|
HC CL TREAT OF NAS BONE FX W/MNP WO STBLZTN
|
Facility
|
IP
|
$4,665.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
900501056
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$933.00 |
| Max. Negotiated Rate |
$3,965.25 |
| Rate for Payer: Adventist Health Commercial |
$933.00
|
| Rate for Payer: Cash Price |
$2,099.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,265.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,866.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,866.00
|
| Rate for Payer: Galaxy Health WC |
$3,965.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,799.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,962.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,752.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,119.60
|
| Rate for Payer: Multiplan Commercial |
$3,732.00
|
| Rate for Payer: Networks By Design Commercial |
$3,032.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,965.25
|
|
|
HC CL TREAT OF NAS BONE FX W/MNP WO STBLZTN
|
Facility
|
OP
|
$4,665.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
900501056
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$150.67 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$1,912.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$992.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,995.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$2,099.25
|
| Rate for Payer: Cash Price |
$2,099.25
|
| Rate for Payer: Cash Price |
$2,099.25
|
| Rate for Payer: Cigna of CA HMO |
$2,985.60
|
| Rate for Payer: Cigna of CA PPO |
$3,452.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,195.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,995.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,265.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,292.74
|
| Rate for Payer: EPIC Health Plan Senior |
$2,195.16
|
| Rate for Payer: Galaxy Health WC |
$3,965.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,799.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,272.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,962.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$150.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,145.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,514.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,674.10
|
| Rate for Payer: Multiplan Commercial |
$3,732.00
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$3,032.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,965.25
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,799.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,799.00
|
| 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 |
$1,995.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Vantage Medical Group Senior |
$1,995.60
|
|
|
HC CL TREAT OF NAS BONE FX W/MNP WO STBLZTN
|
Facility
|
OP
|
$4,665.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
900501056
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.67 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$933.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,995.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$2,099.25
|
| Rate for Payer: Cash Price |
$2,099.25
|
| Rate for Payer: Cash Price |
$2,099.25
|
| Rate for Payer: Cigna of CA HMO |
$2,985.60
|
| Rate for Payer: Cigna of CA PPO |
$3,452.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,195.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,995.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,265.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,292.74
|
| Rate for Payer: EPIC Health Plan Senior |
$2,195.16
|
| Rate for Payer: Galaxy Health WC |
$3,965.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,799.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,272.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,962.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$150.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,145.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,119.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,514.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,674.10
|
| Rate for Payer: Multiplan Commercial |
$3,732.00
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$3,032.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,965.25
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,799.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,332.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,332.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,332.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,332.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,995.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Vantage Medical Group Senior |
$1,995.60
|
|
|
HC CL TREAT OF NAS BONE FX W/MNP WO STBLZTN
|
Facility
|
IP
|
$4,665.00
|
|
|
Service Code
|
CPT 21315
|
| Hospital Charge Code |
900501056
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$933.00 |
| Max. Negotiated Rate |
$3,965.25 |
| Rate for Payer: Adventist Health Commercial |
$933.00
|
| Rate for Payer: Cash Price |
$2,099.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,265.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,866.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,866.00
|
| Rate for Payer: Galaxy Health WC |
$3,965.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,799.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,962.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,752.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,119.60
|
| Rate for Payer: Multiplan Commercial |
$3,732.00
|
| Rate for Payer: Networks By Design Commercial |
$3,032.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,965.25
|
|
|
HC CL TREAT OF NAS BONE FX W/MNP W/STBLZTN
|
Facility
|
IP
|
$5,519.00
|
|
|
Service Code
|
CPT 21320
|
| Hospital Charge Code |
900501405
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,103.80 |
| Max. Negotiated Rate |
$4,691.15 |
| Rate for Payer: Adventist Health Commercial |
$1,103.80
|
| Rate for Payer: Cash Price |
$2,483.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,863.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,207.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,207.60
|
| Rate for Payer: Galaxy Health WC |
$4,691.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,311.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,504.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,256.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,324.56
|
| Rate for Payer: Multiplan Commercial |
$4,415.20
|
| Rate for Payer: Networks By Design Commercial |
$3,587.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,691.15
|
|
|
HC CL TREAT OF NAS BONE FX W/MNP W/STBLZTN
|
Facility
|
OP
|
$5,519.00
|
|
|
Service Code
|
CPT 21320
|
| Hospital Charge Code |
900501405
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$7,035.98 |
| Rate for Payer: Adventist Health Commercial |
$1,103.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$2,483.55
|
| Rate for Payer: Cash Price |
$2,483.55
|
| Rate for Payer: Cash Price |
