|
NEONATE WITH OTHER SIGNIFICANT PROBLEMS
|
Facility
|
IP
|
$38,844.21
|
|
|
Service Code
|
MSDRG 794
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,844.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,844.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,091.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,129.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,074.50
|
| Rate for Payer: EPIC Health Plan Senior |
$23,383.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,257.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29,760.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28,484.74
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,257.27
|
| Rate for Payer: Prime Health Services Medicare |
$22,532.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,809.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,601.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
NEOSTIGMINE 5 MG/5 ML IN STERILE WATER INJECTION SYRINGE [215593]
|
Facility
|
OP
|
$3.43
|
|
|
Service Code
|
HCPCS J2710
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.69 |
| Max. Negotiated Rate |
$25.77 |
| Rate for Payer: Adventist Health Commercial |
$0.69
|
| Rate for Payer: Adventist Health Commercial |
$0.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.77
|
| Rate for Payer: Blue Shield of California Commercial |
$1.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1.06
|
| Rate for Payer: Blue Shield of California EPN |
$0.96
|
| Rate for Payer: Blue Shield of California EPN |
$0.96
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Central Health Plan Commercial |
$2.74
|
| Rate for Payer: Central Health Plan Commercial |
$2.89
|
| Rate for Payer: Cigna of CA HMO |
$2.40
|
| Rate for Payer: Cigna of CA HMO |
$2.53
|
| Rate for Payer: Cigna of CA PPO |
$2.53
|
| Rate for Payer: Cigna of CA PPO |
$2.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.44
|
| Rate for Payer: EPIC Health Plan Senior |
$1.37
|
| Rate for Payer: EPIC Health Plan Senior |
$1.44
|
| Rate for Payer: Galaxy Health WC |
$3.07
|
| Rate for Payer: Galaxy Health WC |
$2.92
|
| Rate for Payer: Global Benefits Group Commercial |
$2.06
|
| Rate for Payer: Global Benefits Group Commercial |
$2.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.53
|
| Rate for Payer: Multiplan Commercial |
$2.71
|
| Rate for Payer: Multiplan Commercial |
$2.57
|
| Rate for Payer: Networks By Design Commercial |
$1.80
|
| Rate for Payer: Networks By Design Commercial |
$1.72
|
| Rate for Payer: Prime Health Services Commercial |
$2.92
|
| Rate for Payer: Prime Health Services Commercial |
$3.07
|
| Rate for Payer: Riverside University Health System MISP |
$1.44
|
| Rate for Payer: Riverside University Health System MISP |
$1.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.35
|
| Rate for Payer: United Healthcare All Other HMO |
$1.32
|
| Rate for Payer: United Healthcare All Other HMO |
$1.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.07
|
| Rate for Payer: Vantage Medical Group Senior |
$3.07
|
| Rate for Payer: Vantage Medical Group Senior |
$2.92
|
|
|
NEOSTIGMINE 5 MG/5 ML IN STERILE WATER INJECTION SYRINGE [215593]
|
Facility
|
IP
|
$3.61
|
|
|
Service Code
|
HCPCS J2710
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$3.25 |
| Rate for Payer: Adventist Health Commercial |
$0.72
|
| Rate for Payer: Adventist Health Commercial |
$0.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2.90
|
| Rate for Payer: Blue Shield of California Commercial |
$2.75
|
| Rate for Payer: Blue Shield of California EPN |
$1.73
|
| Rate for Payer: Blue Shield of California EPN |
$1.82
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Central Health Plan Commercial |
$2.89
|
| Rate for Payer: Central Health Plan Commercial |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$2.40
|
| Rate for Payer: Cigna of CA HMO |
$2.53
|
| Rate for Payer: Cigna of CA PPO |
$2.40
|
| Rate for Payer: Cigna of CA PPO |
$2.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.44
|
| Rate for Payer: EPIC Health Plan Senior |
$1.37
|
| Rate for Payer: EPIC Health Plan Senior |
$1.44
|
| Rate for Payer: Galaxy Health WC |
$3.07
|
| Rate for Payer: Galaxy Health WC |
$2.92
|
| Rate for Payer: Global Benefits Group Commercial |
$2.06
|
| Rate for Payer: Global Benefits Group Commercial |
$2.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.69
|
| Rate for Payer: Multiplan Commercial |
$2.57
|
| Rate for Payer: Multiplan Commercial |
$2.71
|
| Rate for Payer: Networks By Design Commercial |
$1.72
|
| Rate for Payer: Networks By Design Commercial |
$1.80
|
| Rate for Payer: Prime Health Services Commercial |
$3.07
|
| Rate for Payer: Prime Health Services Commercial |
$2.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.35
|
| Rate for Payer: United Healthcare All Other HMO |
$1.32
|
| Rate for Payer: United Healthcare All Other HMO |
$1.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.18
|
|
|
NEOSTIGMINE METHYLSULFATE 1 MG/ML INJECTION SOLUTION. [4085490]
|
Facility
|
IP
|
$3.43
|
|
|
Service Code
|
HCPCS J2710
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.69 |
| Max. Negotiated Rate |
$3.09 |
| Rate for Payer: Adventist Health Commercial |
$0.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2.75
|
| Rate for Payer: Blue Shield of California EPN |
$1.73
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Central Health Plan Commercial |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$2.40
|
| Rate for Payer: Cigna of CA PPO |
$2.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.37
|
| Rate for Payer: EPIC Health Plan Senior |
$1.37
|
| Rate for Payer: Galaxy Health WC |
$2.92
|
| Rate for Payer: Global Benefits Group Commercial |
$2.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.69
|
| Rate for Payer: Multiplan Commercial |
$2.57
|
| Rate for Payer: Networks By Design Commercial |
$1.72
|
| Rate for Payer: Prime Health Services Commercial |
