|
HC OCCLUSIVE DEVICE IN VEIN ART
|
Facility
|
IP
|
$1,074.00
|
|
|
Service Code
|
CPT G0269
|
| Hospital Charge Code |
906811384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.76 |
| Max. Negotiated Rate |
$912.90 |
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.60
|
| Rate for Payer: Galaxy Health WC |
$912.90
|
| Rate for Payer: Global Benefits Group Commercial |
$644.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$716.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$409.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.76
|
| Rate for Payer: Multiplan Commercial |
$859.20
|
| Rate for Payer: Networks By Design Commercial |
$698.10
|
| Rate for Payer: Prime Health Services Commercial |
$912.90
|
|
|
HC OCCULT BLOOD GASTRIC
|
Facility
|
OP
|
$7.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900912329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$28.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.99
|
| Rate for Payer: Blue Distinction Transplant |
$4.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4.52
|
| Rate for Payer: Blue Shield of California EPN |
$3.58
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cigna of CA HMO |
$4.48
|
| Rate for Payer: Cigna of CA PPO |
$5.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.98
|
| Rate for Payer: Dignity Health Media |
$5.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.32
|
| Rate for Payer: Galaxy Health WC |
$5.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.72
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.13
|
| Rate for Payer: Multiplan Commercial |
$5.60
|
| Rate for Payer: Networks By Design Commercial |
$4.55
|
| Rate for Payer: Prime Health Services Commercial |
$5.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.31
|
| Rate for Payer: United Healthcare All Other HMO |
$4.31
|
| Rate for Payer: United Healthcare HMO Rider |
$4.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5.32
|
|
|
HC OCCULT BLOOD OTHR SOURCE
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900911536
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$28.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.99
|
| Rate for Payer: Blue Distinction Transplant |
$5.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5.81
|
| Rate for Payer: Blue Shield of California EPN |
$4.61
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cigna of CA HMO |
$5.76
|
| Rate for Payer: Cigna of CA PPO |
$6.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.98
|
| Rate for Payer: Dignity Health Media |
$5.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.32
|
| Rate for Payer: Galaxy Health WC |
$7.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.72
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.13
|
| Rate for Payer: Multiplan Commercial |
$7.20
|
| Rate for Payer: Networks By Design Commercial |
$5.85
|
| Rate for Payer: Prime Health Services Commercial |
$7.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.31
|
| Rate for Payer: United Healthcare All Other HMO |
$4.31
|
| Rate for Payer: United Healthcare HMO Rider |
$4.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5.32
|
|
|
HC OPEN FX DISTAL TIBIA/FIBULA
|
Facility
|
OP
|
$10,534.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
900501606
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$14,659.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,320.40
|
| Rate for Payer: Cash Price |
$4,740.30
|
| Rate for Payer: Cash Price |
$4,740.30
|
| Rate for Payer: Cash Price |
$4,740.30
|
| Rate for Payer: Cigna of CA PPO |
$7,795.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$8,953.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,320.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,900.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,026.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,528.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$8,427.20
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$6,847.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,953.90
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,320.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,267.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,267.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,267.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,267.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC OPEN FX DISTAL TIBIA/FIBULA
|
Facility
|
IP
|
$10,534.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
900501606
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,528.16 |
| Max. Negotiated Rate |
$8,953.90 |
| Rate for Payer: Cash Price |
$4,740.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,213.60
|
| Rate for Payer: Galaxy Health WC |
$8,953.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,320.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,026.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,013.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,528.16
|
| Rate for Payer: Multiplan Commercial |
$8,427.20
|
| Rate for Payer: Networks By Design Commercial |
$6,847.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,953.90
|
|
|
HC OPEN TREAT ELBOW DISLOCATION
|
Facility
|
OP
|
$26,062.00
|
|
|
Service Code
|
CPT 24615
|
| Hospital Charge Code |
900524615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$22,152.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$15,637.20
|
| Rate for Payer: Cash Price |
$11,727.90
|
| Rate for Payer: Cash Price |
$11,727.90
|
| Rate for Payer: Cash Price |
$11,727.90
|
| Rate for Payer: Cigna of CA PPO |
$19,285.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$22,152.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,637.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19,546.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,383.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,254.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$20,849.60
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$16,940.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,152.70
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,637.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,031.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13,031.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,031.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,031.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC OPEN TREAT ELBOW DISLOCATION
|
Facility
|
IP
|
$26,062.00
|
|
|
Service Code
|
CPT 24615
|
| Hospital Charge Code |
900524615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,254.88 |
| Max. Negotiated Rate |
$22,152.70 |