$2,483.55
|
| Rate for Payer: Cigna of CA HMO |
$3,532.16
|
| Rate for Payer: Cigna of CA PPO |
$4,084.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,863.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$4,691.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,311.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,504.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,324.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,372.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$4,415.20
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$3,587.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,691.15
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,311.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,759.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,759.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,759.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,759.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC CL TREAT OF PAT DISC W/ANESTH
|
Facility
|
OP
|
$4,616.00
|
|
|
Service Code
|
CPT 27562
|
| Hospital Charge Code |
900501089
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$923.20
|
| 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 |
$2,077.20
|
| Rate for Payer: Cash Price |
$2,077.20
|
| Rate for Payer: Cash Price |
$2,077.20
|
| Rate for Payer: Cigna of CA HMO |
$2,954.24
|
| Rate for Payer: Cigna of CA PPO |
$3,415.84
|
| 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 |
$3,231.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$3,923.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,769.60
|
| 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 |
$2,931.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,107.84
|
| 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 |
$3,692.80
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$3,000.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,923.60
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,769.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,308.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,308.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,308.00
|
| 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 OF PAT DISC W/ANESTH
|
Facility
|
IP
|
$4,616.00
|
|
|
Service Code
|
CPT 27562
|
| Hospital Charge Code |
900501089
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$923.20 |
| Max. Negotiated Rate |
$3,923.60 |
| Rate for Payer: Adventist Health Commercial |
$923.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,340.31
|
| Rate for Payer: Blue Shield of California Commercial |
$3,549.70
|
| Rate for Payer: Cash Price |
$2,077.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,231.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,846.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,846.40
|
| Rate for Payer: Galaxy Health WC |
$3,923.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,769.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,931.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,723.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,107.84
|
| Rate for Payer: Multiplan Commercial |
$3,692.80
|
| Rate for Payer: Networks By Design Commercial |
$3,000.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,923.60
|
|
|
HC CL TREAT OF PAT DISC W/O ANEST
|
Facility
|
OP
|
$1,838.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
900501088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Cash Price |
$827.10
|
| Rate for Payer: Cash Price |
$827.10
|
| Rate for Payer: Cash Price |
$827.10
|
| Rate for Payer: Cigna of CA HMO |
$1,176.32
|
| Rate for Payer: Cigna of CA PPO |
$1,360.12
|
| 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 |
$1,286.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,562.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,102.80
|
| 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 |
$1,167.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$383.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$441.12
|
| 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 |
$1,470.40
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,194.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,562.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,102.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$919.00
|
| Rate for Payer: United Healthcare All Other HMO |
$919.00
|
| Rate for Payer: United Healthcare HMO Rider |
$919.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$919.00
|
| 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
|
| Rate for Payer: Adventist Health Commercial |
$367.60
|
| 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
|
|
|
HC CL TREAT OF PAT DISC W/O ANEST
|
Facility
|
IP
|
$1,838.00
|
|
|
Service Code
|
CPT 27560
|
| Hospital Charge Code |
900501088
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$367.60 |
| Max. Negotiated Rate |
$1,562.30 |
| Rate for Payer: Adventist Health Commercial |
$367.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,413.42
|
| Rate for Payer: Blue Shield of California Commercial |
$931.87
|
| Rate for Payer: Cash Price |
$827.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,286.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$735.20
|
| Rate for Payer: EPIC Health Plan Senior |
$735.20
|
| Rate for Payer: Galaxy Health WC |
$1,562.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,102.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,167.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,084.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$441.12
|
| Rate for Payer: Multiplan Commercial |
$1,470.40
|
| Rate for Payer: Networks By Design Commercial |
$1,194.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,562.30
|
|
|
HC CL TREAT OF PATELLAR FX,W/O MA
|
Facility
|
IP
|
$1,674.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
900501455
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$334.80 |
| Max. Negotiated Rate |
$1,422.90 |
| Rate for Payer: Multiplan Commercial |
$1,339.20
|
| Rate for Payer: Networks By Design Commercial |
$1,088.10
|
| Rate for Payer: Adventist Health Commercial |
$334.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,287.31
|
| Rate for Payer: Blue Shield of California Commercial |
$848.72
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,171.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,062.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$987.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.76
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.90
|
|
|
HC CL TREAT OF PATELLAR FX,W/O MA
|
Facility
|
IP
|
$1,674.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
900501455
|
|
Hospital Revenue Code
|
456
|
| 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 |
$1,287.31
|
| Rate for Payer: Blue Shield of California Commercial |
$848.72
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,171.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,062.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$987.66
|
