|
HC STRAPPING KNEE
|
Facility
OP
|
$851.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$195.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$510.60
|
| Rate for Payer: Blue Shield of California Commercial |
$535.28
|
| Rate for Payer: Blue Shield of California EPN |
$416.14
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: Cigna of CA HMO |
$544.64
|
| Rate for Payer: Cigna of CA PPO |
$629.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$638.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$510.60
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.50
|
| Rate for Payer: United Healthcare All Other HMO |
$425.50
|
| Rate for Payer: United Healthcare HMO Rider |
$425.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC STRAPPING KNEE
|
Facility
IP
|
$851.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
|
|
HC STRAPPING KNEE
|
Facility
IP
|
$851.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
|
|
HC STRAPPING KNEE
|
Facility
OP
|
$851.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900419071
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$195.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$510.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: Cigna of CA HMO |
$544.64
|
| Rate for Payer: Cigna of CA PPO |
$629.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$638.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$175.56
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$191.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
903200240
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$178.00 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.00
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.00 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.00
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$193.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$534.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: Cigna of CA HMO |
$569.60
|
| Rate for Payer: Cigna of CA PPO |
$658.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$667.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$126.09
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$84.06
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$178.00 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.00
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$193.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$534.00
|
| Rate for Payer: Blue Shield of California Commercial |
$559.81
|
| Rate for Payer: Blue Shield of California EPN |
$435.21
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: Cigna of CA HMO |
$569.60
|
| Rate for Payer: Cigna of CA PPO |
$658.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$667.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$126.09
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$534.00
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$534.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$445.00
|
| Rate for Payer: United Healthcare All Other HMO |
$445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$445.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
903200240
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$193.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$534.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: Cigna of CA HMO |
$569.60
|
| Rate for Payer: Cigna of CA PPO |
$658.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$667.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$126.09
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$84.06
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$534.00
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: Cigna of CA PPO |
$658.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$667.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$534.00
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$445.00
|
| Rate for Payer: United Healthcare All Other HMO |
$445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$445.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$178.00 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.00
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
|
|
HC STRAPPING OF ELBOW OR WRIST MCAL
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901300015
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$193.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$534.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: Cigna of CA HMO |
$569.60
|
| Rate for Payer: Cigna of CA PPO |
$658.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$667.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$126.09
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$84.06
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC STRAPPING OF ELBOW OR WRIST MCAL
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901300015
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$178.00 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.00
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
|
|
HC STRAPPING OF HAND OR FINGER
|
Facility
OP
|
$1,050.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
903200242
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$185.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$630.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Central Health Plan Commercial |
$840.00
|
| Rate for Payer: Cigna of CA HMO |
$672.00
|
| Rate for Payer: Cigna of CA PPO |
$777.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$892.50
|
| Rate for Payer: Global Benefits Group Commercial |
$630.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$945.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$787.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$126.09
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$700.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$430.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$787.50
|
| Rate for Payer: Networks By Design Commercial |
$682.50
|
| Rate for Payer: Prime Health Services Commercial |
$892.50
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$84.06
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$630.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC STRAPPING OF HAND OR FINGER
|
Facility
IP
|
$1,050.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
903200242
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Central Health Plan Commercial |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$420.00
|
| Rate for Payer: Galaxy Health WC |
$892.50
|
| Rate for Payer: Global Benefits Group Commercial |
$630.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$945.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$700.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.00
|
| Rate for Payer: Multiplan Commercial |
$787.50
|
| Rate for Payer: Networks By Design Commercial |
$682.50
|
| Rate for Payer: Prime Health Services Commercial |
$892.50
|
|
|
HC STRAPPING OF HAND OR FINGER MCAL
|
Facility
OP
|
$1,050.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901300017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$76.42 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$185.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$630.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Central Health Plan Commercial |
$840.00
|
| Rate for Payer: Cigna of CA HMO |
$672.00
|
| Rate for Payer: Cigna of CA PPO |
$777.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$892.50
|
| Rate for Payer: Global Benefits Group Commercial |
$630.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$945.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$787.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$126.09
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$700.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$430.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$787.50
|
| Rate for Payer: Networks By Design Commercial |
$682.50
|
| Rate for Payer: Prime Health Services Commercial |
$892.50
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$84.06
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$630.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC STRAPPING OF HAND OR FINGER MCAL
|
Facility
IP
|
$1,050.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901300017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$210.00 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: Cash Price |
$472.50
|
| Rate for Payer: Central Health Plan Commercial |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$420.00
|
| Rate for Payer: Galaxy Health WC |
$892.50
|
| Rate for Payer: Global Benefits Group Commercial |
$630.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$945.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$700.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.00
|
| Rate for Payer: Multiplan Commercial |
$787.50
|
| Rate for Payer: Networks By Design Commercial |
$682.50
|
| Rate for Payer: Prime Health Services Commercial |
$892.50
|
|
|
HC STRAPPING OF SHOULDER
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.00 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.00
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
|
|
HC STRAPPING OF SHOULDER
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$178.00 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.00
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
|
|
HC STRAPPING OF SHOULDER
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$226.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$534.00
|
| Rate for Payer: Blue Shield of California Commercial |
$559.81
|
| Rate for Payer: Blue Shield of California EPN |
$435.21
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: Cigna of CA HMO |
$569.60
|
| Rate for Payer: Cigna of CA PPO |
$658.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$667.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$534.00
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$534.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$445.00
|
| Rate for Payer: United Healthcare All Other HMO |
$445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$445.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC STRAPPING OF SHOULDER
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$534.00
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: Cigna of CA PPO |
$658.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$667.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$534.00
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$445.00
|
| Rate for Payer: United Healthcare All Other HMO |
$445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$445.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC STRAPPING OF SHOULDER MCAL
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
901300013
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$178.00 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$356.00
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.00
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
|
|
HC STRAPPING OF SHOULDER MCAL
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
901300013
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$226.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$534.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Cash Price |
$400.50
|
| Rate for Payer: Central Health Plan Commercial |
$712.00
|
| Rate for Payer: Cigna of CA HMO |
$569.60
|
| Rate for Payer: Cigna of CA PPO |
$658.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$756.50
|
| Rate for Payer: Global Benefits Group Commercial |
$534.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$801.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$667.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$667.50
|
| Rate for Payer: Networks By Design Commercial |
$578.50
|
| Rate for Payer: Prime Health Services Commercial |
$756.50
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$175.56
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$534.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$191.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC STRAPPING OF TOES
|
Facility
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900501307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
