|
HC CL TREAT CARPAL BONE FX W/MANI
|
Facility
|
IP
|
$2,970.00
|
|
|
Service Code
|
CPT 25635
|
| Hospital Charge Code |
900501382
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$594.00 |
| Max. Negotiated Rate |
$2,524.50 |
| Rate for Payer: Adventist Health Commercial |
$594.00
|
| Rate for Payer: Cash Price |
$1,336.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,188.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,188.00
|
| Rate for Payer: Galaxy Health WC |
$2,524.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,782.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,980.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,131.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,838.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$712.80
|
| Rate for Payer: Multiplan Commercial |
$2,376.00
|
| Rate for Payer: Networks By Design Commercial |
$1,930.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,524.50
|
|
|
HC CL TREAT CARPAL BONE FX W/MANI
|
Facility
|
OP
|
$2,970.00
|
|
|
Service Code
|
CPT 25635
|
| Hospital Charge Code |
900501382
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$437.86 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$594.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,336.50
|
| Rate for Payer: Cash Price |
$1,336.50
|
| Rate for Payer: Cash Price |
$1,336.50
|
| Rate for Payer: Cigna of CA HMO |
$1,900.80
|
| Rate for Payer: Cigna of CA PPO |
$2,197.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$2,524.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,782.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,980.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$437.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$712.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$2,376.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$1,930.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,524.50
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,782.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,485.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,485.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,485.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,485.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT CARPAL SCAPHOID FX W/
|
Facility
|
IP
|
$4,022.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
900501381
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$804.40 |
| Max. Negotiated Rate |
$3,418.70 |
| Rate for Payer: Adventist Health Commercial |
$804.40
|
| Rate for Payer: Cash Price |
$1,809.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,608.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,608.80
|
| Rate for Payer: Galaxy Health WC |
$3,418.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,413.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,682.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,532.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,489.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$965.28
|
| Rate for Payer: Multiplan Commercial |
$3,217.60
|
| Rate for Payer: Networks By Design Commercial |
$2,614.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,418.70
|
|
|
HC CL TREAT CARPAL SCAPHOID FX W/
|
Facility
|
OP
|
$4,022.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
900501381
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$448.48 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Adventist Health Commercial |
$804.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,809.90
|
| Rate for Payer: Cash Price |
$1,809.90
|
| Rate for Payer: Cash Price |
$1,809.90
|
| Rate for Payer: Cigna of CA HMO |
$2,574.08
|
| Rate for Payer: Cigna of CA PPO |
$2,976.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$3,418.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,413.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,682.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$965.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$3,217.60
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$2,614.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,418.70
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,413.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,011.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,011.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,011.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,011.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
IP
|
$1,638.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$1,392.30 |
| Rate for Payer: Adventist Health Commercial |
$327.60
|
| Rate for Payer: Cash Price |
$737.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$655.20
|
| Rate for Payer: EPIC Health Plan Senior |
$655.20
|
| Rate for Payer: Galaxy Health WC |
$1,392.30
|
| Rate for Payer: Global Benefits Group Commercial |
$982.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,092.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$624.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,013.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.12
|
| Rate for Payer: Multiplan Commercial |
$1,310.40
|
| Rate for Payer: Networks By Design Commercial |
$1,064.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,392.30
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
OP
|
$1,638.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$327.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$737.10
|
| Rate for Payer: Cash Price |
$737.10
|
| Rate for Payer: Cash Price |
$737.10
|
| Rate for Payer: Cigna of CA HMO |
$1,048.32
|
| Rate for Payer: Cigna of CA PPO |
$1,212.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$1,392.30
|
| Rate for Payer: Global Benefits Group Commercial |
$982.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,092.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$393.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,310.40
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,064.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,392.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$982.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$819.00
|
| Rate for Payer: United Healthcare All Other HMO |
$819.00
|
| Rate for Payer: United Healthcare HMO Rider |
$819.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$819.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT DIST FIB FRAC W/O MAN
|
Facility
|
IP
|
