|
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
|
|
|
HC STRAPPING OF TOES
|
Facility
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900419073
|
|
Hospital Revenue Code
|
420
|
| 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
|
|
|
HC STRAPPING OF TOES
|
Facility
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900501307
|
|
Hospital Revenue Code
|
516
|
| 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
|
|
|
HC STRAPPING OF TOES
|
Facility
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900501307
|
|
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 |
$87.19
|
| 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 |
$663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$695.04
|
| Rate for Payer: Blue Shield of California EPN |
$540.34
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| 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 |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$828.75
|
| 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 |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| 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 |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$663.00
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$663.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.50
|
| Rate for Payer: United Healthcare All Other HMO |
$552.50
|
| Rate for Payer: United Healthcare HMO Rider |
$552.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.50
|
| 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 TOES
|
Facility
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900501307
|
|
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 |
$663.00
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| 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 |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$828.75
|
| 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 |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| 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 |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$663.00
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.50
|
| Rate for Payer: United Healthcare All Other HMO |
$552.50
|
| Rate for Payer: United Healthcare HMO Rider |
$552.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.50
|
| 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 SHOULDER
|
Facility
OP
|
$890.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
901301208
|
|
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 SHOULDER
|
Facility
IP
|
$890.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
901301208
|
|
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 THORAX
|
Facility
IP
|
$645.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
902890345
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$129.00 |
| Max. Negotiated Rate |
$580.50 |
| Rate for Payer: Cash Price |
$290.25
|
| Rate for Payer: Central Health Plan Commercial |
$516.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$258.00
|
| Rate for Payer: Galaxy Health WC |
$548.25
|
| Rate for Payer: Global Benefits Group Commercial |
$387.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$580.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$430.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$483.75
|
| Rate for Payer: Networks By Design Commercial |
$419.25
|
| Rate for Payer: Prime Health Services Commercial |
$548.25
|
|
|
HC STRAPPING THORAX
|
Facility
OP
|
$645.00
|
|
|
Service Code
|
CPT 29200
|
| Hospital Charge Code |
902890345
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$129.00 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$196.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$207.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| 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 |
$387.00
|
| Rate for Payer: Blue Shield of California Commercial |
$405.70
|
| Rate for Payer: Blue Shield of California EPN |
$315.40
|
| Rate for Payer: Caremore Medicare Advantage |
$196.87
|
| Rate for Payer: Cash Price |
$290.25
|
| Rate for Payer: Cash Price |
$290.25
|
| Rate for Payer: Cash Price |
$290.25
|
| Rate for Payer: Central Health Plan Commercial |
$516.00
|
| Rate for Payer: Cigna of CA HMO |
$412.80
|
| Rate for Payer: Cigna of CA PPO |
$477.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$196.87
|
| Rate for Payer: Galaxy Health WC |
$548.25
|
| Rate for Payer: Global Benefits Group Commercial |
$387.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$580.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$483.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$322.87
|
| Rate for Payer: IEHP medi-cal |
$324.84
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Innovage PACE Commercial |
$295.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$430.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.81
|
| Rate for Payer: Multiplan Commercial |
$483.75
|
| Rate for Payer: Networks By Design Commercial |
$419.25
|
| Rate for Payer: Prime Health Services Commercial |
$548.25
|
| Rate for Payer: Prime Health Services Medicare |
$208.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$387.00
|
| Rate for Payer: Riverside University Health MISP |
$216.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$387.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$387.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$322.50
|
| Rate for Payer: United Healthcare All Other HMO |
$322.50
|
| Rate for Payer: United Healthcare HMO Rider |
$322.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$322.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
OP
|
$810.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
900501109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.00 |
