|
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$105,769.26
|
|
|
Service Code
|
MSDRG 251
|
| Min. Negotiated Rate |
$7,978.00 |
| Max. Negotiated Rate |
$105,769.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,307.26
|
| Rate for Payer: Cigna of CA HMO |
$11,745.00
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$105,769.26
|
| Rate for Payer: EPIC Health Plan Senior |
$70,512.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64,102.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$89,743.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$85,897.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,406.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41,406.00
|
| Rate for Payer: United Healthcare HMO Rider |
$22,531.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20,641.00
|
|
|
PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$140,266.98
|
|
|
Service Code
|
MSDRG 359
|
| Min. Negotiated Rate |
$85,010.29 |
| Max. Negotiated Rate |
$140,266.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$104,244.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$140,266.98
|
| Rate for Payer: EPIC Health Plan Senior |
$93,511.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$85,010.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$119,014.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$113,913.79
|
|
|
PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$122,090.94
|
|
|
Service Code
|
MSDRG 360
|
| Min. Negotiated Rate |
$73,191.92 |
| Max. Negotiated Rate |
$122,090.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$73,191.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$122,090.94
|
| Rate for Payer: EPIC Health Plan Senior |
$81,393.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$73,994.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$103,592.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,152.64
|
|
|
PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$122,231.13
|
|
|
Service Code
|
MSDRG 318
|
| Min. Negotiated Rate |
$73,431.42 |
| Max. Negotiated Rate |
$122,231.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$73,431.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$122,231.13
|
| Rate for Payer: EPIC Health Plan Senior |
$81,487.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$74,079.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$103,711.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$99,266.49
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$55,035.72
|
|
|
Service Code
|
APR-DRG 0302
|
| Min. Negotiated Rate |
$43,956.16 |
| Max. Negotiated Rate |
$55,035.72 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43,956.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55,035.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49,242.49
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$33,837.18
|
|
|
Service Code
|
APR-DRG 0301
|
| Min. Negotiated Rate |
$27,025.22 |
| Max. Negotiated Rate |
$33,837.18 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27,025.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33,837.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,275.37
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$70,344.57
|
|
|
Service Code
|
APR-DRG 0303
|
| Min. Negotiated Rate |
$56,183.10 |
| Max. Negotiated Rate |
$70,344.57 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$56,183.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70,344.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,939.88
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
|
IP
|
$124,578.15
|
|
|
Service Code
|
APR-DRG 0304
|
| Min. Negotiated Rate |
$99,498.61 |
| Max. Negotiated Rate |
$124,578.15 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$99,498.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$124,578.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$111,464.66
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 25606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$873.77 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$873.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$988.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,891.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIOULNAR DISLOCATION
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 25671
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$131.98 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$131.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$149.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,891.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, DISTAL END, MEDIAL OR LATERAL CONDYLE, OR SUPRACONDYLAR OR TRANSCONDYLAR, WITH OR WITHOUT INTERCONDYLAR EXTENSION, OR DISTAL FEMORAL EPIPHYSEAL SEPARATION
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 27509
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$98.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,398.95
|
| Rate for Payer: EPIC Health Plan Senior |
$10,265.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,305.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$98.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,065.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,759.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,505.82
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,332.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, WITH MANIPULATION
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 24582
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$586.07 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,398.95
|
| Rate for Payer: EPIC Health Plan Senior |
$10,265.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,305.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$586.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$662.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,065.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,759.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,505.82
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,332.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF METACARPAL FRACTURE, EACH BONE
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 26608
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$392.16 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,508.41
|
| Rate for Payer: Blue Shield of California Commercial |
$3,638.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$392.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$443.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,891.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF METATARSAL FRACTURE, WITH MANIPULATION, EACH
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 28476
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$263.94 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$263.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$298.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,891.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF SUPRACONDYLAR OR TRANSCONDYLAR HUMERAL FRACTURE, WITH OR WITHOUT INTERCONDYLAR EXTENSION