$2.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.29
|
| Rate for Payer: United Healthcare All Other HMO |
$1.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.12
|
|
|
NEOSTIGMINE METHYLSULFATE 1 MG/ML INJECTION SOLUTION. [4085490]
|
Facility
|
OP
|
$3.43
|
|
|
Service Code
|
HCPCS J2710
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.69 |
| Max. Negotiated Rate |
$25.77 |
| Rate for Payer: Adventist Health Commercial |
$0.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.77
|
| Rate for Payer: Blue Shield of California Commercial |
$1.06
|
| Rate for Payer: Blue Shield of California EPN |
$0.96
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Central Health Plan Commercial |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$2.40
|
| Rate for Payer: Cigna of CA PPO |
$2.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.37
|
| Rate for Payer: EPIC Health Plan Senior |
$1.37
|
| Rate for Payer: Galaxy Health WC |
$2.92
|
| Rate for Payer: Global Benefits Group Commercial |
$2.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$2.57
|
| Rate for Payer: Networks By Design Commercial |
$1.72
|
| Rate for Payer: Prime Health Services Commercial |
$2.92
|
| Rate for Payer: Riverside University Health System MISP |
$1.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.29
|
| Rate for Payer: United Healthcare All Other HMO |
$1.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.92
|
| Rate for Payer: Vantage Medical Group Senior |
$2.92
|
|
|
NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) INTRAVENOUS SYRINGE [120692]
|
Facility
|
OP
|
$2.96
|
|
|
Service Code
|
HCPCS J2710
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.59 |
| Max. Negotiated Rate |
$25.77 |
| Rate for Payer: Adventist Health Commercial |
$0.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.77
|
| Rate for Payer: Blue Shield of California Commercial |
$1.06
|
| Rate for Payer: Blue Shield of California EPN |
$0.96
|
| Rate for Payer: Cash Price |
$1.33
|
| Rate for Payer: Cash Price |
$1.33
|
| Rate for Payer: Central Health Plan Commercial |
$2.37
|
| Rate for Payer: Cigna of CA HMO |
$2.07
|
| Rate for Payer: Cigna of CA PPO |
$2.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.18
|
| Rate for Payer: EPIC Health Plan Senior |
$1.18
|
| Rate for Payer: Galaxy Health WC |
$2.52
|
| Rate for Payer: Global Benefits Group Commercial |
$1.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.07
|
| Rate for Payer: Multiplan Commercial |
$2.22
|
| Rate for Payer: Networks By Design Commercial |
$1.48
|
| Rate for Payer: Prime Health Services Commercial |
$2.52
|
| Rate for Payer: Riverside University Health System MISP |
$1.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1.08
|
| Rate for Payer: United Healthcare HMO Rider |
$1.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.52
|
| Rate for Payer: Vantage Medical Group Senior |
$2.52
|
|
|
NEOSTIGMINE METHYLSULFATE 5 MG/5 ML (1 MG/ML) INTRAVENOUS SYRINGE [120692]
|
Facility
|
IP
|
$2.96
|
|
|
Service Code
|
HCPCS J2710
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.59 |
| Max. Negotiated Rate |
$2.66 |
| Rate for Payer: Adventist Health Commercial |
$0.59
|
| Rate for Payer: Blue Shield of California Commercial |
$2.37
|
| Rate for Payer: Blue Shield of California EPN |
$1.49
|
| Rate for Payer: Cash Price |
$1.33
|
| Rate for Payer: Central Health Plan Commercial |
$2.37
|
| Rate for Payer: Cigna of CA HMO |
$2.07
|
| Rate for Payer: Cigna of CA PPO |
$2.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.18
|
| Rate for Payer: EPIC Health Plan Senior |
$1.18
|
| Rate for Payer: Galaxy Health WC |
$2.52
|
| Rate for Payer: Global Benefits Group Commercial |
$1.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.59
|
| Rate for Payer: Multiplan Commercial |
$2.22
|
| Rate for Payer: Networks By Design Commercial |
$1.48
|
| Rate for Payer: Prime Health Services Commercial |
$2.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1.08
|
| Rate for Payer: United Healthcare HMO Rider |
$1.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.97
|
|
|
NEPHRECTOMY, INCLUDING PARTIAL URETERECTOMY, ANY OPEN APPROACH INCLUDING RIB RESECTION; RADICAL, WITH REGIONAL LYMPHADENECTOMY AND/OR VENA CAVAL THROMBECTOMY
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 50230
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$357.31 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$357.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$394.71
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$39,939.37
|
|
|
Service Code
|
APR-DRG 4624
|
| Min. Negotiated Rate |
$25,224.86 |
| Max. Negotiated Rate |
$39,939.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$25,224.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30,059.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39,939.37
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$7,148.35
|
|
|
Service Code
|
APR-DRG 4621
|
| Min. Negotiated Rate |
$4,514.75 |
| Max. Negotiated Rate |
$7,148.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,514.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,380.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,148.35
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$20,460.15
|
|
|
Service Code
|
APR-DRG 4623
|
| Min. Negotiated Rate |
$12,922.20 |
| Max. Negotiated Rate |
$20,460.15 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,922.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,398.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20,460.15
|
|
|
NEPHRITIS AND NEPHROSIS
|
Facility
|
IP
|
$11,309.67
|
|
|
Service Code
|
APR-DRG 4622
|
| Min. Negotiated Rate |
$7,142.95 |
| Max. Negotiated Rate |
$11,309.67 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,142.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,512.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11,309.67
|
|
|
NERVE PEDICLE TRANSFER; FIRST STAGE