| Rate for Payer: Cash Price |
$11,727.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,424.80
|
| Rate for Payer: Galaxy Health WC |
$22,152.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,637.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,383.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,929.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,254.88
|
| Rate for Payer: Multiplan Commercial |
$20,849.60
|
| Rate for Payer: Networks By Design Commercial |
$16,940.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,152.70
|
|
|
HC OPEN TREAT FINGER FX, EA
|
Facility
|
IP
|
$17,489.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
900501422
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,197.36 |
| Max. Negotiated Rate |
$14,865.65 |
| Rate for Payer: Cash Price |
$7,870.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,995.60
|
| Rate for Payer: Galaxy Health WC |
$14,865.65
|
| Rate for Payer: Global Benefits Group Commercial |
$10,493.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,665.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,663.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,197.36
|
| Rate for Payer: Multiplan Commercial |
$13,991.20
|
| Rate for Payer: Networks By Design Commercial |
$11,367.85
|
| Rate for Payer: Prime Health Services Commercial |
$14,865.65
|
|
|
HC OPEN TREAT FINGER FX, EA
|
Facility
|
OP
|
$17,489.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
900501422
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$14,865.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: Blue Distinction Transplant |
$10,493.40
|
| Rate for Payer: Cash Price |
$7,870.05
|
| Rate for Payer: Cash Price |
$7,870.05
|
| Rate for Payer: Cash Price |
$7,870.05
|
| Rate for Payer: Cigna of CA PPO |
$12,941.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$14,865.65
|
| Rate for Payer: Global Benefits Group Commercial |
$10,493.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13,116.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,665.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,197.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$13,991.20
|
| Rate for Payer: Networks By Design Commercial |
$11,367.85
|
| Rate for Payer: Prime Health Services Commercial |
$14,865.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,493.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,744.50
|
| Rate for Payer: United Healthcare All Other HMO |
$8,744.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,744.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,744.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC OPEN TREAT FINGER/THUMB FX EA
|
Facility
|
IP
|
$16,070.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
900501389
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,856.80 |
| Max. Negotiated Rate |
$13,659.50 |
| Rate for Payer: Cash Price |
$7,231.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,428.00
|
| Rate for Payer: Galaxy Health WC |
$13,659.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,642.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,122.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,856.80
|
| Rate for Payer: Multiplan Commercial |
$12,856.00
|
| Rate for Payer: Networks By Design Commercial |
$10,445.50
|
| Rate for Payer: Prime Health Services Commercial |
$13,659.50
|
|
|
HC OPEN TREAT FINGER/THUMB FX EA
|
Facility
|
OP
|
$16,070.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
900501389
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$13,659.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: Blue Distinction Transplant |
$9,642.00
|
| Rate for Payer: Cash Price |
$7,231.50
|
| Rate for Payer: Cash Price |
$7,231.50
|
| Rate for Payer: Cash Price |
$7,231.50
|
| Rate for Payer: Cigna of CA PPO |
$11,891.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$13,659.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,642.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,052.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,856.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$12,856.00
|
| Rate for Payer: Networks By Design Commercial |
$10,445.50
|
| Rate for Payer: Prime Health Services Commercial |
$13,659.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,642.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,035.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,035.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,035.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,035.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC OPEN TREAT/FINGER/TOE FRACTURE
|
Facility
|
IP
|
$14,727.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
900501351
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,534.48 |
| Max. Negotiated Rate |
$12,517.95 |
| Rate for Payer: Cash Price |
$6,627.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.80
|
| Rate for Payer: Galaxy Health WC |
$12,517.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,836.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,822.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,610.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,534.48
|
| Rate for Payer: Multiplan Commercial |
$11,781.60
|
| Rate for Payer: Networks By Design Commercial |
$9,572.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,517.95
|
|
|
HC OPEN TREAT/FINGER/TOE FRACTURE
|
Facility
|
OP
|
$14,727.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
900501351
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$428.66 |
| Max. Negotiated Rate |
$13,086.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,086.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,836.20
|
| Rate for Payer: Cash Price |
$6,627.15
|
| Rate for Payer: Cash Price |
$6,627.15
|
| Rate for Payer: Cash Price |
$6,627.15
|
| Rate for Payer: Cigna of CA PPO |
$10,897.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$12,517.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,836.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,045.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,822.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$428.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,534.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$11,781.60
|
| Rate for Payer: Networks By Design Commercial |
$9,572.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,517.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,836.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,363.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,363.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,363.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,363.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC OPEN TREAT INTERPHALANGEAL DIS
