|
HC STRAIGHT PUSHABLE COIL
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
909081804
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC STRAP CLAVICLE MEDIUM
|
Facility
|
IP
|
$37.31
|
|
|
Service Code
|
CPT L3650
|
| Hospital Charge Code |
901607796
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cigna of CA HMO |
$26.12
|
| Rate for Payer: Cigna of CA PPO |
$26.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.95
|
| Rate for Payer: Multiplan Commercial |
$29.85
|
| Rate for Payer: Networks By Design Commercial |
$24.25
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13.63
|
| Rate for Payer: United Healthcare HMO Rider |
$13.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.22
|
|
|
HC STRAP CLAVICLE MEDIUM
|
Facility
|
OP
|
$37.31
|
|
|
Service Code
|
CPT L3650
|
| Hospital Charge Code |
901607796
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Adventist Health Commercial |
$15.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.58
|
| Rate for Payer: Blue Shield of California Commercial |
$28.69
|
| Rate for Payer: Blue Shield of California Commercial |
$18.92
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cigna of CA HMO |
$26.12
|
| Rate for Payer: Cigna of CA PPO |
$26.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.92
|
| Rate for Payer: EPIC Health Plan Senior |
$14.92
|
| Rate for Payer: Galaxy Health WC |
$31.71
|
| Rate for Payer: Global Benefits Group Commercial |
$22.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$60.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.12
|
| Rate for Payer: Multiplan Commercial |
$29.85
|
| Rate for Payer: Networks By Design Commercial |
$18.66
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13.63
|
| Rate for Payer: United Healthcare HMO Rider |
$13.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.71
|
| Rate for Payer: Vantage Medical Group Senior |
$31.71
|
|
|
HC STRAP CLAVICLE SMALL
|
Facility
|
IP
|
$73.06
|
|
|
Service Code
|
CPT L3650
|
| Hospital Charge Code |
901607795
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$14.61 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$14.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$32.88
|
| Rate for Payer: Cash Price |
$32.88
|
| Rate for Payer: Cigna of CA HMO |
$51.14
|
| Rate for Payer: Cigna of CA PPO |
$51.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$51.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.22
|
| Rate for Payer: EPIC Health Plan Senior |
$29.22
|
| Rate for Payer: Galaxy Health WC |
$62.10
|
| Rate for Payer: Global Benefits Group Commercial |
$43.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$46.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$43.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.53
|
| Rate for Payer: Multiplan Commercial |
$58.45
|
| Rate for Payer: Networks By Design Commercial |
$47.49
|
| Rate for Payer: Prime Health Services Commercial |
$62.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.42
|
| Rate for Payer: United Healthcare All Other HMO |
$26.69
|
| Rate for Payer: United Healthcare HMO Rider |
$26.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.93
|
|
|
HC STRAP CLAVICLE SMALL
|
Facility
|
OP
|
$73.06
|
|
|
Service Code
|
CPT L3650
|
| Hospital Charge Code |
901607795
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$17.53 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Adventist Health Commercial |
$29.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$62.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$54.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.22
|
| Rate for Payer: Blue Shield of California Commercial |
$56.18
|
| Rate for Payer: Blue Shield of California Commercial |
$37.04
|
| Rate for Payer: Cash Price |
$32.88
|
| Rate for Payer: Cash Price |
$32.88
|
| Rate for Payer: Cigna of CA HMO |
$51.14
|
| Rate for Payer: Cigna of CA PPO |
$51.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$62.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$51.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.22
|
| Rate for Payer: EPIC Health Plan Senior |
$29.22
|
| Rate for Payer: Galaxy Health WC |
$62.10
|
| Rate for Payer: Global Benefits Group Commercial |
$43.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$60.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$46.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$43.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51.14
|
| Rate for Payer: Multiplan Commercial |
$58.45
|
| Rate for Payer: Networks By Design Commercial |
$36.53
|
| Rate for Payer: Prime Health Services Commercial |
$62.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.42
|
| Rate for Payer: United Healthcare All Other HMO |
$26.69
|
| Rate for Payer: United Healthcare HMO Rider |
$26.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$62.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62.10
|
| Rate for Payer: Vantage Medical Group Senior |
$62.10
|
|
|
HC STRAP MONTGOMERY W TWILL 3X7IN
|
Facility
|
OP
|
$26.81
|
|
| Hospital Charge Code |
901607818
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$22.79 |
| Rate for Payer: Adventist Health Commercial |
$5.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.20
|
| Rate for Payer: Cash Price |
$12.06
|
| Rate for Payer: Cigna of CA HMO |
$17.16
|
| Rate for Payer: Cigna of CA PPO |
$19.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.72
|
| Rate for Payer: EPIC Health Plan Senior |
$10.72
|
| Rate for Payer: Galaxy Health WC |
$22.79
|
| Rate for Payer: Global Benefits Group Commercial |
$16.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.77
|
| Rate for Payer: Multiplan Commercial |
$21.45
|
| Rate for Payer: Networks By Design Commercial |
$17.43
|
| Rate for Payer: Prime Health Services Commercial |
$22.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.40
|
| Rate for Payer: United Healthcare All Other HMO |
$13.40
|
| Rate for Payer: United Healthcare HMO Rider |
$13.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.79
