|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
IP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
915356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,759.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,759.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,518.80
|
| Rate for Payer: Galaxy Health WC |
$7,477.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,867.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,351.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,445.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,111.28
|
| Rate for Payer: Multiplan Commercial |
$7,037.60
|
| Rate for Payer: Networks By Design Commercial |
$4,398.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,477.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,301.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3,213.54
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.02
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
IP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
905356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,759.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,759.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,518.80
|
| Rate for Payer: Galaxy Health WC |
$7,477.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,867.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,351.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,445.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,111.28
|
| Rate for Payer: Multiplan Commercial |
$7,037.60
|
| Rate for Payer: Networks By Design Commercial |
$4,398.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,477.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,301.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3,213.54
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.02
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
OP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
905356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,111.28 |
| Max. Negotiated Rate |
$7,477.45 |
| Rate for Payer: Adventist Health Commercial |
$3,606.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,838.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,597.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,095.22
|
| Rate for Payer: Blue Shield of California Commercial |
$6,492.19
|
| Rate for Payer: Blue Shield of California EPN |
$4,275.34
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,477.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,477.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,518.80
|
| Rate for Payer: Galaxy Health WC |
$7,477.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,867.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,445.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,111.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,157.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,157.90
|
| Rate for Payer: Multiplan Commercial |
$7,037.60
|
| Rate for Payer: Networks By Design Commercial |
$4,398.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,477.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,278.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,278.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,301.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3,213.54
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,477.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,477.45
|
|
|
HC TERM DEV MECH HAND VOL CLOSE
|
Facility
|
OP
|
$2,705.00
|
|
|
Service Code
|
CPT L6709
|
| Hospital Charge Code |
915356709
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$649.20 |
| Max. Negotiated Rate |
$2,299.25 |
| Rate for Payer: Adventist Health Commercial |
$1,109.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,487.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,028.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,566.74
|
| Rate for Payer: Blue Shield of California Commercial |
$1,996.29
|
| Rate for Payer: Blue Shield of California EPN |
$1,314.63
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cigna of CA HMO |
$1,893.50
|
| Rate for Payer: Cigna of CA PPO |
$1,893.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,299.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,299.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,082.00
|
| Rate for Payer: Galaxy Health WC |
$2,299.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,623.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,815.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,053.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,674.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$649.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,893.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,893.50
|
| Rate for Payer: Multiplan Commercial |
$2,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,352.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,299.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,623.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,623.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.19
|
| Rate for Payer: United Healthcare All Other HMO |
$988.14
|
| Rate for Payer: United Healthcare HMO Rider |
$966.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,299.25
|
| Rate for Payer: Vantage Medical Group Senior |
$2,299.25
|
|
|
HC TERM DEV MECH HAND VOL CLOSE
|
Facility
|
IP
|
$2,705.00
|
|
|
Service Code
|
CPT L6709
|
| Hospital Charge Code |
915356709
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$541.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$541.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cigna of CA HMO |
$1,893.50
|
| Rate for Payer: Cigna of CA PPO |
$1,893.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,082.00
|
| Rate for Payer: Galaxy Health WC |
$2,299.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,623.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,030.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,674.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$649.20
|
| Rate for Payer: Multiplan Commercial |
$2,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,352.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,299.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.19
|
| Rate for Payer: United Healthcare All Other HMO |
$988.14
|
| Rate for Payer: United Healthcare HMO Rider |
$966.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.89