|
Facility
|
OP
|
$13,654.00
|
|
|
Service Code
|
CPT 26785
|
| Hospital Charge Code |
900501654
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$345.19 |
| Max. Negotiated Rate |
$11,605.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,192.40
|
| Rate for Payer: Cash Price |
$6,144.30
|
| Rate for Payer: Cash Price |
$6,144.30
|
| Rate for Payer: Cash Price |
$6,144.30
|
| Rate for Payer: Cigna of CA PPO |
$10,103.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$11,605.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8,192.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,240.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,107.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$345.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,276.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$10,923.20
|
| Rate for Payer: Networks By Design Commercial |
$8,875.10
|
| Rate for Payer: Prime Health Services Commercial |
$11,605.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,192.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,827.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,827.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,827.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC OPEN TREAT INTERPHALANGEAL DIS
|
Facility
|
IP
|
$13,654.00
|
|
|
Service Code
|
CPT 26785
|
| Hospital Charge Code |
900501654
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,276.96 |
| Max. Negotiated Rate |
$11,605.90 |
| Rate for Payer: Cash Price |
$6,144.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,461.60
|
| Rate for Payer: Galaxy Health WC |
$11,605.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8,192.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,107.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,202.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,276.96
|
| Rate for Payer: Multiplan Commercial |
$10,923.20
|
| Rate for Payer: Networks By Design Commercial |
$8,875.10
|
| Rate for Payer: Prime Health Services Commercial |
$11,605.90
|
|
|
HC OPEN TREAT MANDIBULAR FX W/INT
|
Facility
|
OP
|
$9,277.00
|
|
|
Service Code
|
CPT 21462
|
| Hospital Charge Code |
900501697
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$229.90 |
| Max. Negotiated Rate |
$13,086.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,086.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,566.20
|
| Rate for Payer: Cash Price |
$4,174.65
|
| Rate for Payer: Cash Price |
$4,174.65
|
| Rate for Payer: Cash Price |
$4,174.65
|
| Rate for Payer: Cigna of CA PPO |
$6,864.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Media |
$7,316.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,877.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,316.90
|
| Rate for Payer: Galaxy Health WC |
$7,885.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,566.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,957.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,999.72
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,999.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,316.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,187.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,316.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,226.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,219.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,804.65
|
| Rate for Payer: Multiplan Commercial |
$7,421.60
|
| Rate for Payer: Multiplan WC |
$10,003.24
|
| Rate for Payer: Networks By Design Commercial |
$6,030.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,885.45
|
| Rate for Payer: Prime Health Services WC |
$9,901.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,566.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,638.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,638.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,638.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,638.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
HC OPEN TREAT MANDIBULAR FX W/INT
|
Facility
|
IP
|
$9,277.00
|
|
|
Service Code
|
CPT 21462
|
| Hospital Charge Code |
900501697
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,226.48 |
| Max. Negotiated Rate |
$7,885.45 |
| Rate for Payer: Cash Price |
$4,174.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,710.80
|
| Rate for Payer: Galaxy Health WC |
$7,885.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,566.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,187.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,534.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,226.48
|
| Rate for Payer: Multiplan Commercial |
$7,421.60
|
| Rate for Payer: Networks By Design Commercial |
$6,030.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,885.45
|
|
|
HC OPEN TREAT METACARPAL FX SNGL
|
Facility
|
OP
|
$10,008.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
900501555
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,004.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,375.90
|
| Rate for Payer: Blue Shield of California EPN |
$5,844.67
|
| Rate for Payer: Cash Price |
$4,503.60
|
| Rate for Payer: Cash Price |
$4,503.60
|
| Rate for Payer: Cigna of CA PPO |
$7,405.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$8,506.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,004.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,506.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,551.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6,551.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,675.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,401.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$8,006.40
|
| Rate for Payer: Networks By Design Commercial |
$6,505.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,506.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,004.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,004.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC OPEN TREAT METACARPAL FX SNGL
|
Facility
|
IP
|
$10,008.00
|
|
|
Service Code
|
CPT 26615
|
| Hospital Charge Code |
900501555
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$2,401.92 |
| Max. Negotiated Rate |
$8,506.80 |
| Rate for Payer: Cash Price |
$4,503.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,003.20
|
| Rate for Payer: Galaxy Health WC |
$8,506.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,004.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,675.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,813.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,401.92
