|
HC STRAPPING KNEE
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$788.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.40
|
| Rate for Payer: EPIC Health Plan Senior |
$450.40
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$715.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$664.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900419071
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$51.22 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$461.66
|
| Rate for Payer: Adventist Health Medi-Cal |
$171.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$210.76
|
| 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 |
$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 |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA HMO |
$720.64
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| 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 |
$788.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$715.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$461.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$675.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$205.34
|
| 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 |
$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
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| 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 |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA HMO |
$720.64
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| 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 |
$788.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| 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 |
$715.01
|
| 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 |
$225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| 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 |
$957.10
|
| 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 |
$675.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$563.00
|
| Rate for Payer: United Healthcare All Other HMO |
$563.00
|
| Rate for Payer: United Healthcare HMO Rider |
$563.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$563.00
|
| 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
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$461.66
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$210.76
|
| 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 |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA HMO |
$720.64
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| 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 |
$788.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| 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 |
$715.01
|
| 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 |
$225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| 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 |
$957.10
|
| 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 |
$675.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$675.60
|
| 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 |
$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
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$788.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.40
|
| Rate for Payer: EPIC Health Plan Senior |
$450.40
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$715.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$664.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
|
|
HC STRAPPING KNEE
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900419071
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$788.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.40
|
| Rate for Payer: EPIC Health Plan Senior |
$450.40
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$715.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$664.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$53.75 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| 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 |
$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 |
$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 |
$973.00
|
| 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 |
$81.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$883.50
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| 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 |
$1,001.30
|
| 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 |
$706.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$589.00
|
| Rate for Payer: United Healthcare All Other HMO |
$589.00
|
| Rate for Payer: United Healthcare HMO Rider |
$589.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$589.00
|
| 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 OF ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$53.75 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$482.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| 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 |
$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 |
$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 |
$973.00
|
| 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 |
$81.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$883.50
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| 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 |
$1,001.30
|
| 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 |
$706.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$706.80
|
| 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 |
$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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
456
|
| 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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
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 OF ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
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 OF ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
903200240
|
|
Hospital Revenue Code
|
420
|
| 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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
903200240
|
|
Hospital Revenue Code
|
420
|
| 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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
450
|
| 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 OF ELBOW OR WRIST MCAL
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901300015
|
|
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 OF ELBOW OR WRIST MCAL
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901300015
|
|
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 OF HAND OR FINGER
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
903200242
|
|
Hospital Revenue Code
|
420
|
| 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 OF HAND OR FINGER
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
903200242
|
|
Hospital Revenue Code
|
420
|
| 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 OF HAND OR FINGER MCAL
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901300017
|
|
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 OF HAND OR FINGER MCAL
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901300017
|
|
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 OF SHOULDER
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
450
|
| 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 OF SHOULDER
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$67.91 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$482.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.04
|
| 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 |
$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 |
$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 |
$824.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$1,001.30
|
| 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 |
$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 |
$748.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$67.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$883.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| 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 |
$1,001.30
|
| 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 |
$706.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$706.80
|
| 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
|
|
|
HC STRAPPING OF SHOULDER
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
456
|
| 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 OF SHOULDER
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$67.91 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| 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 |
$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 |
$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 |
$824.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$1,001.30
|
| 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 |
$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 |
$748.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$67.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$883.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| 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 |
$1,001.30
|
| 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 |
$706.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$589.00
|
| Rate for Payer: United Healthcare All Other HMO |
$589.00
|
| Rate for Payer: United Healthcare HMO Rider |
$589.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$589.00
|
| 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 OF SHOULDER MCAL
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
901300013
|
|
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
|
|