$1,674.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
900501092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$334.80 |
| Max. Negotiated Rate |
$1,422.90 |
| Rate for Payer: Adventist Health Commercial |
$334.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,235.41
|
| Rate for Payer: Blue Shield of California EPN |
$813.56
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.60
|
| Rate for Payer: EPIC Health Plan Senior |
$669.60
|
| Rate for Payer: Galaxy Health WC |
$1,422.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,116.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$637.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,036.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.76
|
| Rate for Payer: Multiplan Commercial |
$1,339.20
|
| Rate for Payer: Networks By Design Commercial |
$1,088.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.90
|
|
|
HC CL TREAT DIST FIB FRAC W/O MAN
|
Facility
|
OP
|
$1,674.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
900501092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$334.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: Cigna of CA HMO |
$1,071.36
|
| Rate for Payer: Cigna of CA PPO |
$1,238.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$1,422.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,116.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,339.20
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,088.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.90
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,004.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$837.00
|
| Rate for Payer: United Healthcare All Other HMO |
$837.00
|
| Rate for Payer: United Healthcare HMO Rider |
$837.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$837.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT DIST FIB FX W/MANIP
|
Facility
|
OP
|
$2,542.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$508.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,143.90
|
| Rate for Payer: Cash Price |
$1,143.90
|
| Rate for Payer: Cash Price |
$1,143.90
|
| Rate for Payer: Cigna of CA HMO |
$1,626.88
|
| Rate for Payer: Cigna of CA PPO |
$1,881.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$2,160.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,525.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,695.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$419.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$610.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$2,033.60
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,652.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,160.70
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,525.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,271.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,271.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,271.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,271.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT DIST FIB FX W/MANIP
|
Facility
|
IP
|
$2,542.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$508.40 |
| Max. Negotiated Rate |
$2,160.70 |
| Rate for Payer: Adventist Health Commercial |
$508.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,876.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,235.41
|
| Rate for Payer: Cash Price |
$1,143.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,016.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,016.80
|
| Rate for Payer: Galaxy Health WC |
$2,160.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,525.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,695.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$968.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,573.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$610.08
|
| Rate for Payer: Multiplan Commercial |
$2,033.60
|
| Rate for Payer: Networks By Design Commercial |
$1,652.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,160.70
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
OP
|
$2,457.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$243.33 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$491.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,105.65
|
| Rate for Payer: Cash Price |
$1,105.65
|
| Rate for Payer: Cash Price |
$1,105.65
|
| Rate for Payer: Cigna of CA HMO |
$1,572.48
|
| Rate for Payer: Cigna of CA PPO |
$1,818.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$2,088.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,474.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,638.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$243.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,965.60
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,597.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,088.45
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,474.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
IP
|
$2,457.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$491.40 |
| Max. Negotiated Rate |
$2,088.45 |
| Rate for Payer: Adventist Health Commercial |
$491.40
|
| Rate for Payer: Cash Price |
$1,105.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$982.80
|
| Rate for Payer: EPIC Health Plan Senior |
$982.80
|
| Rate for Payer: Galaxy Health WC |
$2,088.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,474.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,638.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$936.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,520.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.68
|
| Rate for Payer: Multiplan Commercial |
$1,965.60
|
| Rate for Payer: Networks By Design Commercial |
$1,597.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,088.45
|
|
|
HC CL TREAT DIST PHAL FX W/O MANI
|
Facility
|
OP
|
$1,983.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
900501362
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$155.51 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$396.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$892.35
|
| Rate for Payer: Cash Price |
$892.35
|
| Rate for Payer: Cash Price |
$892.35
|
| Rate for Payer: Cigna of CA HMO |
$1,269.12
|
| Rate for Payer: Cigna of CA PPO |
$1,467.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$1,685.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,189.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,322.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,586.40
