|
HC STRAIGHT PUSHABLE COIL
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
909081804
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$264.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$318.07
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| 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: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| 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
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC STRAP CLAVICLE MEDIUM
|
Facility
|
OP
|
$37.31
|
|
|
Service Code
|
CPT L3650
|
| Hospital Charge Code |
901607796
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$12.22 |
| 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 |
$21.70
|
| Rate for Payer: Blue Shield of California Commercial |
$29.92
|
| Rate for Payer: Blue Shield of California EPN |
$18.80
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| 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: Health Management Network EPO/PPO |
$33.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$61.89
|
| 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 |
$15.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.12
|
| Rate for Payer: Multiplan Commercial |
$27.98
|
| Rate for Payer: Networks By Design Commercial |
$18.66
|
| Rate for Payer: Prime Health Services Commercial |
$31.71
|
| Rate for Payer: Riverside University Health System MISP |
$14.92
|
| 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 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 |
$33.58 |
| Rate for Payer: Adventist Health Commercial |
$7.46
|
| Rate for Payer: Blue Shield of California Commercial |
$29.92
|
| Rate for Payer: Blue Shield of California EPN |
$18.80
|
| Rate for Payer: Cash Price |
$16.79
|
| Rate for Payer: Central Health Plan Commercial |
$29.85
|
| 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: Health Management Network EPO/PPO |
$33.58
|
| 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 |
$7.46
|
| Rate for Payer: Multiplan Commercial |
$27.98
|
| 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 SMALL
|
Facility
|
OP
|
$73.06
|
|
|
Service Code
|
CPT L3650
|
| Hospital Charge Code |
901607795
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$23.93 |
| 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 |
$42.50
|
| Rate for Payer: Blue Shield of California Commercial |
$58.59
|
| Rate for Payer: Blue Shield of California EPN |
$36.82
|
| Rate for Payer: Cash Price |
$32.88
|
| Rate for Payer: Cash Price |
$32.88
|
| Rate for Payer: Central Health Plan Commercial |
$58.45
|
| 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: Health Management Network EPO/PPO |
$65.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$61.89
|
| 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 |
$29.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$51.14
|
| Rate for Payer: Multiplan Commercial |
$54.80
|
| Rate for Payer: Networks By Design Commercial |
$36.53
|
| Rate for Payer: Prime Health Services Commercial |
$62.10
|
| Rate for Payer: Riverside University Health System MISP |
$29.22
|
| 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 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 |
$65.75 |
| Rate for Payer: Adventist Health Commercial |
$14.61
|
| Rate for Payer: Blue Shield of California Commercial |
$58.59
|
| Rate for Payer: Blue Shield of California EPN |
$36.82
|
| Rate for Payer: Cash Price |
$32.88
|
| Rate for Payer: Central Health Plan Commercial |
$58.45
|
| 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: Health Management Network EPO/PPO |
$65.75
|
| 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 |
$14.61
|
| Rate for Payer: Multiplan Commercial |
$54.80
|
| 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 MONTGOMERY W TWILL 3X7IN
|
Facility
|
IP
|
$26.81
|
|
| Hospital Charge Code |
901607818
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$24.13 |
| Rate for Payer: Adventist Health Commercial |
$5.36
|
| Rate for Payer: Cash Price |
$12.06
|
| Rate for Payer: Central Health Plan Commercial |
$21.45
|
| 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: Health Management Network EPO/PPO |
$24.13
|
| 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 |
$5.36
|
| Rate for Payer: Multiplan Commercial |
$20.11
|
| Rate for Payer: Networks By Design Commercial |
$17.43
|
| Rate for Payer: Prime Health Services Commercial |
$22.79
|
|
|
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 |
$24.13 |
| Rate for Payer: Adventist Health Commercial |
$5.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.28
|
| 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 Exchange |
$12.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.60
|
| Rate for Payer: Blue Shield of California Commercial |
$17.00
|
| Rate for Payer: Blue Shield of California EPN |
$10.70
|
| Rate for Payer: Cash Price |
$12.06
|
| Rate for Payer: Central Health Plan Commercial |
$21.45
|
| 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: Health Management Network EPO/PPO |
$24.13
|
| 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 |
$5.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.77
|
| Rate for Payer: Multiplan Commercial |
$20.11
|
| Rate for Payer: Networks By Design Commercial |
$17.43
|
| Rate for Payer: Prime Health Services Commercial |
$22.79
|
| Rate for Payer: Riverside University Health System MISP |
$10.72
|
| 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 STRAPPING ANKLE
|
Facility
|
OP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$284.13
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.27
|
| 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 Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$319.45
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Cigna of CA HMO |
$443.52
|
| Rate for Payer: Cigna of CA PPO |
$512.82
|
| 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 |
$485.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.85
|
| Rate for Payer: EPIC Health Plan Senior |
$229.90
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| 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 |
$440.06
|
| 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 |
$138.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$209.00
|
| Rate for Payer: Preferred Health Network WC |
$325.97
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
| Rate for Payer: Prime Health Services Medicare |
$221.54
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Riverside University Health System MISP |
$229.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$415.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$415.80
|
| 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
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$485.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$277.20
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$440.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
|
|
HC STRAPPING ANKLE
|
Facility
|
IP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$485.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$277.20
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$440.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
|
|
HC STRAPPING ANKLE
|
Facility
|
IP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900419072
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$485.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$277.20
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$440.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$408.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
|
|
HC STRAPPING ANKLE
|
Facility
|
OP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| 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 Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$319.45
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Cigna of CA HMO |
$443.52
|
| Rate for Payer: Cigna of CA PPO |
$512.82
|
| 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 |
$485.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.85
|
| Rate for Payer: EPIC Health Plan Senior |
$229.90
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| 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 |
$440.06
|
| 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 |
$138.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$209.00
|
| Rate for Payer: Preferred Health Network WC |
$325.97
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
| Rate for Payer: Prime Health Services Medicare |
$221.54
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Riverside University Health System MISP |
$229.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$415.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$346.50
|
| Rate for Payer: United Healthcare All Other HMO |
$346.50
|
| Rate for Payer: United Healthcare HMO Rider |
$346.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$346.50
|
| 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
|
OP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900419072
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$284.13
|
| Rate for Payer: Adventist Health Medi-Cal |
$209.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.27
|
| 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 Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Cigna of CA HMO |
$443.52
|
| Rate for Payer: Cigna of CA PPO |
$512.82
|
| 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 |
$485.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.85
|
| Rate for Payer: EPIC Health Plan Senior |
$229.90
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$342.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$44.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$440.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$292.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$209.00
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
| Rate for Payer: Prime Health Services Medicare |