|
| Rate for Payer: Vantage Medical Group Senior |
$22.79
|
|
|
HC STRAP MONTGOMERY W TWILL 3X7IN
|
Facility
|
IP
|
$26.81
|
|
| Hospital Charge Code |
901607818
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$22.79 |
| Rate for Payer: Adventist Health Commercial |
$5.36
|
| Rate for Payer: Cash Price |
$12.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.72
|
| Rate for Payer: EPIC Health Plan Senior |
$10.72
|
| Rate for Payer: Galaxy Health WC |
$22.79
|
| Rate for Payer: Global Benefits Group Commercial |
$16.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.43
|
| Rate for Payer: Multiplan Commercial |
$21.45
|
| Rate for Payer: Networks By Design Commercial |
$17.43
|
| Rate for Payer: Prime Health Services Commercial |
$22.79
|
|
|
HC STRAPPING ANKLE
|
Facility
|
OP
|
$713.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$292.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$154.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$209.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Cigna of CA HMO |
$456.32
|
| Rate for Payer: Cigna of CA PPO |
$527.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$313.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$209.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$499.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.85
|
| Rate for Payer: EPIC Health Plan Senior |
$229.90
|
| Rate for Payer: Galaxy Health WC |
$606.05
|
| Rate for Payer: Global Benefits Group Commercial |
$427.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$342.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$452.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$570.40
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$463.45
|
| Rate for Payer: Prime Health Services Commercial |
$606.05
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$427.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$427.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Vantage Medical Group Senior |
$209.00
|
|
|
HC STRAPPING ANKLE
|
Facility
|
IP
|
$713.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$142.60 |
| Max. Negotiated Rate |
$606.05 |
| Rate for Payer: Adventist Health Commercial |
$142.60
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$499.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$285.20
|
| Rate for Payer: EPIC Health Plan Senior |
$285.20
|
| Rate for Payer: Galaxy Health WC |
$606.05
|
| Rate for Payer: Global Benefits Group Commercial |
$427.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$452.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$420.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.12
|
| Rate for Payer: Multiplan Commercial |
$570.40
|
| Rate for Payer: Networks By Design Commercial |
$463.45
|
| Rate for Payer: Prime Health Services Commercial |
$606.05
|
|
|
HC STRAPPING ANKLE
|
Facility
|
OP
|
$713.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$142.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$209.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Cigna of CA HMO |
$456.32
|
| Rate for Payer: Cigna of CA PPO |
$527.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$313.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$209.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$499.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.85
|
| Rate for Payer: EPIC Health Plan Senior |
$229.90
|
| Rate for Payer: Galaxy Health WC |
$606.05
|
| Rate for Payer: Global Benefits Group Commercial |
$427.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$342.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$452.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$570.40
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$463.45
|
| Rate for Payer: Prime Health Services Commercial |
$606.05
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$427.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$356.50
|
| Rate for Payer: United Healthcare All Other HMO |
$356.50
|
| Rate for Payer: United Healthcare HMO Rider |
$356.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$356.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Vantage Medical Group Senior |
$209.00
|
|
|
HC STRAPPING ANKLE
|
Facility
|
IP
|
$713.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$142.60 |
| Max. Negotiated Rate |
$606.05 |
| Rate for Payer: Adventist Health Commercial |
$142.60
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$499.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$285.20
|
| Rate for Payer: EPIC Health Plan Senior |
$285.20
|
| Rate for Payer: Galaxy Health WC |
$606.05
|
| Rate for Payer: Global Benefits Group Commercial |
$427.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$452.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$420.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.12
|
| Rate for Payer: Multiplan Commercial |
$570.40
|
| Rate for Payer: Networks By Design Commercial |
$463.45
|
| Rate for Payer: Prime Health Services Commercial |
$606.05
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
IP
|
$870.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901301209
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$739.50 |
| Rate for Payer: EPIC Health Plan Senior |
$348.00
|
| Rate for Payer: Galaxy Health WC |
$739.50
|
| Rate for Payer: Global Benefits Group Commercial |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$552.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$513.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.80
|
| Rate for Payer: Multiplan Commercial |
$696.00
|
| Rate for Payer: Networks By Design Commercial |
$565.50
|
| Rate for Payer: Prime Health Services Commercial |
$739.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.00
|
| Rate for Payer: Adventist Health Commercial |
$174.00
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$609.00
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
OP
|
$870.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901301209