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,288.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,685.55
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,189.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$991.50
|
| Rate for Payer: United Healthcare All Other HMO |
$991.50
|
| Rate for Payer: United Healthcare HMO Rider |
$991.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$991.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT DIST PHAL FX W/O MANI
|
Facility
|
IP
|
$1,983.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
900501362
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$396.60 |
| Max. Negotiated Rate |
$1,685.55 |
| Rate for Payer: Adventist Health Commercial |
$396.60
|
| Rate for Payer: Cash Price |
$892.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$793.20
|
| Rate for Payer: EPIC Health Plan Senior |
$793.20
|
| Rate for Payer: Galaxy Health WC |
$1,685.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,189.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,322.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$755.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,227.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.92
|
| Rate for Payer: Multiplan Commercial |
$1,586.40
|
| Rate for Payer: Networks By Design Commercial |
$1,288.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,685.55
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
OP
|
$1,907.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$381.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$858.15
|
| Rate for Payer: Cash Price |
$858.15
|
| Rate for Payer: Cash Price |
$858.15
|
| Rate for Payer: Cigna of CA HMO |
$1,220.48
|
| Rate for Payer: Cigna of CA PPO |
$1,411.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$1,620.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,144.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,271.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$457.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,525.60
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,239.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,620.95
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,144.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$953.50
|
| Rate for Payer: United Healthcare All Other HMO |
$953.50
|
| Rate for Payer: United Healthcare HMO Rider |
$953.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$953.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
IP
|
$1,907.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$381.40 |
| Max. Negotiated Rate |
$1,620.95 |
| Rate for Payer: Adventist Health Commercial |
$381.40
|
| Rate for Payer: Cash Price |
$858.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$762.80
|
| Rate for Payer: EPIC Health Plan Senior |
$762.80
|
| Rate for Payer: Galaxy Health WC |
$1,620.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,144.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,271.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$726.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,180.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$457.68
|
| Rate for Payer: Multiplan Commercial |
$1,525.60
|
| Rate for Payer: Networks By Design Commercial |
$1,239.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,620.95
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
OP
|
$2,134.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.85 |
| Max. Negotiated Rate |
$9,590.00 |
| Rate for Payer: Adventist Health Commercial |
$426.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Cigna of CA HMO |
$1,365.76
|
| Rate for Payer: Cigna of CA PPO |
$1,579.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$1,813.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,423.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$176.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$1,707.20
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$1,387.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,813.90
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,280.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,067.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,067.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,067.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,067.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
IP
|
$2,134.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$426.80 |
| Max. Negotiated Rate |
$1,813.90 |
| Rate for Payer: Adventist Health Commercial |
$426.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,574.89
|
| Rate for Payer: Blue Shield of California EPN |
$1,037.12
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$853.60
|
| Rate for Payer: EPIC Health Plan Senior |
$853.60
|
| Rate for Payer: Galaxy Health WC |
$1,813.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,423.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$813.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,320.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.16
|
| Rate for Payer: Multiplan Commercial |
$1,707.20
|
| Rate for Payer: Networks By Design Commercial |
$1,387.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,813.90
|
|
|
HC CL TREAT FEMORAL FX W/ MANIPUL
|
Facility
|
OP
|
$5,531.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
900501442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$134.47 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$1,106.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,701.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,042.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,148.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$2,488.95
|
| Rate for Payer: Cash Price |
$2,488.95
|
| Rate for Payer: Cash Price |
$2,488.95
|
| Rate for Payer: Cigna of CA HMO |
$3,539.84
|
| Rate for Payer: Cigna of CA PPO |
$4,092.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,701.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,701.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,701.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,212.40
|
| Rate for Payer: Galaxy Health WC |
$4,701.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,318.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$134.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,689.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,423.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,327.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,871.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,871.70
