|
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 |
$317.26 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Cigna of CA PPO |
$1,881.08
|
| Rate for Payer: Adventist Health Commercial |
$508.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,779.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| 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/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,614.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$419.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$610.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
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 |
$1,288.79
|
| Rate for Payer: Blue Shield of California Commercial |
$1,954.80
|
| Rate for Payer: Cash Price |
$1,143.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,779.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,614.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,499.78
|
| 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
|
IP
|
$2,457.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
456
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,719.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,560.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,449.63
|
| 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/MANIPU
|
Facility
|
OP
|
$2,457.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$243.33 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$1,007.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,709.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,719.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| 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/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,560.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$243.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| 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: TriValley Medical Group Commercial/Senior |
$1,474.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,719.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,560.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,449.63
|
| 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/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 |
$5,641.00 |
| 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 |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,719.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| 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/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,560.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$243.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$589.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,388.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,169.97
|
| 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 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 |
$5,641.00 |
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,685.55
|
| 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 |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,388.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,189.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,259.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$155.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
IP
|
$1,907.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
456
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,334.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,210.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,125.13
|
| 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 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 |
$317.26 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
| Rate for Payer: Adventist Health Commercial |
$381.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,334.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| 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/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,210.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$457.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,334.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,210.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,125.13
|
| 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 ELBOW DISLOC W O ANES
|
Facility
|
OP
|
$1,907.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$781.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,334.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| 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/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,210.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$457.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| 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: TriValley Medical Group Commercial/Senior |
$1,144.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
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
|
456
|
| 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 |
$1,081.94
|
| Rate for Payer: Blue Shield of California Commercial |
$1,641.05
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,493.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,355.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,259.06
|
| 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 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: Multiplan Commercial |
$1,707.20
|
| Rate for Payer: Networks By Design Commercial |
$1,387.10
|
| Rate for Payer: Adventist Health Commercial |
$426.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,081.94
|
| Rate for Payer: Blue Shield of California Commercial |
$1,641.05
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,493.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,355.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,259.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.16
|
| Rate for Payer: Prime Health Services Commercial |
$1,813.90
|
|
|
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
|
456
|
| Min. Negotiated Rate |
$176.85 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$874.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,107.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,493.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| 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/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,355.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$176.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,605.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,771.32
|
| 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: TriValley Medical Group Commercial/Senior |
$1,280.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
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 |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$426.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,493.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| 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/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,355.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$176.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,605.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,771.32
|
| 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 |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,106.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,871.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| Rate for Payer: Galaxy Health WC |
$4,701.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,318.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$134.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,512.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$152.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,895.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,327.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,605.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,771.32
|
| 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 |
$2,765.50
|
| 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: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,871.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,512.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,263.29
|
| 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
|
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 |
$1,081.94
|
| Rate for Payer: Blue Shield of California Commercial |
$1,641.05
|
| Rate for Payer: Cash Price |
$960.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,493.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,355.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,259.06
|
| 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
|
$2,134.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$426.80 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$426.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,493.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| 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/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,355.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$640.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,605.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,771.32
|
| 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 |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
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 |
$5,641.00 |
| 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: Adventist Health Commercial |
$273.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$956.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| 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/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$868.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$488.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
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 |
$1,051.22
|
| Rate for Payer: Blue Shield of California Commercial |
$693.07
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$956.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$868.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$806.53
|
| 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 SHAFT FX,W/O
|
Facility
|
OP
|
$1,367.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
900501463
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$273.40 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$273.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$956.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| 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/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$868.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$655.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
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 |
$1,051.22
|
| Rate for Payer: Blue Shield of California Commercial |
$693.07
|
| Rate for Payer: Cash Price |
$615.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$956.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$868.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$806.53
|
| 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 FEM SHAFT FRAC W/MANI
|
Facility
|
OP
|
$4,642.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
900501085
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$679.78 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$928.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$2,088.90
|
| Rate for Payer: Cash Price |
$2,088.90
|
| Rate for Payer: Cash Price |
$2,088.90
|
| Rate for Payer: Cigna of CA HMO |
$2,970.88
|
| Rate for Payer: Cigna of CA PPO |
$3,435.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,249.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| Rate for Payer: Galaxy Health WC |
$3,945.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,785.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,947.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$679.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,114.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,605.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$3,713.60
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,017.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,945.70
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,785.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,321.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,321.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,321.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,321.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
