|
PERAMPANEL 6 MG TABLET [204503]
|
Facility
OP
|
$46.32
|
|
|
Service Code
|
NDC 62856-276-30
|
| Hospital Charge Code |
ERX204503
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$39.37 |
| Rate for Payer: Adventist Health Commercial |
$9.26
|
| Rate for Payer: Aetna of CA Gatekeeper |
$24.76
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$39.37
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$34.74
|
| Rate for Payer: Blue Shield of California Commercial |
$28.76
|
| Rate for Payer: Blue Shield of California EPN |
$27.19
|
| Rate for Payer: Cash Price |
$20.84
|
| Rate for Payer: Cigna of CA HMO/PPO |
$30.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$39.37
|
| Rate for Payer: Dignity Health Senior |
$39.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.67
|
| Rate for Payer: Heritage Provider Network Senior |
$28.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$22.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.58
|
| Rate for Payer: Multiplan Commercial |
$34.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39.37
|
| Rate for Payer: Vantage Medical Group Senior |
$39.37
|
|
|
PERAMPANEL 6 MG TABLET [204503]
|
Facility
IP
|
$46.32
|
|
|
Service Code
|
NDC 62856-276-30
|
| Hospital Charge Code |
ERX204503
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$34.74 |
| Rate for Payer: Adventist Health Commercial |
$9.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$31.82
|
| Rate for Payer: Cash Price |
$20.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$31.36
|
| Rate for Payer: Heritage Provider Network Senior |
$31.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.58
|
| Rate for Payer: Multiplan Commercial |
$34.74
|
|
|
Percutaneous access and closure of femoral artery for delivery of endograft through a large sheath (12 French or larger), including ultrasound guidance, when performed, unilateral (List separately in addition to code for primary procedure)
|
Facility
OP
|
$9,616.00
|
|
|
Service Code
|
CPT 34713
|
| Min. Negotiated Rate |
$168.31 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: IEHP Medi-Cal |
$168.31
|
|
|
Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s)
|
Facility
OP
|
$5,505.00
|
|
|
Service Code
|
CPT 61645
|
| Min. Negotiated Rate |
$1,033.22 |
| Max. Negotiated Rate |
$5,505.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$5,245.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: IEHP Medi-Cal |
$1,033.22
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI
|
Facility
IP
|
$17,670.34
|
|
|
Service Code
|
APR-DRG 1741
|
| Min. Negotiated Rate |
$17,670.34 |
| Max. Negotiated Rate |
$17,670.34 |
| Rate for Payer: IEHP Medi-Cal |
$17,670.34
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI
|
Facility
IP
|
$19,174.63
|
|
|
Service Code
|
APR-DRG 1742
|
| Min. Negotiated Rate |
$19,174.63 |
| Max. Negotiated Rate |
$19,174.63 |
| Rate for Payer: IEHP Medi-Cal |
$19,174.63
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI
|
Facility
IP
|
$32,872.36
|
|
|
Service Code
|
APR-DRG 1744
|
| Min. Negotiated Rate |
$32,872.36 |
| Max. Negotiated Rate |
$32,872.36 |
| Rate for Payer: IEHP Medi-Cal |
$32,872.36
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITH AMI
|
Facility
IP
|
$23,522.32
|
|
|
Service Code
|
APR-DRG 1743
|
| Min. Negotiated Rate |
$23,522.32 |
| Max. Negotiated Rate |
$23,522.32 |
| Rate for Payer: IEHP Medi-Cal |
$23,522.32
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI
|
Facility
IP
|
$24,821.66
|
|
|
Service Code
|
APR-DRG 1753
|
| Min. Negotiated Rate |
$24,821.66 |
| Max. Negotiated Rate |
$24,821.66 |
| Rate for Payer: IEHP Medi-Cal |
$24,821.66
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI
|
Facility
IP
|
$20,111.82
|
|
|
Service Code
|
APR-DRG 1752
|
| Min. Negotiated Rate |
$20,111.82 |
| Max. Negotiated Rate |
$20,111.82 |
| Rate for Payer: IEHP Medi-Cal |
$20,111.82
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI
|
Facility
IP
|
$36,323.65
|
|
|
Service Code
|
APR-DRG 1754
|
| Min. Negotiated Rate |
$36,323.65 |
| Max. Negotiated Rate |
$36,323.65 |
| Rate for Payer: IEHP Medi-Cal |
$36,323.65
|
|
|
PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI
|
Facility
IP
|
$17,794.71
|
|
|
Service Code
|
APR-DRG 1751
|
| Min. Negotiated Rate |
$17,794.71 |
| Max. Negotiated Rate |
$17,794.71 |
| Rate for Payer: IEHP Medi-Cal |
$17,794.71
|
|
|
Percutaneous implantation of neurostimulator electrode array, epidural
|
Facility
OP
|
$16,235.61
|
|
|
Service Code
|
CPT 63650
|
| Min. Negotiated Rate |
$135.91 |
| Max. Negotiated Rate |
$16,235.61 |
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12,817.59
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,399.57
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,545.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,817.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,399.57