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.53 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$356.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$237.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Cash Price |
$391.50
|
| Rate for Payer: Cigna of CA HMO |
$556.80
|
| Rate for Payer: Cigna of CA PPO |
$643.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$609.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$739.50
|
| Rate for Payer: Global Benefits Group Commercial |
$522.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$552.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$696.00
|
| Rate for Payer: Networks By Design Commercial |
$565.50
|
| Rate for Payer: Prime Health Services Commercial |
$739.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$522.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$1,026.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$205.20 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Adventist Health Commercial |
$205.20
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$718.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.40
|
| Rate for Payer: EPIC Health Plan Senior |
$410.40
|
| Rate for Payer: Galaxy Health WC |
$872.10
|
| Rate for Payer: Global Benefits Group Commercial |
$615.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$651.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$605.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.24
|
| Rate for Payer: Multiplan Commercial |
$820.80
|
| Rate for Payer: Networks By Design Commercial |
$666.90
|
| Rate for Payer: Prime Health Services Commercial |
$872.10
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$1,026.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901301210
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$205.20 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Adventist Health Commercial |
$205.20
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$718.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.40
|
| Rate for Payer: EPIC Health Plan Senior |
$410.40
|
| Rate for Payer: Galaxy Health WC |
$872.10
|
| Rate for Payer: Global Benefits Group Commercial |
$615.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$651.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$605.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.24
|
| Rate for Payer: Multiplan Commercial |
$820.80
|
| Rate for Payer: Networks By Design Commercial |
$666.90
|
| Rate for Payer: Prime Health Services Commercial |
$872.10
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$1,026.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$205.20 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Adventist Health Commercial |
$205.20
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$718.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.40
|
| Rate for Payer: EPIC Health Plan Senior |
$410.40
|
| Rate for Payer: Galaxy Health WC |
$872.10
|
| Rate for Payer: Global Benefits Group Commercial |
$615.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$651.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$605.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.24
|
| Rate for Payer: Multiplan Commercial |
$820.80
|
| Rate for Payer: Networks By Design Commercial |
$666.90
|
| Rate for Payer: Prime Health Services Commercial |
$872.10
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,026.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$75.87 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$420.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$227.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cigna of CA HMO |
$656.64
|
| Rate for Payer: Cigna of CA PPO |
$759.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$718.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$872.10
|
| Rate for Payer: Global Benefits Group Commercial |
$615.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$651.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$820.80
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$666.90
|
| Rate for Payer: Prime Health Services Commercial |
$872.10
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$615.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$615.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,026.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901301210
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$75.87 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$420.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$227.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cigna of CA HMO |
$656.64
|
| Rate for Payer: Cigna of CA PPO |
$759.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$718.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$872.10
|
| Rate for Payer: Global Benefits Group Commercial |
$615.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$87.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$651.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$820.80
|
| Rate for Payer: Networks By Design Commercial |
$666.90
|
| Rate for Payer: Prime Health Services Commercial |
$872.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$615.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,026.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.87 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$205.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cash Price |
$461.70
|
| Rate for Payer: Cigna of CA HMO |
$656.64
|
| Rate for Payer: Cigna of CA PPO |
$759.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$718.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$872.10
|
| Rate for Payer: Global Benefits Group Commercial |
$615.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$651.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$820.80
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$666.90
|
| Rate for Payer: Prime Health Services Commercial |
$872.10
