|
HC STRAP MONTGOMERY W TWILL 3X7IN
|
Facility
|
OP
|
$26.81
|
|
| Hospital Charge Code |
901607818
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$24.13 |
| Rate for Payer: Adventist Health Commercial |
$5.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.75
|
| Rate for Payer: Blue Shield of California Commercial |
$16.38
|
| Rate for Payer: Blue Shield of California EPN |
$10.70
|
| Rate for Payer: Cash Price |
$12.06
|
| Rate for Payer: Central Health Plan Commercial |
$21.45
|
| Rate for Payer: Cigna of CA HMO |
$17.16
|
| Rate for Payer: Cigna of CA PPO |
$19.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.72
|
| Rate for Payer: EPIC Health Plan Senior |
$10.72
|
| Rate for Payer: Galaxy Health WC |
$22.79
|
| Rate for Payer: Global Benefits Group Commercial |
$16.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.13
|
| Rate for Payer: InnovAge PACE Commercial |
$13.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.77
|
| Rate for Payer: Multiplan Commercial |
$20.11
|
| Rate for Payer: Networks By Design Commercial |
$17.43
|
| Rate for Payer: Prime Health Services Commercial |
$22.79
|
| Rate for Payer: Riverside University Health System MISP |
$10.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.40
|
| Rate for Payer: United Healthcare All Other HMO |
$13.40
|
| Rate for Payer: United Healthcare HMO Rider |
$13.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.79
|
| Rate for Payer: Vantage Medical Group Senior |
$22.79
|
|
|
HC STRAP MONTGOMERY W TWILL 3X7IN
|
Facility
|
IP
|
$26.81
|
|
| Hospital Charge Code |
901607818
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$24.13 |
| Rate for Payer: Adventist Health Commercial |
$5.36
|
| Rate for Payer: Cash Price |
$12.06
|
| Rate for Payer: Central Health Plan Commercial |
$21.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.72
|
| Rate for Payer: EPIC Health Plan Senior |
$10.72
|
| Rate for Payer: Galaxy Health WC |
$22.79
|
| Rate for Payer: Global Benefits Group Commercial |
$16.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.36
|
| Rate for Payer: Multiplan Commercial |
$20.11
|
| Rate for Payer: Networks By Design Commercial |
$17.43
|
| Rate for Payer: Prime Health Services Commercial |
$22.79
|
|
|
HC STRAPPING ANKLE
|
Facility
|
IP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$277.20
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$462.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$428.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
|
|
HC STRAPPING ANKLE
|
Facility
|
OP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$284.13
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$420.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$300.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$200.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$407.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$319.45
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Cigna of CA HMO |
$443.52
|
| Rate for Payer: Cigna of CA PPO |
$512.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$300.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$200.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.66
|
| Rate for Payer: EPIC Health Plan Senior |
$200.49
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$328.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$200.49
|
| Rate for Payer: InnovAge PACE Commercial |
$300.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$462.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$200.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$268.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$268.66
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$200.49
|
| Rate for Payer: Preferred Health Network WC |
$325.97
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
| Rate for Payer: Prime Health Services Medicare |
$212.52
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Riverside University Health System MISP |
$220.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$415.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$415.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$200.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$300.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.54
|
| Rate for Payer: Vantage Medical Group Senior |
$200.49
|
|
|
HC STRAPPING ANKLE
|
Facility
|
OP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$300.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$200.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$319.45
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Cigna of CA HMO |
$443.52
|
| Rate for Payer: Cigna of CA PPO |
$512.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$300.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$200.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.66
|
| Rate for Payer: EPIC Health Plan Senior |
$200.49
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$328.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$200.49
|
| Rate for Payer: InnovAge PACE Commercial |
$300.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$462.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$200.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$268.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$268.66
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$200.49
|
| Rate for Payer: Preferred Health Network WC |
$325.97
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
| Rate for Payer: Prime Health Services Medicare |
$212.52
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Riverside University Health System MISP |
$220.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$415.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$346.50
|
| Rate for Payer: United Healthcare All Other HMO |
$346.50
|
| Rate for Payer: United Healthcare HMO Rider |
$346.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$346.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$200.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$300.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.54
|
| Rate for Payer: Vantage Medical Group Senior |
$200.49
|
|
|
HC STRAPPING ANKLE
|
Facility
|
IP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900501219
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$277.20
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$462.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$428.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
|
|
HC STRAPPING ANKLE
|
Facility
|
OP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900419072
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Adventist Health Commercial |
$284.13
|
| Rate for Payer: Adventist Health Medi-Cal |
$200.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$420.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$300.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$200.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: Cigna of CA HMO |
$443.52
|
| Rate for Payer: Cigna of CA PPO |
$512.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$300.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$200.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.66
|
| Rate for Payer: EPIC Health Plan Senior |
$200.49
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$328.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$44.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$200.49
|
| Rate for Payer: InnovAge PACE Commercial |
$300.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$462.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$200.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$268.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$268.66
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$200.49
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
| Rate for Payer: Prime Health Services Medicare |
$212.52
|
| Rate for Payer: Riverside University Health System MISP |
$220.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$415.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$200.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$300.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.54
|
| Rate for Payer: Vantage Medical Group Senior |
$200.49
|
|
|
HC STRAPPING ANKLE
|
Facility
|
IP
|
$693.00
|
|
|
Service Code
|
CPT 29540
|
| Hospital Charge Code |
900419072
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$138.60 |
| Max. Negotiated Rate |
$623.70 |
| Rate for Payer: Adventist Health Commercial |
$138.60
|
| Rate for Payer: Cash Price |
$311.85
|
| Rate for Payer: Central Health Plan Commercial |
$554.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$277.20
|
| Rate for Payer: EPIC Health Plan Senior |
$277.20
|
| Rate for Payer: Galaxy Health WC |
$589.05
|
| Rate for Payer: Global Benefits Group Commercial |
$415.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$623.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$462.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$428.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.60
|
| Rate for Payer: Multiplan Commercial |
$519.75
|
| Rate for Payer: Networks By Design Commercial |
$450.45
|
| Rate for Payer: Prime Health Services Commercial |
$589.05
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901301209
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Central Health Plan Commercial |
$942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$471.20
|
| Rate for Payer: EPIC Health Plan Senior |
$471.20
|
| Rate for Payer: Galaxy Health WC |
$1,001.30
|
| Rate for Payer: Global Benefits Group Commercial |
$706.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,060.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$785.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$729.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.60
|
| Rate for Payer: Multiplan Commercial |