|
| Rate for Payer: Multiplan Commercial |
$4,424.80
|
| Rate for Payer: Networks By Design Commercial |
$3,595.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,701.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,318.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,701.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,701.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4,701.35
|
|
|
HC CL TREAT FEMORAL FX W/ MANIPUL
|
Facility
|
IP
|
$5,531.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
900501442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,106.20 |
| Max. Negotiated Rate |
$4,701.35 |
| Rate for Payer: Adventist Health Commercial |
$1,106.20
|
| Rate for Payer: Cash Price |
$2,488.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,212.40
|
| Rate for Payer: Galaxy Health WC |
$4,701.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,689.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,107.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,423.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,327.44
|
| Rate for Payer: Multiplan Commercial |
$4,424.80
|
| Rate for Payer: Networks By Design Commercial |
$3,595.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,701.35
|
|
|
HC CL TREAT FEMORAL FX, W MANIPUL
|
Facility
|
OP
|
$2,134.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$426.80 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$426.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Cigna of CA HMO |
$1,365.76
|
| Rate for Payer: Cigna of CA PPO |
$1,579.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$1,813.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,423.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$640.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$1,707.20
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$1,387.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,813.90
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,280.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,067.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,067.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,067.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,067.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT FEMORAL FX, W MANIPUL
|
Facility
|
IP
|
$2,134.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$426.80 |
| Max. Negotiated Rate |
$1,813.90 |
| Rate for Payer: Adventist Health Commercial |
$426.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,574.89
|
| Rate for Payer: Blue Shield of California EPN |
$1,037.12
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$853.60
|
| Rate for Payer: EPIC Health Plan Senior |
$853.60
|
| Rate for Payer: Galaxy Health WC |
$1,813.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,280.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,423.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$813.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,320.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.16
|
| Rate for Payer: Multiplan Commercial |
$1,707.20
|
| Rate for Payer: Networks By Design Commercial |
$1,387.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,813.90
|
|
|
HC CL TREAT FEMORAL FX, W/O MANIP
|
Facility
|
IP
|
$1,367.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
900501482
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$273.40 |
| Max. Negotiated Rate |
$1,161.95 |
| Rate for Payer: Adventist Health Commercial |
$273.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,008.85
|
| Rate for Payer: Blue Shield of California EPN |
$664.36
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$546.80
|
| Rate for Payer: EPIC Health Plan Senior |
$546.80
|
| Rate for Payer: Galaxy Health WC |
$1,161.95
|
| Rate for Payer: Global Benefits Group Commercial |
$820.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$911.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$520.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$846.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.08
|
| Rate for Payer: Multiplan Commercial |
$1,093.60
|
| Rate for Payer: Networks By Design Commercial |
$888.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,161.95
|
|
|
HC CL TREAT FEMORAL FX, W/O MANIP
|
Facility
|
OP
|
$1,367.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
900501482
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$273.40 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$273.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: Cigna of CA HMO |
$874.88
|
| Rate for Payer: Cigna of CA PPO |
$1,011.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$1,161.95
|
| Rate for Payer: Global Benefits Group Commercial |
$820.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$911.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,093.60
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$888.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,161.95
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$820.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$683.50
|
| Rate for Payer: United Healthcare All Other HMO |
$683.50
|
| Rate for Payer: United Healthcare HMO Rider |
$683.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$683.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT FEMORAL SHAFT FX,W/O
|
Facility
|
IP
|
$1,367.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
900501463
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$273.40 |
| Max. Negotiated Rate |
$1,161.95 |
| Rate for Payer: Adventist Health Commercial |
$273.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,008.85
|
| Rate for Payer: Blue Shield of California EPN |
$664.36
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$546.80
|
| Rate for Payer: EPIC Health Plan Senior |
$546.80
|
| Rate for Payer: Galaxy Health WC |
$1,161.95
|
| Rate for Payer: Global Benefits Group Commercial |
$820.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$911.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$520.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$846.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.08
|
| Rate for Payer: Multiplan Commercial |
$1,093.60
|
| Rate for Payer: Networks By Design Commercial |
$888.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,161.95
|
|