| 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 |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| 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 |
$486.00
|
| Rate for Payer: Caremore Medicare Advantage |
$196.87
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: Cigna of CA PPO |
$599.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$196.87
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$607.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$322.87
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Innovage PACE Commercial |
$295.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.81
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
| Rate for Payer: Prime Health Services Medicare |
$208.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: Riverside University Health MISP |
$216.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$405.00
|
| Rate for Payer: United Healthcare All Other HMO |
$405.00
|
| Rate for Payer: United Healthcare HMO Rider |
$405.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
IP
|
$810.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
900501109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.00
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
OP
|
$810.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
900501109
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$196.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$187.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| 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 |
$486.00
|
| Rate for Payer: Blue Shield of California Commercial |
$509.49
|
| Rate for Payer: Blue Shield of California EPN |
$396.09
|
| Rate for Payer: Caremore Medicare Advantage |
$196.87
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: Cigna of CA HMO |
$518.40
|
| Rate for Payer: Cigna of CA PPO |
$599.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$196.87
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$607.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$322.87
|
| Rate for Payer: IEHP medi-cal |
$324.84
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Innovage PACE Commercial |
$295.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.81
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
| Rate for Payer: Prime Health Services Medicare |
$208.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: Riverside University Health MISP |
$216.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$405.00
|
| Rate for Payer: United Healthcare All Other HMO |
$405.00
|
| Rate for Payer: United Healthcare HMO Rider |
$405.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
OP
|
$810.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
900501109
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$187.94 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$196.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$187.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| 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 |
$486.00
|
| 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 |
$196.87
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: Cigna of CA HMO |
$518.40
|
| Rate for Payer: Cigna of CA PPO |
$599.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$196.87
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$607.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$322.87
|
| Rate for Payer: IEHP medi-cal |
$324.84
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Innovage PACE Commercial |
$295.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.81
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
| Rate for Payer: Prime Health Services Medicare |
$208.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$216.56
|
| Rate for Payer: Riverside University Health MISP |
$216.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$236.24
|
| 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 |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
IP
|
$810.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
900501109
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.00
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
IP
|
$810.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
900501109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.00
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
IP
|
$810.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
900501109
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$729.00 |
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.00
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
|
|
HC STRAPPING UNNA BOOT
|
Facility
OP
|
$810.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
900501109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$196.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$187.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| 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 |
$486.00
|
| Rate for Payer: Blue Shield of California Commercial |
$509.49
|
| Rate for Payer: Blue Shield of California EPN |
$396.09
|
| Rate for Payer: Caremore Medicare Advantage |
$196.87
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Cash Price |
$364.50
|
| Rate for Payer: Central Health Plan Commercial |
$648.00
|
| Rate for Payer: Cigna of CA HMO |
$518.40
|
| Rate for Payer: Cigna of CA PPO |
$599.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$196.87
|
| Rate for Payer: Galaxy Health WC |
$688.50
|
| Rate for Payer: Global Benefits Group Commercial |
$486.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$607.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$322.87
|
| Rate for Payer: IEHP medi-cal |
$324.84
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Innovage PACE Commercial |