|
|
|
HC TERM DEV MECH HAND VOL CLOSE
|
Facility
|
IP
|
$2,705.00
|
|
|
Service Code
|
CPT L6709
|
| Hospital Charge Code |
905356709
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$541.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$541.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cigna of CA HMO |
$1,893.50
|
| Rate for Payer: Cigna of CA PPO |
$1,893.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,082.00
|
| Rate for Payer: Galaxy Health WC |
$2,299.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,623.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,030.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,674.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$649.20
|
| Rate for Payer: Multiplan Commercial |
$2,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,352.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,299.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.19
|
| Rate for Payer: United Healthcare All Other HMO |
$988.14
|
| Rate for Payer: United Healthcare HMO Rider |
$966.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.89
|
|
|
HC TERM DEV MECH HAND VOL CLOSE
|
Facility
|
OP
|
$2,705.00
|
|
|
Service Code
|
CPT L6709
|
| Hospital Charge Code |
905356709
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$649.20 |
| Max. Negotiated Rate |
$2,299.25 |
| Rate for Payer: Adventist Health Commercial |
$1,109.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,487.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,028.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,566.74
|
| Rate for Payer: Blue Shield of California Commercial |
$1,996.29
|
| Rate for Payer: Blue Shield of California EPN |
$1,314.63
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cigna of CA HMO |
$1,893.50
|
| Rate for Payer: Cigna of CA PPO |
$1,893.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,299.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,299.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,082.00
|
| Rate for Payer: Galaxy Health WC |
$2,299.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,623.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,815.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,053.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,674.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$649.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,893.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,893.50
|
| Rate for Payer: Multiplan Commercial |
$2,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,352.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,299.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,623.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,623.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.19
|
| Rate for Payer: United Healthcare All Other HMO |
$988.14
|
| Rate for Payer: United Healthcare HMO Rider |
$966.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,299.25
|
| Rate for Payer: Vantage Medical Group Senior |
$2,299.25
|
|
|
HC TERM DEV MECH HAND VOL OPEN
|
Facility
|
OP
|
$1,865.00
|
|
|
Service Code
|
CPT L6708
|
| Hospital Charge Code |
905356708
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$447.60 |
| Max. Negotiated Rate |
$1,585.25 |
| Rate for Payer: Adventist Health Commercial |
$764.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,025.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,398.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,080.21
|
| Rate for Payer: Blue Shield of California Commercial |
$1,376.37
|
| Rate for Payer: Blue Shield of California EPN |
$906.39
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cigna of CA HMO |
$1,305.50
|
| Rate for Payer: Cigna of CA PPO |
$1,305.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,585.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,585.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$746.00
|
| Rate for Payer: EPIC Health Plan Senior |
$746.00
|
| Rate for Payer: Galaxy Health WC |
$1,585.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,119.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,253.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,243.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,417.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$447.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,305.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,305.50
|
| Rate for Payer: Multiplan Commercial |
$1,492.00
|
| Rate for Payer: Networks By Design Commercial |
$932.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,585.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,119.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,119.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.93
|
| Rate for Payer: United Healthcare All Other HMO |
$681.28
|
| Rate for Payer: United Healthcare HMO Rider |
$666.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$610.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,585.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,585.25
|
|
|
HC TERM DEV MECH HAND VOL OPEN
|
Facility
|
IP
|
$1,865.00
|
|
|
Service Code
|
CPT L6708
|
| Hospital Charge Code |
905356708
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$373.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$373.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cigna of CA HMO |
$1,305.50
|
| Rate for Payer: Cigna of CA PPO |
$1,305.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$746.00
|
| Rate for Payer: EPIC Health Plan Senior |
$746.00
|
| Rate for Payer: Galaxy Health WC |
$1,585.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,119.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,243.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$710.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$447.60
|
| Rate for Payer: Multiplan Commercial |
$1,492.00
|
| Rate for Payer: Networks By Design Commercial |
$932.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,585.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.93
|
| Rate for Payer: United Healthcare All Other HMO |
$681.28
|
| Rate for Payer: United Healthcare HMO Rider |
$666.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$610.79
|
|
|
HC TERM DEV MECH HAND VOL OPEN
|
Facility
|
IP
|
$1,865.00
|
|
|
Service Code
|
CPT L6708
|
| Hospital Charge Code |
915356708
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$373.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$373.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cigna of CA HMO |