|
| Rate for Payer: Dignity Health Senior |
$8,545.06
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,545.06
|
| Rate for Payer: Humana Medicare |
$8,545.06
|
| Rate for Payer: IEHP Medi-Cal |
$135.91
|
| Rate for Payer: IEHP Medicare Advantage |
$8,545.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16,235.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,083.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,766.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,766.78
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,399.57
|
| Rate for Payer: TriValley Medical Group Senior |
$8,545.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,817.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,399.57
|
| Rate for Payer: Vantage Medical Group Senior |
$8,545.06
|
|
|
Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed
|
Facility
OP
|
$16,235.61
|
|
|
Service Code
|
CPT 64561
|
| Min. Negotiated Rate |
$1,053.55 |
| Max. Negotiated Rate |
$16,235.61 |
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12,817.59
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,399.57
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,545.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,266.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,817.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,399.57
|
| Rate for Payer: Dignity Health Senior |
$8,545.06
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,545.06
|
| Rate for Payer: Humana Medicare |
$8,545.06
|
| Rate for Payer: IEHP Medi-Cal |
$1,053.55
|
| Rate for Payer: IEHP Medicare Advantage |
$8,545.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16,235.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,083.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,766.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,766.78
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,399.57
|
| Rate for Payer: TriValley Medical Group Senior |
$8,545.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,817.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,399.57
|
| Rate for Payer: Vantage Medical Group Senior |
$8,545.06
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
IP
|
$22,163.30
|
|
|
Service Code
|
APR-DRG 0302
|
| Min. Negotiated Rate |
$22,163.30 |
| Max. Negotiated Rate |
$22,163.30 |
| Rate for Payer: IEHP Medi-Cal |
$22,163.30
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
IP
|
$16,540.15
|
|
|
Service Code
|
APR-DRG 0301
|
| Min. Negotiated Rate |
$16,540.15 |
| Max. Negotiated Rate |
$16,540.15 |
| Rate for Payer: IEHP Medi-Cal |
$16,540.15
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
IP
|
$40,088.34
|
|
|
Service Code
|
APR-DRG 0304
|
| Min. Negotiated Rate |
$40,088.34 |
| Max. Negotiated Rate |
$40,088.34 |
| Rate for Payer: IEHP Medi-Cal |
$40,088.34
|
|
|
PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES
|
Facility
IP
|
$30,364.22
|
|
|
Service Code
|
APR-DRG 0303
|
| Min. Negotiated Rate |
$30,364.22 |
| Max. Negotiated Rate |
$30,364.22 |
| Rate for Payer: IEHP Medi-Cal |
$30,364.22
|
|
|
Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, CT), single or multiple levels, unilateral or bilateral; lumbar
|
Facility
OP
|
$16,983.21
|
|
|
Service Code
|
CPT 0275T
|
| Min. Negotiated Rate |
$2,183.94 |
| Max. Negotiated Rate |
$16,983.21 |
| Rate for Payer: Aetna of CA Gatekeeper |
$2,183.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: Dignity Health Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Medicare |
$8,938.53
|
| Rate for Payer: Humana Medicare |
$8,938.53
|
| Rate for Payer: IEHP Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16,983.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,547.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,262.55
|
| Rate for Payer: TriValley Medical Group Commercial |
$9,832.38
|
| Rate for Payer: TriValley Medical Group Senior |
$8,938.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; complex (eg, stone[s] > 2 cm, branching stones, stones in multiple locations, ureter stones, complicated anatomy)
|
Facility
OP
|
$21,869.32
|
|
|
Service Code
|
CPT 50081
|
| Min. Negotiated Rate |
$197.46 |
| Max. Negotiated Rate |
$21,869.32 |
| Rate for Payer: Aetna of CA Gatekeeper |
$5,088.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17,265.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12,661.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11,510.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,265.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,661.19
|
| Rate for Payer: Dignity Health Senior |
$11,510.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$11,510.17
|
| Rate for Payer: Humana Medicare |
$11,510.17
|