$295.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$540.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.81
|
| Rate for Payer: Multiplan Commercial |
$607.50
|
| Rate for Payer: Networks By Design Commercial |
$526.50
|
| Rate for Payer: Prime Health Services Commercial |
$688.50
|
| Rate for Payer: Prime Health Services Medicare |
$208.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: Riverside University Health MISP |
$216.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$486.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$405.00
|
| Rate for Payer: United Healthcare All Other HMO |
$405.00
|
| Rate for Payer: United Healthcare HMO Rider |
$405.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC STRAP SURGI-BRA NYLON 2XL
|
Facility
IP
|
$324.38
|
|
| Hospital Charge Code |
901605686
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.88 |
| Max. Negotiated Rate |
$291.94 |
| Rate for Payer: Cash Price |
$145.97
|
| Rate for Payer: Central Health Plan Commercial |
$259.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.75
|
| Rate for Payer: Galaxy Health WC |
$275.72
|
| Rate for Payer: Global Benefits Group Commercial |
$194.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$291.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$216.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.88
|
| Rate for Payer: Multiplan Commercial |
$243.28
|
| Rate for Payer: Networks By Design Commercial |
$210.85
|
| Rate for Payer: Prime Health Services Commercial |
$275.72
|
|
|
HC STRAP SURGI-BRA NYLON 2XL
|
Facility
OP
|
$324.38
|
|
| Hospital Charge Code |
901605686
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$64.88 |
| Max. Negotiated Rate |
$291.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$197.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$275.72
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$178.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$178.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$157.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$191.64
|
| Rate for Payer: BCBS Transplant Transplant |
$194.63
|
| Rate for Payer: Blue Shield of California Commercial |
$204.04
|
| Rate for Payer: Blue Shield of California EPN |
$158.62
|
| Rate for Payer: Cash Price |
$145.97
|
| Rate for Payer: Central Health Plan Commercial |
$259.50
|
| Rate for Payer: Cigna of CA HMO |
$207.60
|
| Rate for Payer: Cigna of CA PPO |
$240.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$275.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$129.75
|
| Rate for Payer: Galaxy Health WC |
$275.72
|
| Rate for Payer: Global Benefits Group Commercial |
$194.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$291.94
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$243.28
|
| Rate for Payer: IEHP medi-cal |
$113.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$216.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.88
|
| Rate for Payer: Multiplan Commercial |
$243.28
|
| Rate for Payer: Networks By Design Commercial |
$210.85
|
| Rate for Payer: Prime Health Services Commercial |
$275.72
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$194.63
|
| Rate for Payer: Riverside University Health MISP |
$129.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$194.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$194.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$162.19
|
| Rate for Payer: United Healthcare All Other HMO |
$162.19
|
| Rate for Payer: United Healthcare HMO Rider |
$162.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$162.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.72
|
| Rate for Payer: Vantage Medical Group Senior |
$275.72
|
|
|
HC STRAP SURGI-BRA NYLON LG
|
Facility
OP
|
$162.47
|
|
| Hospital Charge Code |
901605684
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$146.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$138.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$89.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$89.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.99
|
| Rate for Payer: BCBS Transplant Transplant |
$97.48
|
| Rate for Payer: Blue Shield of California Commercial |
$102.19
|
| Rate for Payer: Blue Shield of California EPN |
$79.45
|
| Rate for Payer: Cash Price |
$73.11
|
| Rate for Payer: Central Health Plan Commercial |
$129.98
|
| Rate for Payer: Cigna of CA HMO |
$103.98
|
| Rate for Payer: Cigna of CA PPO |
$120.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$138.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$64.99
|
| Rate for Payer: Galaxy Health WC |
$138.10
|
| Rate for Payer: Global Benefits Group Commercial |
$97.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$146.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$121.85
|
| Rate for Payer: IEHP medi-cal |
$56.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.49
|
| Rate for Payer: Multiplan Commercial |
$121.85
|
| Rate for Payer: Networks By Design Commercial |
$105.61
|
| Rate for Payer: Prime Health Services Commercial |
$138.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$97.48
|
| Rate for Payer: Riverside University Health MISP |
$64.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$97.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$97.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$81.24
|
| Rate for Payer: United Healthcare All Other HMO |
$81.24
|
| Rate for Payer: United Healthcare HMO Rider |
$81.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$138.10
|
| Rate for Payer: Vantage Medical Group Senior |
$138.10
|
|
|
HC STRAP SURGI-BRA NYLON LG
|
Facility
IP
|
$162.47
|
|
| Hospital Charge Code |
901605684
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$146.22 |
| Rate for Payer: Cash Price |
$73.11
|