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$615.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$513.00
|
| Rate for Payer: United Healthcare All Other HMO |
$513.00
|
| Rate for Payer: United Healthcare HMO Rider |
$513.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$513.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC STRAPPING, HIP
|
Facility
|
IP
|
$910.00
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
900501627
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$182.00 |
| Max. Negotiated Rate |
$773.50 |
| Rate for Payer: Adventist Health Commercial |
$182.00
|
| Rate for Payer: Cash Price |
$409.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$637.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$364.00
|
| Rate for Payer: EPIC Health Plan Senior |
$364.00
|
| Rate for Payer: Galaxy Health WC |
$773.50
|
| Rate for Payer: Global Benefits Group Commercial |
$546.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$577.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$536.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.40
|
| Rate for Payer: Multiplan Commercial |
$728.00
|
| Rate for Payer: Networks By Design Commercial |
$591.50
|
| Rate for Payer: Prime Health Services Commercial |
$773.50
|
|
|
HC STRAPPING, HIP
|
Facility
|
OP
|
$910.00
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
900501627
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$61.39 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$182.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$409.50
|
| Rate for Payer: Cash Price |
$409.50
|
| Rate for Payer: Cash Price |
$409.50
|
| Rate for Payer: Cigna of CA HMO |
$582.40
|
| Rate for Payer: Cigna of CA PPO |
$673.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$637.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$773.50
|
| Rate for Payer: Global Benefits Group Commercial |
$546.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$577.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$61.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$728.00
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$591.50
|
| Rate for Payer: Prime Health Services Commercial |
$773.50
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$546.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$455.00
|
| Rate for Payer: United Healthcare All Other HMO |
$455.00
|
| Rate for Payer: United Healthcare HMO Rider |
$455.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$455.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC STRAPPING KNEE
|
Facility
|
IP
|
$723.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$144.60 |
| Max. Negotiated Rate |
$614.55 |
| Rate for Payer: Adventist Health Commercial |
$144.60
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$506.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$289.20
|
| Rate for Payer: EPIC Health Plan Senior |
$289.20
|
| Rate for Payer: Galaxy Health WC |
$614.55
|
| Rate for Payer: Global Benefits Group Commercial |
$433.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$459.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$426.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.52
|
| Rate for Payer: Multiplan Commercial |
$578.40
|
| Rate for Payer: Networks By Design Commercial |
$469.95
|
| Rate for Payer: Prime Health Services Commercial |
$614.55
|
|
|
HC STRAPPING KNEE
|
Facility
|
IP
|
$723.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.60 |
| Max. Negotiated Rate |
$614.55 |
| Rate for Payer: Adventist Health Commercial |
$144.60
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$506.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$289.20
|
| Rate for Payer: EPIC Health Plan Senior |
$289.20
|
| Rate for Payer: Galaxy Health WC |
$614.55
|
| Rate for Payer: Global Benefits Group Commercial |
$433.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$459.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$426.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.52
|
| Rate for Payer: Multiplan Commercial |
$578.40
|
| Rate for Payer: Networks By Design Commercial |
$469.95
|
| Rate for Payer: Prime Health Services Commercial |
$614.55
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$723.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$144.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Cigna of CA HMO |
$462.72
|
| Rate for Payer: Cigna of CA PPO |
$535.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$506.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$614.55
|
| Rate for Payer: Global Benefits Group Commercial |
$433.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$459.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$578.40
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$469.95
|
| Rate for Payer: Prime Health Services Commercial |
$614.55
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$433.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$361.50
|
| Rate for Payer: United Healthcare All Other HMO |
$361.50
|
| Rate for Payer: United Healthcare HMO Rider |
$361.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$361.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$723.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Cash Price |
$325.35
|
| Rate for Payer: Cigna of CA HMO |
$462.72
|
| Rate for Payer: Cigna of CA PPO |
$535.02
|
| Rate for Payer: Adventist Health Commercial |
$296.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$238.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$506.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$614.55
|
| Rate for Payer: Global Benefits Group Commercial |
$433.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$459.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$578.40
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$469.95
|
| Rate for Payer: Prime Health Services Commercial |
$614.55
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$433.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$433.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
