|
HC STRAPPING OF ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$53.75 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$482.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$691.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$120.25
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 |
$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 |
$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 |
$235.60
|
| 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: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| 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 |
$1,001.30
|
| 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 |
$706.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$706.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| 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 OF ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$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 |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
903200240
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF ELBOW OR WRIST
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$53.75 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| 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 |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 |
$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 |
$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 |
$235.60
|
| 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: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| 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 |
$1,001.30
|
| 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 |
$706.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$589.00
|
| Rate for Payer: United Healthcare All Other HMO |
$589.00
|
| Rate for Payer: United Healthcare HMO Rider |
$589.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$589.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| 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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF ELBOW OR WRIST
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
900501428
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF ELBOW OR WRIST MCAL
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901300015
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF ELBOW OR WRIST MCAL
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29260
|
| Hospital Charge Code |
901300015
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$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 |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF HAND OR FINGER
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
903200242
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$763.95
|
| 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 OF HAND OR FINGER
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
903200242
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$75.47 |
| 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 |
$763.95
|
| Rate for Payer: Cash Price |
$763.95
|
| Rate for Payer: Cash Price |
$763.95
|
| Rate for Payer: Cash Price |
$763.95
|
| 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 OF HAND OR FINGER MCAL
|
Facility
|
IP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901300017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$277.80 |
| Max. Negotiated Rate |
$1,250.10 |
| Rate for Payer: Adventist Health Commercial |
$277.80
|
| Rate for Payer: Cash Price |
$763.95
|
| 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 OF HAND OR FINGER MCAL
|
Facility
|
OP
|
$1,389.00
|
|
|
Service Code
|
CPT 29280
|
| Hospital Charge Code |
901300017
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$75.47 |
| 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 |
$763.95
|
| Rate for Payer: Cash Price |
$763.95
|
| Rate for Payer: Cash Price |
$763.95
|
| Rate for Payer: Cash Price |
$763.95
|
| 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 OF SHOULDER
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$67.91 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 |
$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 |
$1,001.30
|
| 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 |
$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 |
$785.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.60
|
| 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 |
$883.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.30
|
| Rate for Payer: Prime Health Services Medicare |
$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 |
$706.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$589.00
|
| Rate for Payer: United Healthcare All Other HMO |
$589.00
|
| Rate for Payer: United Healthcare HMO Rider |
$589.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$589.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$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 OF SHOULDER
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF SHOULDER
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$67.91 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$482.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$715.40
|
| 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 |
$691.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 |
$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 |
$1,001.30
|
| 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 |
$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 |
$785.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.60
|
| 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 |
$883.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.30
|
| Rate for Payer: Prime Health Services Medicare |
$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 |
$706.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$706.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$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 OF SHOULDER
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
900501103
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF SHOULDER MCAL
|
Facility
|
IP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
901300013
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$235.60 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$235.60
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 OF SHOULDER MCAL
|
Facility
|
OP
|
$1,178.00
|
|
|
Service Code
|
CPT 29240
|
| Hospital Charge Code |
901300013
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$61.47 |
| Max. Negotiated Rate |
$1,060.20 |
| Rate for Payer: Adventist Health Commercial |
$482.98
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$715.40
|
| 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 |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| Rate for Payer: Cash Price |
$647.90
|
| 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 |
$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 |
$1,001.30
|
| 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 |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$61.47
|
| 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 |
$785.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.98
|
| 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 |
$883.50
|
| Rate for Payer: Networks By Design Commercial |
$765.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.30
|
| 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 |
$706.80
|
| 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 OF TOES
|
Facility
|
OP
|
$1,462.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900501307
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$599.42
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$887.87
|
| 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 |
$858.63
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$120.25
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,169.60
|
| Rate for Payer: Cigna of CA HMO |
$935.68
|
| Rate for Payer: Cigna of CA PPO |
$1,081.88
|
| 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 |
$1,242.70
|
| Rate for Payer: Global Benefits Group Commercial |
$877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,315.80
|
| 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 |
$975.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.40
|
| 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 |
$1,096.50
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$950.30
|
| 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 |
$1,242.70
|
| 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 |
$877.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$877.20
|
| 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 OF TOES
|
Facility
|
OP
|
$1,462.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900419073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$28.81 |
| Max. Negotiated Rate |
$1,315.80 |
| Rate for Payer: Adventist Health Commercial |
$599.42
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$887.87
|
| 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 |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,169.60
|
| Rate for Payer: Cigna of CA HMO |
$935.68
|
| Rate for Payer: Cigna of CA PPO |
$1,081.88
|
| 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 |
$1,242.70
|
| Rate for Payer: Global Benefits Group Commercial |
$877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,315.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.81
|
| 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 |
$975.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.42
|
| 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 |
$1,096.50
|
| Rate for Payer: Networks By Design Commercial |
$950.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,242.70
|
| 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 |
$877.20
|
| 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 OF TOES
|
Facility
|
OP
|
$1,462.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900501307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$292.40
|
| 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 |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,169.60
|
| Rate for Payer: Cigna of CA HMO |
$935.68
|
| Rate for Payer: Cigna of CA PPO |
$1,081.88
|
| 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 |
$1,242.70
|
| Rate for Payer: Global Benefits Group Commercial |
$877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,315.80
|
| 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 |
$975.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.40
|
| 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 |
$1,096.50
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$950.30
|
| 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 |
$1,242.70
|
| 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 |
$877.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$731.00
|
| Rate for Payer: United Healthcare All Other HMO |
$731.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$731.00
|
| 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 OF TOES
|
Facility
|
IP
|
$1,462.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900419073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$292.40 |
| Max. Negotiated Rate |
$1,315.80 |
| Rate for Payer: Adventist Health Commercial |
$292.40
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,169.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$584.80
|
| Rate for Payer: Galaxy Health WC |
$1,242.70
|
| Rate for Payer: Global Benefits Group Commercial |
$877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,315.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$975.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$557.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$904.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.40
|
| Rate for Payer: Multiplan Commercial |
$1,096.50
|
| Rate for Payer: Networks By Design Commercial |
$950.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,242.70
|
|
|
HC STRAPPING OF TOES
|
Facility
|
IP
|
$1,462.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900501307
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$292.40 |
| Max. Negotiated Rate |
$1,315.80 |
| Rate for Payer: Adventist Health Commercial |
$292.40
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,169.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$584.80
|
| Rate for Payer: Galaxy Health WC |
$1,242.70
|
| Rate for Payer: Global Benefits Group Commercial |
$877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,315.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$975.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$557.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$904.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.40
|
| Rate for Payer: Multiplan Commercial |
$1,096.50
|
| Rate for Payer: Networks By Design Commercial |
$950.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,242.70
|
|
|
HC STRAPPING OF TOES
|
Facility
|
IP
|
$1,462.00
|
|
|
Service Code
|
CPT 29550
|
| Hospital Charge Code |
900501307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$292.40 |
| Max. Negotiated Rate |
$1,315.80 |
| Rate for Payer: Adventist Health Commercial |
$292.40
|
| Rate for Payer: Cash Price |
$804.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,169.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$584.80
|
| Rate for Payer: Galaxy Health WC |
$1,242.70
|
| Rate for Payer: Global Benefits Group Commercial |
$877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,315.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$975.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$557.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$904.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$292.40
|
| Rate for Payer: Multiplan Commercial |
$1,096.50
|
| Rate for Payer: Networks By Design Commercial |
$950.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,242.70
|
|