$1,305.50
|
| Rate for Payer: Cigna of CA PPO |
$1,305.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$746.00
|
| Rate for Payer: EPIC Health Plan Senior |
$746.00
|
| Rate for Payer: Galaxy Health WC |
$1,585.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,119.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,243.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$710.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$447.60
|
| Rate for Payer: Multiplan Commercial |
$1,492.00
|
| Rate for Payer: Networks By Design Commercial |
$932.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,585.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.93
|
| Rate for Payer: United Healthcare All Other HMO |
$681.28
|
| Rate for Payer: United Healthcare HMO Rider |
$666.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$610.79
|
|
|
HC TERM DEV MECH HAND VOL OPEN
|
Facility
|
OP
|
$1,865.00
|
|
|
Service Code
|
CPT L6708
|
| Hospital Charge Code |
915356708
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$447.60 |
| Max. Negotiated Rate |
$1,585.25 |
| Rate for Payer: Adventist Health Commercial |
$764.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,025.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,398.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,080.21
|
| Rate for Payer: Blue Shield of California Commercial |
$1,376.37
|
| Rate for Payer: Blue Shield of California EPN |
$906.39
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cigna of CA HMO |
$1,305.50
|
| Rate for Payer: Cigna of CA PPO |
$1,305.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,585.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,585.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$746.00
|
| Rate for Payer: EPIC Health Plan Senior |
$746.00
|
| Rate for Payer: Galaxy Health WC |
$1,585.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,119.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,253.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,243.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,417.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$447.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,305.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,305.50
|
| Rate for Payer: Multiplan Commercial |
$1,492.00
|
| Rate for Payer: Networks By Design Commercial |
$932.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,585.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,119.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,119.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.93
|
| Rate for Payer: United Healthcare All Other HMO |
$681.28
|
| Rate for Payer: United Healthcare HMO Rider |
$666.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$610.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,585.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,585.25
|
|
|
HC TERM DEV MECH HOOK VOL CLOSE
|
Facility
|
IP
|
$2,760.00
|
|
|
Service Code
|
CPT L6707
|
| Hospital Charge Code |
915356707
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$552.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Cigna of CA HMO |
$1,932.00
|
| Rate for Payer: Cigna of CA PPO |
$1,932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,104.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,104.00
|
| Rate for Payer: Galaxy Health WC |
$2,346.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,840.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,051.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,708.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$662.40
|
| Rate for Payer: Multiplan Commercial |
$2,208.00
|
| Rate for Payer: Networks By Design Commercial |
$1,380.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,035.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1,008.23
|
| Rate for Payer: United Healthcare HMO Rider |
$986.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$903.90
|
|
|
HC TERM DEV MECH HOOK VOL CLOSE
|
Facility
|
OP
|
$2,760.00
|
|
|
Service Code
|
CPT L6707
|
| Hospital Charge Code |
915356707
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$662.40 |
| Max. Negotiated Rate |
$2,346.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,518.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,070.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,598.59
|
| Rate for Payer: Blue Shield of California Commercial |
$2,036.88
|
| Rate for Payer: Blue Shield of California EPN |
$1,341.36
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Cigna of CA HMO |
$1,932.00
|
| Rate for Payer: Cigna of CA PPO |
$1,932.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,346.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,346.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,104.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,104.00
|
| Rate for Payer: Galaxy Health WC |
$2,346.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,852.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,840.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,095.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,708.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$662.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,932.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,932.00
|
| Rate for Payer: Multiplan Commercial |
$2,208.00
|
| Rate for Payer: Networks By Design Commercial |
$1,380.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,656.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,656.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,035.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1,008.23
|
| Rate for Payer: United Healthcare HMO Rider |
$986.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$903.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,346.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,346.00
|
|
|
HC TERM DEV MECH HOOK VOL CLOSE
|
Facility
|
IP
|
$2,760.00
|
|
|
Service Code
|
CPT L6707
|
| Hospital Charge Code |
905356707
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$552.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Cigna of CA HMO |
$1,932.00
|
| Rate for Payer: Cigna of CA PPO |
$1,932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,104.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,104.00
|
| Rate for Payer: Galaxy Health WC |