| 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 OF PATELLAR FX,W/O MA
|
Facility
|
OP
|
$1,674.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
900501455
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$686.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,851.37
|
| 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 |
$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 |
$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 |
$1,171.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,422.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.40
|
| 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 |
$1,062.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.76
|
| 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 |
$1,339.20
|
| 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: TriValley Medical Group Commercial/Senior |
$1,004.40
|
| 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 |
$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 OF PATELLAR FX,W/O MA
|
Facility
|
OP
|
$1,674.00
|
|
|
Service Code
|
CPT 27520
|
| Hospital Charge Code |
900501455
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$334.80
|
| 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 |
$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 |
$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 |
$1,171.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,422.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.40
|
| 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 |
$1,062.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.76
|
| 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 |
$1,339.20
|
| 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 |
$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 OF PROX HUM FRAC W/MA
|
Facility
|
OP
|
$5,369.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
900501059
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$410.27 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$1,073.80
|
| 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 |
$6,716.00
|
| Rate for Payer: Cash Price |
$2,416.05
|
| Rate for Payer: Cash Price |
$2,416.05
|
| Rate for Payer: Cash Price |
$2,416.05
|
| Rate for Payer: Cigna of CA HMO |
$3,436.16
|
| Rate for Payer: Cigna of CA PPO |
$3,973.06
|
| 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 |
$3,758.30
|
| 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 |
$4,563.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,221.40
|
| 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 |
$3,409.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$410.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,288.56
|
| 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 |
$4,295.20
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,489.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,563.65
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,221.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,684.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,684.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,684.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,684.50
|
| 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 OF PROX HUM FRAC W/MA
|
Facility
|
IP
|
$5,369.00
|
|
|
Service Code
|
CPT 23605
|
| Hospital Charge Code |
900501059
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,073.80 |
| Max. Negotiated Rate |
$4,563.65 |
| Rate for Payer: Adventist Health Commercial |
$1,073.80
|
| Rate for Payer: Cash Price |
$2,416.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,758.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,147.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,147.60
|
| Rate for Payer: Galaxy Health WC |
$4,563.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,221.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,409.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,167.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,288.56
|
| Rate for Payer: Multiplan Commercial |
$4,295.20
|
| Rate for Payer: Networks By Design Commercial |
$3,489.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,563.65
|
|
|
HC CL TREAT OF RAD ELBOW CHILD
|
Facility
|
OP
|
$2,179.00
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
900501065
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$215.75 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$435.80
|
| 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 |
$980.55
|
| Rate for Payer: Cash Price |
$980.55
|
| Rate for Payer: Cash Price |
$980.55
|
| Rate for Payer: Cigna of CA HMO |
$1,394.56
|
| Rate for Payer: Cigna of CA PPO |
$1,612.46
|
| 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 |
$1,525.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,852.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,307.40
|
| 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 |
$1,383.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$215.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.96
|
| 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 |
$1,743.20
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,416.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,852.15
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,307.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,089.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,089.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,089.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,089.50
|
| 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 OF RAD ELBOW CHILD
|
Facility
|
OP
|
$2,179.00
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
900501065
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$215.75 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$893.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$556.18
|
| 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 |
$980.55
|
| Rate for Payer: Cash Price |
$980.55
|
| Rate for Payer: Cash Price |
$980.55
|
| Rate for Payer: Cigna of CA HMO |
$1,394.56
|
| Rate for Payer: Cigna of CA PPO |
$1,612.46
|
| 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 |
$1,525.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,852.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,307.40
|
| 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 |
$1,383.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$215.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.96
|
| 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 |
$1,743.20
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,416.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,852.15
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,307.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,307.40
|
| 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 |
$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 OF RAD ELBOW CHILD
|
Facility
|
IP
|
$2,179.00
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
900501065
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$435.80 |
| Max. Negotiated Rate |
$1,852.15 |