| Rate for Payer: IEHP Medi-Cal |
$197.46
|
| Rate for Payer: IEHP Medicare Advantage |
$11,510.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21,869.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,582.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,502.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,502.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$12,661.19
|
| Rate for Payer: TriValley Medical Group Senior |
$11,510.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,265.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,661.19
|
| Rate for Payer: Vantage Medical Group Senior |
$11,510.17
|
|
|
Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guidance; simple (eg, stone[s] up to 2 cm in single location of kidney or renal pelvis, nonbranching stones)
|
Facility
OP
|
$21,869.32
|
|
|
Service Code
|
CPT 50080
|
| Min. Negotiated Rate |
$881.63 |
| Max. Negotiated Rate |
$21,869.32 |
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17,265.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12,661.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11,510.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,265.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,661.19
|
| Rate for Payer: Dignity Health Senior |
$11,510.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$11,510.17
|
| Rate for Payer: Humana Medicare |
$11,510.17
|
| Rate for Payer: IEHP Medi-Cal |
$881.63
|
| Rate for Payer: IEHP Medicare Advantage |
$11,510.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$21,869.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,582.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,502.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,502.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$12,661.19
|
| Rate for Payer: TriValley Medical Group Senior |
$11,510.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,265.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,661.19
|
| Rate for Payer: Vantage Medical Group Senior |
$11,510.17
|
|
|
Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each
|
Facility
OP
|
$9,616.00
|
|
|
Service Code
|
CPT 26756
|
| Min. Negotiated Rate |
$569.76 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: Dignity Health Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,044.21
|
| Rate for Payer: Humana Medicare |
$4,044.21
|
| Rate for Payer: IEHP Medi-Cal |
$569.76
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,684.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,772.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,095.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,448.63
|
| Rate for Payer: TriValley Medical Group Senior |
$4,044.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation
|
Facility
OP
|
$9,616.00
|
|
|
Service Code
|
CPT 25606
|
| Min. Negotiated Rate |
$811.17 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: Dignity Health Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,044.21
|
| Rate for Payer: Humana Medicare |
$4,044.21
|
| Rate for Payer: IEHP Medi-Cal |
$811.17
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,684.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,772.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,095.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,448.63
|
| Rate for Payer: TriValley Medical Group Senior |
$4,044.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation
|
Facility
OP
|
$9,616.00
|
|
|
Service Code
|
CPT 26776
|
| Min. Negotiated Rate |
$322.92 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: Dignity Health Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,044.21
|
| Rate for Payer: Humana Medicare |
$4,044.21
|
| Rate for Payer: IEHP Medi-Cal |
$322.92
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,684.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,772.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,095.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,448.63
|
| Rate for Payer: TriValley Medical Group Senior |
$4,044.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
Percutaneous skeletal fixation of metacarpal fracture, each bone
|
Facility
OP
|
$9,616.00
|
|
|
Service Code
|
CPT 26608
|
| Min. Negotiated Rate |
$364.15 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: Dignity Health Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,044.21
|
| Rate for Payer: Humana Medicare |
$4,044.21
|
| Rate for Payer: IEHP Medi-Cal |
$364.15
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,684.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,772.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,095.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,448.63
|
| Rate for Payer: TriValley Medical Group Senior |
$4,044.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