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 64905
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,165.61 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,287.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16,930.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,415.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,287.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$12,964.88
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16,930.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,415.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,287.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,623.90
|
| Rate for Payer: EPIC Health Plan Senior |
$12,415.93
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18,511.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,287.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,802.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15,124.86
|
| Rate for Payer: Multiplan WC |
$12,964.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,287.21
|
| Rate for Payer: Preferred Health Network WC |
$13,229.47
|
| Rate for Payer: Prime Health Services Medicare |
$11,964.44
|
| Rate for Payer: Prime Health Services WC |
$12,832.59
|
| Rate for Payer: Riverside University Health System MISP |
$12,415.93
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$11,287.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16,930.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,415.93
|
| Rate for Payer: Vantage Medical Group Senior |
$11,287.21
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$13,851.59
|
|
|
Service Code
|
APR-DRG 0412
|
| Min. Negotiated Rate |
$8,748.37 |
| Max. Negotiated Rate |
$13,851.59 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,748.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,425.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13,851.59
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$18,675.58
|
|
|
Service Code
|
APR-DRG 0413
|
| Min. Negotiated Rate |
$11,795.10 |
| Max. Negotiated Rate |
$18,675.58 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,795.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,055.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18,675.58
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$26,540.99
|
|
|
Service Code
|
APR-DRG 0414
|
| Min. Negotiated Rate |
$16,762.73 |
| Max. Negotiated Rate |
$26,540.99 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,762.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19,975.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$26,540.99
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$11,780.99
|
|
|
Service Code
|
APR-DRG 0411
|
| Min. Negotiated Rate |
$7,440.62 |
| Max. Negotiated Rate |
$11,780.99 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,440.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,866.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11,780.99
|
|
|
NERVOUS SYSTEM NEOPLASMS WITH MCC
|
Facility
|
IP
|
$40,186.48
|
|
|
Service Code
|
MSDRG 054
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$40,186.48 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40,186.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,958.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,343.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,235.12
|
| Rate for Payer: EPIC Health Plan Senior |
$24,156.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,960.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$30,744.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29,427.31
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,960.68
|
| Rate for Payer: Prime Health Services Medicare |
$23,278.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
NERVOUS SYSTEM NEOPLASMS WITHOUT MCC
|
Facility
|
IP
|
$26,834.85
|
|
|
Service Code
|
MSDRG 055
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$26,834.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,834.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,334.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24,268.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,690.53
|
| Rate for Payer: EPIC Health Plan Senior |
$16,460.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,963.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,949.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20,051.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,963.96
|
| Rate for Payer: Prime Health Services Medicare |
$15,861.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
NEUROLOGICAL EYE DISORDERS
|
Facility
|
IP
|
$21,018.35
|
|
|
Service Code
|
MSDRG 123
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$21,018.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,018.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,577.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,008.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,661.30
|
| Rate for Payer: EPIC Health Plan Senior |
$13,107.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,915.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,682.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15,967.36
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,915.94
|
| Rate for Payer: Prime Health Services Medicare |
$12,630.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
NEUROPLASTY AND/OR TRANSPOSITION; CRANIAL NERVE (SPECIFY)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 64716
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$685.82 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: EPIC Health Plan Senior |
$2,762.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,144.02
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,511.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,511.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,953.34