$2,346.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,840.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,051.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,708.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$662.40
|
| Rate for Payer: Multiplan Commercial |
$2,208.00
|
| Rate for Payer: Networks By Design Commercial |
$1,380.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,035.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1,008.23
|
| Rate for Payer: United Healthcare HMO Rider |
$986.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$903.90
|
|
|
HC TERM DEV MECH HOOK VOL CLOSE
|
Facility
|
OP
|
$2,760.00
|
|
|
Service Code
|
CPT L6707
|
| Hospital Charge Code |
905356707
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$662.40 |
| Max. Negotiated Rate |
$2,346.00 |
| Rate for Payer: Adventist Health Commercial |
$1,131.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,518.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,070.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,598.59
|
| Rate for Payer: Blue Shield of California Commercial |
$2,036.88
|
| Rate for Payer: Blue Shield of California EPN |
$1,341.36
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Cigna of CA HMO |
$1,932.00
|
| Rate for Payer: Cigna of CA PPO |
$1,932.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,346.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,346.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,104.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,104.00
|
| Rate for Payer: Galaxy Health WC |
$2,346.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,852.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,840.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,095.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,708.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$662.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,932.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,932.00
|
| Rate for Payer: Multiplan Commercial |
$2,208.00
|
| Rate for Payer: Networks By Design Commercial |
$1,380.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,656.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,656.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,035.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1,008.23
|
| Rate for Payer: United Healthcare HMO Rider |
$986.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$903.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,346.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,346.00
|
|
|
HC TERM DEV MECH HOOK VOL OPEN
|
Facility
|
IP
|
$725.00
|
|
|
Service Code
|
CPT L6706
|
| Hospital Charge Code |
915356706
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$145.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$145.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$398.75
|
| Rate for Payer: Cash Price |
$398.75
|
| Rate for Payer: Cigna of CA HMO |
$507.50
|
| Rate for Payer: Cigna of CA PPO |
$507.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.00
|
| Rate for Payer: EPIC Health Plan Senior |
$290.00
|
| Rate for Payer: Galaxy Health WC |
$616.25
|
| Rate for Payer: Global Benefits Group Commercial |
$435.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$483.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$448.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.00
|
| Rate for Payer: Multiplan Commercial |
$580.00
|
| Rate for Payer: Networks By Design Commercial |
$362.50
|
| Rate for Payer: Prime Health Services Commercial |
$616.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.09
|
| Rate for Payer: United Healthcare All Other HMO |
$264.84
|
| Rate for Payer: United Healthcare HMO Rider |
$259.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$237.44
|
|
|
HC TERM DEV MECH HOOK VOL OPEN
|
Facility
|
OP
|
$725.00
|
|
|
Service Code
|
CPT L6706
|
| Hospital Charge Code |
915356706
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$616.25 |
| Rate for Payer: Adventist Health Commercial |
$297.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$616.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$398.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$543.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.92
|
| Rate for Payer: Blue Shield of California Commercial |
$535.05
|
| Rate for Payer: Blue Shield of California EPN |
$352.35
|
| Rate for Payer: Cash Price |
$398.75
|
| Rate for Payer: Cash Price |
$398.75
|
| Rate for Payer: Cigna of CA HMO |
$507.50
|
| Rate for Payer: Cigna of CA PPO |
$507.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$616.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$616.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$616.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.00
|
| Rate for Payer: EPIC Health Plan Senior |
$290.00
|
| Rate for Payer: Galaxy Health WC |
$616.25
|
| Rate for Payer: Global Benefits Group Commercial |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$485.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$483.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$548.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$448.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$507.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$507.50
|
| Rate for Payer: Multiplan Commercial |
$580.00
|
| Rate for Payer: Networks By Design Commercial |
$362.50
|
| Rate for Payer: Prime Health Services Commercial |
$616.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$435.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$435.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.09
|
| Rate for Payer: United Healthcare All Other HMO |
$264.84
|
| Rate for Payer: United Healthcare HMO Rider |
$259.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$237.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$616.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$616.25
|
| Rate for Payer: Vantage Medical Group Senior |
$616.25
|
|
|
HC TERM DEV MECH HOOK VOL OPEN
|
Facility
|
IP
|
$725.00
|
|
|
Service Code
|
CPT L6706
|
| Hospital Charge Code |
905356706
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$145.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$145.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$398.75
|
| Rate for Payer: Cash Price |
$398.75
|
| Rate for Payer: Cigna of CA HMO |
$507.50
|
| Rate for Payer: Cigna of CA PPO |
$507.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.00
|
| Rate for Payer: EPIC Health Plan Senior |