| Rate for Payer: Adventist Health Commercial |
$435.80
|
| Rate for Payer: Cash Price |
$980.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,525.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$871.60
|
| Rate for Payer: EPIC Health Plan Senior |
$871.60
|
| Rate for Payer: Galaxy Health WC |
$1,852.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,307.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,383.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.96
|
| Rate for Payer: Multiplan Commercial |
$1,743.20
|
| Rate for Payer: Networks By Design Commercial |
$1,416.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,852.15
|
|
|
HC CL TREAT OF RAD ELBOW CHILD
|
Facility
|
IP
|
$2,179.00
|
|
|
Service Code
|
CPT 24640
|
| Hospital Charge Code |
900501065
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$435.80 |
| Max. Negotiated Rate |
$1,852.15 |
| Rate for Payer: Adventist Health Commercial |
$435.80
|
| Rate for Payer: Cash Price |
$980.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,525.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$871.60
|
| Rate for Payer: EPIC Health Plan Senior |
$871.60
|
| Rate for Payer: Galaxy Health WC |
$1,852.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,307.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,383.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.96
|
| Rate for Payer: Multiplan Commercial |
$1,743.20
|
| Rate for Payer: Networks By Design Commercial |
$1,416.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,852.15
|
|
|
HC CL TREAT OF RAD & ULN SHAFT FR
|
Facility
|
OP
|
$3,214.00
|
|
|
Service Code
|
CPT 25565
|
| Hospital Charge Code |
900501069
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$505.06 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$642.80
|
| 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 |
$6,716.00
|
| Rate for Payer: Cash Price |
$1,446.30
|
| Rate for Payer: Cash Price |
$1,446.30
|
| Rate for Payer: Cash Price |
$1,446.30
|
| Rate for Payer: Cigna of CA HMO |
$2,056.96
|
| Rate for Payer: Cigna of CA PPO |
$2,378.36
|
| 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 |
$2,249.80
|
| 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 |
$2,731.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,928.40
|
| 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 |
$2,040.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$771.36
|
| 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 |
$2,571.20
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$2,089.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,731.90
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,928.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,607.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,607.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,607.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,607.00
|
| 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 OF RAD & ULN SHAFT FR
|
Facility
|
IP
|
$3,214.00
|
|
|
Service Code
|
CPT 25565
|
| Hospital Charge Code |
900501069
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$642.80 |
| Max. Negotiated Rate |
$2,731.90 |
| Rate for Payer: Adventist Health Commercial |
$642.80
|
| Rate for Payer: Cash Price |
$1,446.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,249.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,285.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,285.60
|
| Rate for Payer: Galaxy Health WC |
$2,731.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,928.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,040.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,896.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$771.36
|
| Rate for Payer: Multiplan Commercial |
$2,571.20
|
| Rate for Payer: Networks By Design Commercial |
$2,089.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,731.90
|
|
|
HC CL TREAT OF SHLD DISLOC W/MANI
|
Facility
|
OP
|
$2,165.00
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
900501060
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$266.51 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$887.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,718.86
|
| 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 |
$974.25
|
| Rate for Payer: Cash Price |
$974.25
|
| Rate for Payer: Cash Price |
$974.25
|
| Rate for Payer: Cigna of CA HMO |
$1,385.60
|
| Rate for Payer: Cigna of CA PPO |
$1,602.10
|
| 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 |
$1,515.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,840.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,299.00
|
| 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 |
$1,374.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$266.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$519.60
|
| 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 |
$1,732.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,407.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,840.25
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,299.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,299.00
|
| 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 OF SHLD DISLOC W/MANI
|
Facility
|
IP
|
$2,165.00
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
900501060
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$433.00 |
| Max. Negotiated Rate |
$1,840.25 |
| Rate for Payer: Galaxy Health WC |
$1,840.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,299.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,374.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,277.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$519.60
|
| Rate for Payer: Multiplan Commercial |
$1,732.00
|
| Rate for Payer: Networks By Design Commercial |
$1,407.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,840.25
|
| Rate for Payer: Adventist Health Commercial |
$433.00
|
| Rate for Payer: Cash Price |
$974.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,515.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$866.00
|
| Rate for Payer: EPIC Health Plan Senior |
$866.00
|
|
|
HC CL TREAT OF SHLD DISLOC W/MANI
|
Facility
|
IP
|
$2,165.00
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
900501060
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$433.00 |
| Max. Negotiated Rate |
$1,840.25 |
| Rate for Payer: Adventist Health Commercial |
$433.00
|
| Rate for Payer: Cash Price |
$974.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,515.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$866.00
|
| Rate for Payer: EPIC Health Plan Senior |
$866.00
|
| Rate for Payer: Galaxy Health WC |
$1,840.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,299.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,374.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,277.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$519.60
|
| Rate for Payer: Multiplan Commercial |
$1,732.00
|
| Rate for Payer: Networks By Design Commercial |
$1,407.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,840.25
|
|
