rate |
$16,011.85 |
| Max. Negotiated Rate |
$16,011.85 |
| Rate for Payer: IEHP Medi-Cal |
$16,011.85
|
|
|
OTHER SIGNIFICANT HIP AND FEMUR SURGERY
|
Facility
IP
|
$22,772.18
|
|
|
Service Code
|
APR-DRG 3093
|
| Min. Negotiated Rate |
$22,772.18 |
| Max. Negotiated Rate |
$22,772.18 |
| Rate for Payer: IEHP Medi-Cal |
$22,772.18
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS
|
Facility
IP
|
$15,399.00
|
|
|
Service Code
|
APR-DRG 3854
|
| Min. Negotiated Rate |
$15,399.00 |
| Max. Negotiated Rate |
$15,399.00 |
| Rate for Payer: IEHP Medi-Cal |
$15,399.00
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS
|
Facility
IP
|
$7,675.62
|
|
|
Service Code
|
APR-DRG 3853
|
| Min. Negotiated Rate |
$7,675.62 |
| Max. Negotiated Rate |
$7,675.62 |
| Rate for Payer: IEHP Medi-Cal |
$7,675.62
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS
|
Facility
IP
|
$3,747.77
|
|
|
Service Code
|
APR-DRG 3851
|
| Min. Negotiated Rate |
$3,747.77 |
| Max. Negotiated Rate |
$3,747.77 |
| Rate for Payer: IEHP Medi-Cal |
$3,747.77
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS
|
Facility
IP
|
$4,943.64
|
|
|
Service Code
|
APR-DRG 3852
|
| Min. Negotiated Rate |
$4,943.64 |
| Max. Negotiated Rate |
$4,943.64 |
| Rate for Payer: IEHP Medi-Cal |
$4,943.64
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES
|
Facility
IP
|
$9,155.03
|
|
|
Service Code
|
APR-DRG 3642
|
| Min. Negotiated Rate |
$9,155.03 |
| Max. Negotiated Rate |
$9,155.03 |
| Rate for Payer: IEHP Medi-Cal |
$9,155.03
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES
|
Facility
IP
|
$26,131.94
|
|
|
Service Code
|
APR-DRG 3644
|
| Min. Negotiated Rate |
$26,131.94 |
| Max. Negotiated Rate |
$26,131.94 |
| Rate for Payer: IEHP Medi-Cal |
$26,131.94
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES
|
Facility
IP
|
$6,626.01
|
|
|
Service Code
|
APR-DRG 3641
|
| Min. Negotiated Rate |
$6,626.01 |
| Max. Negotiated Rate |
$6,626.01 |
| Rate for Payer: IEHP Medi-Cal |
$6,626.01
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES
|
Facility
IP
|
$14,619.99
|
|
|
Service Code
|
APR-DRG 3643
|
| Min. Negotiated Rate |
$14,619.99 |
| Max. Negotiated Rate |
$14,619.99 |
| Rate for Payer: IEHP Medi-Cal |
$14,619.99
|
|
|
OTHER SMALL AND LARGE BOWEL PROCEDURES
|
Facility
IP
|
$34,359.72
|
|
|
Service Code
|
APR-DRG 2234
|
| Min. Negotiated Rate |
$34,359.72 |
| Max. Negotiated Rate |
$34,359.72 |
| Rate for Payer: IEHP Medi-Cal |
$34,359.72
|
|
|
OTHER SMALL AND LARGE BOWEL PROCEDURES
|
Facility
IP
|
$13,852.93
|
|
|
Service Code
|
APR-DRG 2232
|
| Min. Negotiated Rate |
$13,852.93 |
| Max. Negotiated Rate |
$13,852.93 |
| Rate for Payer: IEHP Medi-Cal |
$13,852.93
|
|
|
OTHER SMALL AND LARGE BOWEL PROCEDURES
|
Facility
IP
|
$9,157.02
|
|
|
Service Code
|
APR-DRG 2231
|
| Min. Negotiated Rate |
$9,157.02 |
| Max. Negotiated Rate |
$9,157.02 |
| Rate for Payer: IEHP Medi-Cal |
$9,157.02
|
|
|
OTHER SMALL AND LARGE BOWEL PROCEDURES
|
Facility
IP
|
$19,470.11
|
|
|
Service Code
|
APR-DRG 2233
|
| Min. Negotiated Rate |
$19,470.11 |
| Max. Negotiated Rate |
$19,470.11 |
| Rate for Payer: IEHP Medi-Cal |
$19,470.11
|
|
|
OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
IP
|
$6,653.87
|
|
|
Service Code
|
APR-DRG 2221
|
| Min. Negotiated Rate |
$6,653.87 |
| Max. Negotiated Rate |
$6,653.87 |
| Rate for Payer: IEHP Medi-Cal |
$6,653.87
|
|
|
OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
IP
|
$16,767.97
|
|
|
Service Code
|
APR-DRG 2223
|
| Min. Negotiated Rate |
$16,767.97 |
| Max. Negotiated Rate |
$16,767.97 |
| Rate for Payer: IEHP Medi-Cal |
$16,767.97
|
|
|
OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
IP
|
$11,225.41
|
|
|
Service Code
|
APR-DRG 2222
|
| Min. Negotiated Rate |
$11,225.41 |
| Max. Negotiated Rate |
$11,225.41 |
| Rate for Payer: IEHP Medi-Cal |
$11,225.41
|
|
|
OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES
|
Facility
IP
|
$35,749.60
|
|
|
Service Code
|
APR-DRG 2224
|
| Min. Negotiated Rate |
$35,749.60 |
| Max. Negotiated Rate |
$35,749.60 |
| Rate for Payer: IEHP Medi-Cal |
$35,749.60
|
|
|
Otolaryngologic examination under general anesthesia
|
Facility
OP
|
$3,237.00
|
|
|
Service Code
|
CPT 92502
|
| Min. Negotiated Rate |
$96.35 |
| Max. Negotiated Rate |
$3,237.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$223.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$687.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: Dignity Health Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Medicare |
$687.44
|
| Rate for Payer: Humana Medicare |
$687.44
|
| Rate for Payer: IEHP Medi-Cal |
$96.35
|
| Rate for Payer: IEHP Medicare Advantage |
$687.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,306.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$811.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$866.17
|
| Rate for Payer: TriValley Medical Group Commercial |
$756.18
|
| Rate for Payer: TriValley Medical Group Senior |
$687.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