$290.00
|
| Rate for Payer: Galaxy Health WC |
$616.25
|
| Rate for Payer: Global Benefits Group Commercial |
$435.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$483.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$448.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.00
|
| Rate for Payer: Multiplan Commercial |
$580.00
|
| Rate for Payer: Networks By Design Commercial |
$362.50
|
| Rate for Payer: Prime Health Services Commercial |
$616.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.09
|
| Rate for Payer: United Healthcare All Other HMO |
$264.84
|
| Rate for Payer: United Healthcare HMO Rider |
$259.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$237.44
|
|
|
HC TERM DEV MECH HOOK VOL OPEN
|
Facility
|
OP
|
$725.00
|
|
|
Service Code
|
CPT L6706
|
| Hospital Charge Code |
905356706
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$616.25 |
| Rate for Payer: Adventist Health Commercial |
$297.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$616.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$398.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$543.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.92
|
| Rate for Payer: Blue Shield of California Commercial |
$535.05
|
| Rate for Payer: Blue Shield of California EPN |
$352.35
|
| Rate for Payer: Cash Price |
$398.75
|
| Rate for Payer: Cash Price |
$398.75
|
| Rate for Payer: Cigna of CA HMO |
$507.50
|
| Rate for Payer: Cigna of CA PPO |
$507.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$616.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$616.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$616.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$290.00
|
| Rate for Payer: EPIC Health Plan Senior |
$290.00
|
| Rate for Payer: Galaxy Health WC |
$616.25
|
| Rate for Payer: Global Benefits Group Commercial |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$485.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$483.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$548.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$448.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$507.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$507.50
|
| Rate for Payer: Multiplan Commercial |
$580.00
|
| Rate for Payer: Networks By Design Commercial |
$362.50
|
| Rate for Payer: Prime Health Services Commercial |
$616.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$435.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$435.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$272.09
|
| Rate for Payer: United Healthcare All Other HMO |
$264.84
|
| Rate for Payer: United Healthcare HMO Rider |
$259.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$237.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$616.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$616.25
|
| Rate for Payer: Vantage Medical Group Senior |
$616.25
|
|
|
HC TERM DEV, PASSIVE HAND MITT
|
Facility
|
IP
|
$605.00
|
|
|
Service Code
|
CPT L6703
|
| Hospital Charge Code |
915356703
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$121.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$121.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$332.75
|
| Rate for Payer: Cash Price |
$332.75
|
| Rate for Payer: Cigna of CA HMO |
$423.50
|
| Rate for Payer: Cigna of CA PPO |
$423.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.00
|
| Rate for Payer: EPIC Health Plan Senior |
$242.00
|
| Rate for Payer: Galaxy Health WC |
$514.25
|
| Rate for Payer: Global Benefits Group Commercial |
$363.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$374.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.20
|
| Rate for Payer: Multiplan Commercial |
$484.00
|
| Rate for Payer: Networks By Design Commercial |
$302.50
|
| Rate for Payer: Prime Health Services Commercial |
$514.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.06
|
| Rate for Payer: United Healthcare All Other HMO |
$221.01
|
| Rate for Payer: United Healthcare HMO Rider |
$216.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.14
|
|
|
HC TERM DEV, PASSIVE HAND MITT
|
Facility
|
OP
|
$605.00
|
|
|
Service Code
|
CPT L6703
|
| Hospital Charge Code |
915356703
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$145.20 |
| Max. Negotiated Rate |
$514.25 |
| Rate for Payer: Adventist Health Commercial |
$248.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$514.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$332.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$350.42
|
| Rate for Payer: Blue Shield of California Commercial |
$446.49
|
| Rate for Payer: Blue Shield of California EPN |
$294.03
|
| Rate for Payer: Cash Price |
$332.75
|
| Rate for Payer: Cash Price |
$332.75
|
| Rate for Payer: Cigna of CA HMO |
$423.50
|
| Rate for Payer: Cigna of CA PPO |
$423.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$514.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$514.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.00
|
| Rate for Payer: EPIC Health Plan Senior |
$242.00
|
| Rate for Payer: Galaxy Health WC |
$514.25
|
| Rate for Payer: Global Benefits Group Commercial |
$363.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$404.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$456.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$374.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$423.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$423.50
|
| Rate for Payer: Multiplan Commercial |
$484.00
|
| Rate for Payer: Networks By Design Commercial |
$302.50
|
| Rate for Payer: Prime Health Services Commercial |
$514.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$363.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$363.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.06
|
| Rate for Payer: United Healthcare All Other HMO |
$221.01
|
| Rate for Payer: United Healthcare HMO Rider |
$216.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$514.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$514.25
|
| Rate for Payer: Vantage Medical Group Senior |
$514.25
|
|
|
HC TERM DEV, PASSIVE HAND MITT
|
Facility
|
IP
|
$605.00
|
|
|
Service Code
|
CPT L6703
|
| Hospital Charge Code |
905356703
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$121.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$121.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$332.75
|
| Rate for Payer: Cash Price |
$332.75
|
| Rate for Payer: Cigna of CA HMO |
