|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02C13ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 027J3DZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 027G3ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02704T6
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02733D6
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02724TZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 027H34Z
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02724ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 027J4DZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02713D6
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 027F4DZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02C24ZZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02713T6
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02703D6
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02704TZ
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 0270346
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 02714D6
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
Percutaneous Cardiovascular Procedure (PTCA)
|
Facility
IP
|
$11,541.00
|
|
|
Service Code
|
ICD 027334Z
|
| Min. Negotiated Rate |
$7,205.00 |
| Max. Negotiated Rate |
$11,541.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,022.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,205.00
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
IP
|
$29,483.78
|
|
|
Service Code
|
APR-DRG 0301
|
| Min. Negotiated Rate |
$22,617.16 |
| Max. Negotiated Rate |
$29,483.78 |
| Rate for Payer: IEHP Medi-Cal |
$22,617.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,483.78
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
IP
|
$39,507.36
|
|
|
Service Code
|
APR-DRG 0302
|
| Min. Negotiated Rate |
$30,306.31 |
| Max. Negotiated Rate |
$39,507.36 |
| Rate for Payer: IEHP Medi-Cal |
$30,306.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39,507.36
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
IP
|
$71,459.80
|
|
|
Service Code
|
APR-DRG 0304
|
| Min. Negotiated Rate |
$54,817.19 |
| Max. Negotiated Rate |
$71,459.80 |
| Rate for Payer: IEHP Medi-Cal |
$54,817.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71,459.80
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
IP
|
$54,126.00
|
|
|
Service Code
|
APR-DRG 0303
|
| Min. Negotiated Rate |
$41,520.34 |
| Max. Negotiated Rate |
$54,126.00 |
| Rate for Payer: IEHP Medi-Cal |
$41,520.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54,126.00
|
|
|
Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation
|
Facility
OP
|
$9,590.00
|
|
|
Service Code
|
CPT 25606
|
| Min. Negotiated Rate |
$987.96 |
| Max. Negotiated Rate |
$9,590.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: IEHP Medi-Cal |
$6,551.62
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,551.62
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$987.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation
|
Facility
OP
|
$14,659.19
|
|
|
Service Code
|
CPT 24582
|
| Min. Negotiated Rate |
$662.82 |
| Max. Negotiated Rate |
$14,659.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: IEHP Medi-Cal |
$14,480.42
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$14,480.42
|
| Rate for Payer: IEHP Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$662.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension
|
Facility
OP
|
$14,659.19
|
|
|
Service Code
|
CPT 24538
|
| Min. Negotiated Rate |
$801.46 |
| Max. Negotiated Rate |
$14,659.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: IEHP Medi-Cal |
$14,480.42
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$14,480.42
|
| Rate for Payer: IEHP Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$801.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