| Rate for Payer: Central Health Plan Commercial |
$129.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.99
|
| Rate for Payer: Galaxy Health WC |
$138.10
|
| Rate for Payer: Global Benefits Group Commercial |
$97.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$146.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.49
|
| Rate for Payer: Multiplan Commercial |
$121.85
|
| Rate for Payer: Networks By Design Commercial |
$105.61
|
| Rate for Payer: Prime Health Services Commercial |
$138.10
|
|
|
HC STRAP SURGI-BRA NYLON MED
|
Facility
IP
|
$162.47
|
|
| Hospital Charge Code |
901605685
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$146.22 |
| Rate for Payer: Cash Price |
$73.11
|
| Rate for Payer: Central Health Plan Commercial |
$129.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.99
|
| Rate for Payer: Galaxy Health WC |
$138.10
|
| Rate for Payer: Global Benefits Group Commercial |
$97.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$146.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.49
|
| Rate for Payer: Multiplan Commercial |
$121.85
|
| Rate for Payer: Networks By Design Commercial |
$105.61
|
| Rate for Payer: Prime Health Services Commercial |
$138.10
|
|
|
HC STRAP SURGI-BRA NYLON MED
|
Facility
OP
|
$162.47
|
|
| Hospital Charge Code |
901605685
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$146.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$138.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$89.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$89.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.99
|
| Rate for Payer: BCBS Transplant Transplant |
$97.48
|
| Rate for Payer: Blue Shield of California Commercial |
$102.19
|
| Rate for Payer: Blue Shield of California EPN |
$79.45
|
| Rate for Payer: Cash Price |
$73.11
|
| Rate for Payer: Central Health Plan Commercial |
$129.98
|
| Rate for Payer: Cigna of CA HMO |
$103.98
|
| Rate for Payer: Cigna of CA PPO |
$120.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$138.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$64.99
|
| Rate for Payer: Galaxy Health WC |
$138.10
|
| Rate for Payer: Global Benefits Group Commercial |
$97.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$146.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$121.85
|
| Rate for Payer: IEHP medi-cal |
$56.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.49
|
| Rate for Payer: Multiplan Commercial |
$121.85
|
| Rate for Payer: Networks By Design Commercial |
$105.61
|
| Rate for Payer: Prime Health Services Commercial |
$138.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$97.48
|
| Rate for Payer: Riverside University Health MISP |
$64.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$97.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$97.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$81.24
|
| Rate for Payer: United Healthcare All Other HMO |
$81.24
|
| Rate for Payer: United Healthcare HMO Rider |
$81.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$138.10
|
| Rate for Payer: Vantage Medical Group Senior |
$138.10
|
|
|
HC STRAP SURGI-BRA X-LARGE
|
Facility
OP
|
$162.47
|
|
| Hospital Charge Code |
901603298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$146.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$138.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$89.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$89.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.99
|
| Rate for Payer: BCBS Transplant Transplant |
$97.48
|
| Rate for Payer: Blue Shield of California Commercial |
$102.19
|
| Rate for Payer: Blue Shield of California EPN |
$79.45
|
| Rate for Payer: Cash Price |
$73.11
|
| Rate for Payer: Central Health Plan Commercial |
$129.98
|
| Rate for Payer: Cigna of CA HMO |
$103.98
|
| Rate for Payer: Cigna of CA PPO |
$120.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$138.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.99
|
| Rate for Payer: EPIC Health Plan Transplant |
$64.99
|
| Rate for Payer: Galaxy Health WC |
$138.10
|
| Rate for Payer: Global Benefits Group Commercial |
$97.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$146.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$121.85
|
| Rate for Payer: IEHP medi-cal |
$56.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.49
|
| Rate for Payer: Multiplan Commercial |
$121.85
|
| Rate for Payer: Networks By Design Commercial |
$105.61
|
| Rate for Payer: Prime Health Services Commercial |
$138.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$97.48
|
| Rate for Payer: Riverside University Health MISP |
$64.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$97.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$97.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$81.24
|
| Rate for Payer: United Healthcare All Other HMO |
$81.24
|
| Rate for Payer: United Healthcare HMO Rider |
$81.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$138.10
|
| Rate for Payer: Vantage Medical Group Senior |
$138.10
|
|
|
HC STRAP SURGI-BRA X-LARGE
|
Facility
IP
|
$162.47
|
|
| Hospital Charge Code |
901603298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.49 |
| Max. Negotiated Rate |
$146.22 |
| Rate for Payer: Cash Price |
$73.11
|
| Rate for Payer: Central Health Plan Commercial |
$129.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.99
|
| Rate for Payer: Galaxy Health WC |
$138.10
|
| Rate for Payer: Global Benefits Group Commercial |
$97.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$146.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.49
|
| Rate for Payer: Multiplan Commercial |
$121.85
|
| Rate for Payer: Networks By Design Commercial |
$105.61
|
| Rate for Payer: Prime Health Services Commercial |
$138.10
|
|