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 24538
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$708.66 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,398.95
|
| Rate for Payer: EPIC Health Plan Senior |
$10,265.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,305.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$708.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$801.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,065.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,759.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,505.82
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,332.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) (EG, PINS OR SCREWS)
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 27756
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$850.01 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,942.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,454.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,398.95
|
| Rate for Payer: EPIC Health Plan Senior |
$10,265.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,305.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$850.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$961.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,065.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,759.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,505.82
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,332.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
PERCUTANEOUS SKELETAL FIXATION OF UNSTABLE PHALANGEAL SHAFT FRACTURE, PROXIMAL OR MIDDLE PHALANX, FINGER OR THUMB, WITH MANIPULATION, EACH
|
Facility
|
OP
|
$32,312.00
|
|
|
Service Code
|
CPT 26727
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$366.53 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,695.24
|
| Rate for Payer: Blue Shield of California Commercial |
$5,743.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$366.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$414.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,891.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$81,979.85
|
|
|
Service Code
|
APR-DRG 1831
|
| Min. Negotiated Rate |
$65,476.01 |
| Max. Negotiated Rate |
$81,979.85 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$65,476.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81,979.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73,350.39
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$106,212.96
|
|
|
Service Code
|
APR-DRG 1833
|
| Min. Negotiated Rate |
$84,830.62 |
| Max. Negotiated Rate |
$106,212.96 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$84,830.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106,212.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95,032.65
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$86,877.04
|
|
|
Service Code
|
APR-DRG 1832
|
| Min. Negotiated Rate |
$69,387.32 |
| Max. Negotiated Rate |
$86,877.04 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$69,387.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86,877.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77,732.09
|
|
|
PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES
|
Facility
|
IP
|
$195,406.15
|
|
|
Service Code
|
APR-DRG 1834
|
| Min. Negotiated Rate |
$156,067.80 |
| Max. Negotiated Rate |
$195,406.15 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$156,067.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195,406.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$174,837.08
|
|
|
PERFLUTREN PROTEIN-TYPE A MICROSPHERES 0.22 MG/ML INTRAVENOUS SUSP [82177]
|
Facility
|
IP
|
$56.16
|
|
|
Service Code
|
HCPCS Q9956
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Adventist Health Commercial |
$11.23
|
| Rate for Payer: Blue Shield of California Commercial |
$28.47
|
| Rate for Payer: Blue Shield of California Commercial |
$43.19
|
| Rate for Payer: Cash Price |
$25.27
|
| Rate for Payer: Cigna of CA HMO |
$39.31
|
| Rate for Payer: Cigna of CA PPO |
$39.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.46
|
| Rate for Payer: EPIC Health Plan Senior |
$22.46
|
| Rate for Payer: Galaxy Health WC |
$47.74
|
| Rate for Payer: Global Benefits Group Commercial |
$33.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.48
|
| Rate for Payer: Multiplan Commercial |
$44.93
|
| Rate for Payer: Networks By Design Commercial |
$28.08
|
| Rate for Payer: Prime Health Services Commercial |
$47.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.08
|
| Rate for Payer: United Healthcare All Other HMO |
$20.52
|
| Rate for Payer: United Healthcare HMO Rider |
$20.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.39
|
|
|
PERFLUTREN PROTEIN-TYPE A MICROSPHERES 0.22 MG/ML INTRAVENOUS SUSP [82177]
|
Facility
|
OP
|
$56.16
|
|
|
Service Code
|
HCPCS Q9956
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$263.41 |
| Rate for Payer: Adventist Health Commercial |
$11.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$263.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.13
|
| Rate for Payer: Cash Price |
$25.27
|
| Rate for Payer: Cash Price |
$25.27
|
| Rate for Payer: Cigna of CA HMO |
$39.31
|
| Rate for Payer: Cigna of CA PPO |
$39.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.46
|
| Rate for Payer: EPIC Health Plan Senior |
$22.46
|
| Rate for Payer: Galaxy Health WC |
$47.74
|
| Rate for Payer: Global Benefits Group Commercial |
$33.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$40.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$57.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.31
|
| Rate for Payer: Multiplan Commercial |
$44.93
|
| Rate for Payer: Networks By Design Commercial |
$28.08
|
| Rate for Payer: Prime Health Services Commercial |
$47.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.08
|
| Rate for Payer: United Healthcare All Other HMO |
$20.52
|
| Rate for Payer: United Healthcare HMO Rider |
$20.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.74
|
| Rate for Payer: Vantage Medical Group Senior |
$47.74
|
|
|
PERIPHERAL AND OTHER VASCULAR DISORDERS
|
Facility
|
IP
|
$10,615.58
|
|
|
Service Code
|
APR-DRG 1971
|
| Min. Negotiated Rate |
$8,478.50 |
| Max. Negotiated Rate |
$10,615.58 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8,478.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,615.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,498.16
|
|
|
PERIPHERAL AND OTHER VASCULAR DISORDERS
|
Facility
|
IP
|
$22,142.09
|
|
|
Service Code
|
APR-DRG 1973
|
| Min. Negotiated Rate |
$17,684.54 |
| Max. Negotiated Rate |
$22,142.09 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17,684.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22,142.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,811.34
|
|