|
| Rate for Payer: Multiplan Commercial |
$8,006.40
|
| Rate for Payer: Networks By Design Commercial |
$6,505.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,506.80
|
|
|
HC OPEN TREAT METATARSAL FX, EA
|
Facility
|
IP
|
$15,274.00
|
|
|
Service Code
|
CPT 28485
|
| Hospital Charge Code |
900501691
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,665.76 |
| Max. Negotiated Rate |
$12,982.90 |
| Rate for Payer: Cash Price |
$6,873.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,109.60
|
| Rate for Payer: Galaxy Health WC |
$12,982.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,164.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,187.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,819.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,665.76
|
| Rate for Payer: Multiplan Commercial |
$12,219.20
|
| Rate for Payer: Networks By Design Commercial |
$9,928.10
|
| Rate for Payer: Prime Health Services Commercial |
$12,982.90
|
|
|
HC OPEN TREAT METATARSAL FX, EA
|
Facility
|
OP
|
$15,274.00
|
|
|
Service Code
|
CPT 28485
|
| Hospital Charge Code |
900501691
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$891.99 |
| Max. Negotiated Rate |
$14,659.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$9,164.40
|
| Rate for Payer: Cash Price |
$6,873.30
|
| Rate for Payer: Cash Price |
$6,873.30
|
| Rate for Payer: Cash Price |
$6,873.30
|
| Rate for Payer: Cigna of CA PPO |
$11,302.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$12,982.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,164.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,455.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,187.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,665.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$12,219.20
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$9,928.10
|
| Rate for Payer: Prime Health Services Commercial |
$12,982.90
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,164.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,637.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,637.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,637.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,637.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC OPEN TREAT TALUS FRACTURE
|
Facility
|
IP
|
$8,426.00
|
|
|
Service Code
|
CPT 28445
|
| Hospital Charge Code |
900501370
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,022.24 |
| Max. Negotiated Rate |
$7,162.10 |
| Rate for Payer: Cash Price |
$3,791.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,370.40
|
| Rate for Payer: Galaxy Health WC |
$7,162.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,055.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,620.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,210.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,022.24
|
| Rate for Payer: Multiplan Commercial |
$6,740.80
|
| Rate for Payer: Networks By Design Commercial |
$5,476.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,162.10
|
|
|
HC OPEN TREAT TALUS FRACTURE
|
Facility
|
OP
|
$8,426.00
|
|
|
Service Code
|
CPT 28445
|
| Hospital Charge Code |
900501370
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$801.46 |
| Max. Negotiated Rate |
$14,659.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,055.60
|
| Rate for Payer: Cash Price |
$3,791.70
|
| Rate for Payer: Cash Price |
$3,791.70
|
| Rate for Payer: Cash Price |
$3,791.70
|
| Rate for Payer: Cigna of CA PPO |
$6,235.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$7,162.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,055.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,319.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,620.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$801.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,022.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$6,740.80
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$5,476.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,162.10
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,055.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,213.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,213.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,213.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC OPERATING MICROSCOPE
|
Facility
|
IP
|
$1,096.00
|
|
|
Service Code
|
CPT 69990
|
| Hospital Charge Code |
900501663
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$263.04 |
| Max. Negotiated Rate |
$931.60 |
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.40
|
| Rate for Payer: Galaxy Health WC |
$931.60
|
| Rate for Payer: Global Benefits Group Commercial |
$657.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$731.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$417.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.04
|
| Rate for Payer: Multiplan Commercial |
$876.80
|
| Rate for Payer: Networks By Design Commercial |
$712.40
|
| Rate for Payer: Prime Health Services Commercial |
$931.60
|
|
|
HC OPERATING MICROSCOPE
|
Facility
|
OP
|
$1,096.00
|
|
|
Service Code
|
CPT 69990
|
| Hospital Charge Code |
900501663
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$263.04 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$931.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$602.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$602.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$657.60
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cigna of CA PPO |
$811.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$931.60
|
| Rate for Payer: Dignity Health Media |
$931.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$931.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$438.40
|
| Rate for Payer: Galaxy Health WC |
$931.60
|
| Rate for Payer: Global Benefits Group Commercial |
$657.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$822.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$731.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.04
|
| Rate for Payer: Multiplan Commercial |
$876.80
|
| Rate for Payer: Networks By Design Commercial |
$712.40
|
| Rate for Payer: Prime Health Services Commercial |
$931.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$657.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$548.00
|
| Rate for Payer: United Healthcare All Other HMO |
$548.00
|
| Rate for Payer: United Healthcare HMO Rider |
$548.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$931.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$931.60
|
| Rate for Payer: Vantage Medical Group Senior |
$931.60
|
|