$883.50
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.30
|
|
|
HC STRAPPING ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901301209
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$482.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$715.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Cash Price |
$530.10
|
| Rate for Payer: Central Health Plan Commercial |
$942.40
|
| Rate for Payer: Cigna of CA HMO |
$753.92
|
| Rate for Payer: Cigna of CA PPO |
$871.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$1,001.30
|
| Rate for Payer: Global Benefits Group Commercial |
$706.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,060.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$785.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$883.50
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.30
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$706.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$75.47 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$569.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$843.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Cigna of CA HMO |
$888.96
|
| Rate for Payer: Cigna of CA PPO |
$1,027.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$89.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$926.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$569.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$833.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$555.60
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$926.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$529.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$859.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901301210
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$75.47 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$569.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$843.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Cigna of CA HMO |
$888.96
|
| Rate for Payer: Cigna of CA PPO |
$1,027.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$89.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$926.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$569.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$833.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$555.60
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$926.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$529.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$859.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$75.47 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$569.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$843.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$815.76
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$120.25
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Cigna of CA HMO |
$888.96
|
| Rate for Payer: Cigna of CA PPO |
$1,027.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$926.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Preferred Health Network WC |
$122.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$833.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$833.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901301210
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$555.60
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$926.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$529.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$859.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$555.60
|
| Rate for Payer: EPIC Health Plan Senior |
$555.60
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$926.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$529.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$859.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
|
|
HC STRAPPING HAND OR FINGER
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
900501366
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$75.47 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$120.25
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,111.20
|
| Rate for Payer: Cigna of CA HMO |
$888.96
|
| Rate for Payer: Cigna of CA PPO |
$1,027.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$1,180.65
|
| Rate for Payer: Global Benefits Group Commercial |
$833.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,250.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$926.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$1,041.75
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$902.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Preferred Health Network WC |
$122.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,180.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$833.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$694.50
|
| Rate for Payer: United Healthcare All Other HMO |
$694.50
|
| Rate for Payer: United Healthcare HMO Rider |
$694.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$694.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC STRAPPING, HIP
|
Facility
|
IP
|
$1,233.00
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
900501627
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$246.60 |
| Max. Negotiated Rate |
$1,109.70 |
| Rate for Payer: Adventist Health Commercial |
$246.60
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Central Health Plan Commercial |
$986.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$493.20
|
| Rate for Payer: EPIC Health Plan Senior |
$493.20
|
| Rate for Payer: Galaxy Health WC |
$1,048.05
|
| Rate for Payer: Global Benefits Group Commercial |
$739.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,109.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$822.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$469.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$763.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.60
|
| Rate for Payer: Multiplan Commercial |
$924.75
|
| Rate for Payer: Networks By Design Commercial |
$801.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,048.05
|
|
|
HC STRAPPING, HIP
|
Facility
|
OP
|
$1,233.00
|
|
|
Service Code
|
CPT 29520
|
| Hospital Charge Code |
900501627
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$61.39 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$246.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Cash Price |
$554.85
|
| Rate for Payer: Central Health Plan Commercial |
$986.40
|
| Rate for Payer: Cigna of CA HMO |
$789.12
|
| Rate for Payer: Cigna of CA PPO |
$912.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,048.05
|
| Rate for Payer: Global Benefits Group Commercial |
$739.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,109.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$822.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$61.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$924.75
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$801.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$1,048.05
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$739.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$616.50
|
| Rate for Payer: United Healthcare All Other HMO |
$616.50
|
| Rate for Payer: United Healthcare HMO Rider |
$616.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$616.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$461.66
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$683.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$661.30
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA HMO |
$720.64
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$675.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$675.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC STRAPPING KNEE
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.40
|
| Rate for Payer: EPIC Health Plan Senior |
$450.40
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
|
|
HC STRAPPING KNEE
|
Facility
|
IP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900419071
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$225.20 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$450.40
|
| Rate for Payer: EPIC Health Plan Senior |
$450.40
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900419071
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$51.22 |
| Max. Negotiated Rate |
$1,013.40 |
| Rate for Payer: Adventist Health Commercial |
$461.66
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$683.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA HMO |
$720.64
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$461.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$675.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC STRAPPING KNEE
|
Facility
|
OP
|
$1,126.00
|
|
|
Service Code
|
CPT 29530
|
| Hospital Charge Code |
900501108
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$56.58 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$225.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Cash Price |
$506.70
|
| Rate for Payer: Central Health Plan Commercial |
$900.80
|
| Rate for Payer: Cigna of CA HMO |
$720.64
|
| Rate for Payer: Cigna of CA PPO |
$833.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$957.10
|
| Rate for Payer: Global Benefits Group Commercial |
$675.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,013.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$751.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$844.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$731.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$957.10
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$675.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$563.00
|
| Rate for Payer: United Healthcare All Other HMO |
$563.00
|
| Rate for Payer: United Healthcare HMO Rider |
$563.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$563.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