$221.54
|
| Rate for Payer: Riverside University Health System MISP |
$229.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$415.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$250.80
|
| 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 |
$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 ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901301209
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Central Health Plan Commercial |
$942.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$824.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$471.20
|
| Rate for Payer: EPIC Health Plan Senior |
$471.20
|
| Rate for Payer: Galaxy Health WC |
$1,001.30
|
| Rate for Payer: Global Benefits Group Commercial |
$706.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,060.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$748.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$695.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.60
|
| Rate for Payer: Multiplan Commercial |
$883.50
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.30
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901301209
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$482.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$209.29
|
| 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 Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Central Health Plan Commercial |
$942.40
|
| Rate for Payer: Cigna of CA HMO |
$753.92
|
| Rate for Payer: Cigna of CA PPO |
$871.72
|
| 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 |
$824.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$1,001.30
|
| Rate for Payer: Global Benefits Group Commercial |
$706.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,060.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$748.03
|
| 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 |
$482.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$883.50
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.87
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.30
|
| Rate for Payer: Prime Health Services Medicare |
$80.42
|
| Rate for Payer: Riverside University Health System MISP |
$83.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$706.80
|
| 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
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$972.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$555.60
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$882.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$819.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$75.87 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$569.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$200.64
|
| 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 Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$120.25
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Cigna of CA HMO |
$888.96
|
| Rate for Payer: Cigna of CA PPO |
$1,027.86
|
| 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 |
$972.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| 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 |
$882.01
|
| 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 |
$277.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.87
|
| Rate for Payer: Preferred Health Network WC |
$122.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.42
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Riverside University Health System MISP |
$83.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$833.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$833.40
|
| 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
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$75.87 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$569.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$200.64
|
| 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 Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Cigna of CA HMO |
$888.96
|
| Rate for Payer: Cigna of CA PPO |
$1,027.86
|
| 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 |
$972.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$89.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$882.01
|
| 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 |
$569.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.87
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.42
|
| Rate for Payer: Riverside University Health System MISP |
$83.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$833.40
|
| 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
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$972.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$555.60
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$882.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$819.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901301210
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$972.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$555.60
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$882.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$819.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.87 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| 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 Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$120.25
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Cigna of CA HMO |
$888.96
|
| Rate for Payer: Cigna of CA PPO |
$1,027.86
|
| 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 |
$972.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| 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 |
$882.01
|
| 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 |
$277.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.87
|
| Rate for Payer: Preferred Health Network WC |
$122.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.42
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Riverside University Health System MISP |
$83.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$833.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$694.50
|
| Rate for Payer: United Healthcare All Other HMO |
$694.50
|
| Rate for Payer: United Healthcare HMO Rider |
$694.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$694.50
|
| 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
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901301210
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$75.87 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$569.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$200.64
|
| 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 Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Cigna of CA HMO |
$888.96
|
| Rate for Payer: Cigna of CA PPO |
$1,027.86
|
| 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 |
$972.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$89.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$882.01
|
| 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 |
$569.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.87
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.42
|
| Rate for Payer: Riverside University Health System MISP |
$83.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$833.40
|
| 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
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$972.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$555.60
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$882.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$819.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
|
|
HC STRAPPING, HIP
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
900501627
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$61.39 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$246.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| 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 Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Central Health Plan Commercial |
$986.40
|
| Rate for Payer: Cigna of CA HMO |
$789.12
|
| Rate for Payer: Cigna of CA PPO |
$912.42
|
| 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 |
$863.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$1,048.05
|
| Rate for Payer: Global Benefits Group Commercial |
$739.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,109.70
|
| 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 |
$782.96
|
| 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 |
$246.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$924.75
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$801.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$1,048.05
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$739.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$616.50
|
| Rate for Payer: United Healthcare All Other HMO |
$616.50
|
| Rate for Payer: United Healthcare HMO Rider |
$616.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$616.50
|
| 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, HIP
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
900501627
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$246.60 |
| Max. Negotiated Rate |
$1,109.70 |
| Rate for Payer: Adventist Health Commercial |
$246.60
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Central Health Plan Commercial |
$986.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$863.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$493.20
|
| Rate for Payer: EPIC Health Plan Senior |
$493.20
|
| Rate for Payer: Galaxy Health WC |
$1,048.05
|
| Rate for Payer: Global Benefits Group Commercial |
$739.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,109.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$782.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$727.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.60
|
| Rate for Payer: Multiplan Commercial |
$924.75
|
| Rate for Payer: Networks By Design Commercial |
$801.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,048.05
|
|