$423.50
|
| Rate for Payer: Cigna of CA PPO |
$423.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.00
|
| Rate for Payer: EPIC Health Plan Senior |
$242.00
|
| Rate for Payer: Galaxy Health WC |
$514.25
|
| Rate for Payer: Global Benefits Group Commercial |
$363.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$374.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.20
|
| Rate for Payer: Multiplan Commercial |
$484.00
|
| Rate for Payer: Networks By Design Commercial |
$302.50
|
| Rate for Payer: Prime Health Services Commercial |
$514.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.06
|
| Rate for Payer: United Healthcare All Other HMO |
$221.01
|
| Rate for Payer: United Healthcare HMO Rider |
$216.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.14
|
|
|
HC TERM DEV, PASSIVE HAND MITT
|
Facility
|
OP
|
$605.00
|
|
|
Service Code
|
CPT L6703
|
| Hospital Charge Code |
905356703
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$145.20 |
| Max. Negotiated Rate |
$514.25 |
| Rate for Payer: Adventist Health Commercial |
$248.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$514.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$332.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$350.42
|
| Rate for Payer: Blue Shield of California Commercial |
$446.49
|
| Rate for Payer: Blue Shield of California EPN |
$294.03
|
| Rate for Payer: Cash Price |
$332.75
|
| Rate for Payer: Cash Price |
$332.75
|
| Rate for Payer: Cigna of CA HMO |
$423.50
|
| Rate for Payer: Cigna of CA PPO |
$423.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$514.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$514.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.00
|
| Rate for Payer: EPIC Health Plan Senior |
$242.00
|
| Rate for Payer: Galaxy Health WC |
$514.25
|
| Rate for Payer: Global Benefits Group Commercial |
$363.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$404.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$403.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$456.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$374.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$145.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$423.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$423.50
|
| Rate for Payer: Multiplan Commercial |
$484.00
|
| Rate for Payer: Networks By Design Commercial |
$302.50
|
| Rate for Payer: Prime Health Services Commercial |
$514.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$363.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$363.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$227.06
|
| Rate for Payer: United Healthcare All Other HMO |
$221.01
|
| Rate for Payer: United Healthcare HMO Rider |
$216.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$198.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$514.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$514.25
|
| Rate for Payer: Vantage Medical Group Senior |
$514.25
|
|
|
HC TERM DEV, SPORT/REC/WORK ATT
|
Facility
|
IP
|
$1,310.00
|
|
|
Service Code
|
CPT L6704
|
| Hospital Charge Code |
915356704
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$262.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$720.50
|
| Rate for Payer: Cash Price |
$720.50
|
| Rate for Payer: Cigna of CA HMO |
$917.00
|
| Rate for Payer: Cigna of CA PPO |
$917.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$524.00
|
| Rate for Payer: EPIC Health Plan Senior |
$524.00
|
| Rate for Payer: Galaxy Health WC |
$1,113.50
|
| Rate for Payer: Global Benefits Group Commercial |
$786.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$873.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$499.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$810.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.40
|
| Rate for Payer: Multiplan Commercial |
$1,048.00
|
| Rate for Payer: Networks By Design Commercial |
$655.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,113.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.64
|
| Rate for Payer: United Healthcare All Other HMO |
$478.54
|
| Rate for Payer: United Healthcare HMO Rider |
$468.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$429.02
|
|
|
HC TERM DEV, SPORT/REC/WORK ATT
|
Facility
|
OP
|
$1,310.00
|
|
|
Service Code
|
CPT L6704
|
| Hospital Charge Code |
905356704
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$314.40 |
| Max. Negotiated Rate |
$1,113.50 |
| Rate for Payer: Adventist Health Commercial |
$537.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,113.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$720.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$982.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$758.75
|
| Rate for Payer: Blue Shield of California Commercial |
$966.78
|
| Rate for Payer: Blue Shield of California EPN |
$636.66
|
| Rate for Payer: Cash Price |
$720.50
|
| Rate for Payer: Cash Price |
$720.50
|
| Rate for Payer: Cigna of CA HMO |
$917.00
|
| Rate for Payer: Cigna of CA PPO |
$917.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,113.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,113.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,113.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$524.00
|
| Rate for Payer: EPIC Health Plan Senior |
$524.00
|
| Rate for Payer: Galaxy Health WC |
$1,113.50
|
| Rate for Payer: Global Benefits Group Commercial |
$786.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$877.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$873.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$992.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$810.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$917.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$917.00
|
| Rate for Payer: Multiplan Commercial |
$1,048.00
|
| Rate for Payer: Networks By Design Commercial |
$655.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,113.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$786.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$786.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.64
|
| Rate for Payer: United Healthcare All Other HMO |
$478.54
|
| Rate for Payer: United Healthcare HMO Rider |
$468.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$429.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,113.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,113.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,113.50
|
|