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,762.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,511.53
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,118.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$685.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$757.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,516.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,365.45
|
| Rate for Payer: Multiplan WC |
$3,953.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Preferred Health Network WC |
$4,034.02
|
| Rate for Payer: Prime Health Services Medicare |
$2,662.22
|
| Rate for Payer: Prime Health Services WC |
$3,913.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,762.68
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,511.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,511.53
|
|
|
NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 64721
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$108.86 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,511.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,511.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,953.34
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,762.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,511.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,144.02
|
| Rate for Payer: EPIC Health Plan Senior |
$2,762.68
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,118.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$108.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$120.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,516.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,365.45
|
| Rate for Payer: Multiplan WC |
$3,953.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Preferred Health Network WC |
$4,034.02
|
| Rate for Payer: Prime Health Services Medicare |
$2,662.22
|
| Rate for Payer: Prime Health Services WC |
$3,913.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,762.68
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,511.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,511.53
|
|
|
NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 64718
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$153.68 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,511.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,511.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,953.34
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,762.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,511.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,144.02
|
| Rate for Payer: EPIC Health Plan Senior |
$2,762.68
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,118.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$153.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,516.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,365.45
|
| Rate for Payer: Multiplan WC |
$3,953.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Preferred Health Network WC |
$4,034.02
|
| Rate for Payer: Prime Health Services Medicare |
$2,662.22
|
| Rate for Payer: Prime Health Services WC |
$3,913.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,762.68
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,511.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,511.53
|
|
|
NEUROPLASTY; DIGITAL, 1 OR BOTH, SAME DIGIT
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 64702
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$348.35 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,511.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,511.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,953.34
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,762.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,511.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,144.02
|
| Rate for Payer: EPIC Health Plan Senior |
$2,762.68
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,118.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$348.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$384.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,516.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,365.45
|
| Rate for Payer: Multiplan WC |
$3,953.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Preferred Health Network WC |
$4,034.02
|
| Rate for Payer: Prime Health Services Medicare |
$2,662.22
|
| Rate for Payer: Prime Health Services WC |
$3,913.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,762.68
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,511.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,511.53
|
|
|
NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG, OPEN; OTHER THAN SPECIFIED
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 64708
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$768.43 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Upland Medical Group Pediatric |
$2,511.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,511.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,511.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,953.34
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,762.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,511.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,144.02
|
| Rate for Payer: EPIC Health Plan Senior |
$2,762.68
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,118.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$768.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$848.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,516.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,365.45
|
| Rate for Payer: Multiplan WC |
$3,953.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Preferred Health Network WC |
$4,034.02
|
| Rate for Payer: Prime Health Services Medicare |
$2,662.22
|
| Rate for Payer: Prime Health Services WC |
$3,913.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,762.68
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,511.53
|
|
