|
HC HEAD SCARVES
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380013
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$9.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$26.95
|
| Rate for Payer: Cash Price |
$26.95
|
| Rate for Payer: Cigna of CA HMO |
$34.30
|
| Rate for Payer: Cigna of CA PPO |
$34.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.60
|
| Rate for Payer: EPIC Health Plan Senior |
$19.60
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.76
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: Networks By Design Commercial |
$24.50
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.39
|
| Rate for Payer: United Healthcare All Other HMO |
$17.90
|
| Rate for Payer: United Healthcare HMO Rider |
$17.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.05
|
|
|
HC HEAD SCARVES
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380013
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$41.65 |
| Rate for Payer: Adventist Health Commercial |
$20.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.38
|
| Rate for Payer: Blue Shield of California Commercial |
$36.16
|
| Rate for Payer: Blue Shield of California EPN |
$23.81
|
| Rate for Payer: Cash Price |
$26.95
|
| Rate for Payer: Cigna of CA HMO |
$34.30
|
| Rate for Payer: Cigna of CA PPO |
$34.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.60
|
| Rate for Payer: EPIC Health Plan Senior |
$19.60
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.30
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: Networks By Design Commercial |
$24.50
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.39
|
| Rate for Payer: United Healthcare All Other HMO |
$17.90
|
| Rate for Payer: United Healthcare HMO Rider |
$17.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.65
|
| Rate for Payer: Vantage Medical Group Senior |
$41.65
|
|
|
HC HEART CATH CONGENITAL R & L
|
Facility
|
OP
|
$10,044.00
|
|
|
Service Code
|
CPT 93531
|
| Hospital Charge Code |
906811251
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,008.80 |
| Max. Negotiated Rate |
$15,561.00 |
| Rate for Payer: Adventist Health Commercial |
$2,008.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,537.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,524.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,533.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$5,510.17
|
| Rate for Payer: Cash Price |
$5,524.20
|
| Rate for Payer: Cash Price |
$5,524.20
|
| Rate for Payer: Cigna of CA HMO |
$6,528.60
|
| Rate for Payer: Cigna of CA PPO |
$7,432.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,537.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,537.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,537.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,017.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,017.60
|
| Rate for Payer: Galaxy Health WC |
$8,537.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,026.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,699.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,826.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,217.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,410.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,030.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,030.80
|
| Rate for Payer: Multiplan Commercial |
$8,035.20
|
| Rate for Payer: Networks By Design Commercial |
$6,528.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,537.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,026.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,026.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,022.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,022.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,022.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,022.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,537.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,537.40
|
| Rate for Payer: Vantage Medical Group Senior |
$8,537.40
|
|
|
HC HEART CATH CONGENITAL R & L
|
Facility
|
IP
|
$10,044.00
|
|
|
Service Code
|
CPT 93531
|
| Hospital Charge Code |
906811251
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,008.80 |
| Max. Negotiated Rate |
$8,537.40 |
| Rate for Payer: Adventist Health Commercial |
$2,008.80
|
| Rate for Payer: Cash Price |
$5,524.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,017.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,017.60
|
| Rate for Payer: Galaxy Health WC |
$8,537.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,026.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,699.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,826.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,217.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,410.56
|
| Rate for Payer: Multiplan Commercial |
$8,035.20
|
| Rate for Payer: Networks By Design Commercial |
$6,528.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,537.40
|
|
|
HC HEART CATH CONGENITAL RT
|
Facility
|
OP
|
$8,035.00
|
|
|
Service Code
|
CPT 93530
|
| Hospital Charge Code |
906811250
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,607.00 |
| Max. Negotiated Rate |
$9,339.00 |
| Rate for Payer: Adventist Health Commercial |
$1,607.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,829.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,419.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,026.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,339.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$4,419.25
|
| Rate for Payer: Cash Price |
$4,419.25
|
| Rate for Payer: Cigna of CA HMO |
$5,222.75
|
| Rate for Payer: Cigna of CA PPO |
$5,945.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,829.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,829.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,829.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,214.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,214.00
|
| Rate for Payer: Galaxy Health WC |
$6,829.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,821.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,359.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,061.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,973.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,928.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,624.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,624.50
|
| Rate for Payer: Multiplan Commercial |
$6,428.00
|
| Rate for Payer: Networks By Design Commercial |
$5,222.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,829.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,821.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,821.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,017.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,017.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,017.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,017.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,829.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,829.75
|
| Rate for Payer: Vantage Medical Group Senior |
$6,829.75
|
|
|
HC HEART CATH CONGENITAL RT
|
Facility
|
IP
|
$8,035.00
|
|
|
Service Code
|
CPT 93530
|
| Hospital Charge Code |
906811250
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,607.00 |
| Max. Negotiated Rate |
$6,829.75 |
| Rate for Payer: Adventist Health Commercial |
$1,607.00
|
| Rate for Payer: Cash Price |
$4,419.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,214.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,214.00
|
| Rate for Payer: Galaxy Health WC |
$6,829.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,821.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,359.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,061.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,973.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,928.40
|
| Rate for Payer: Multiplan Commercial |
$6,428.00
|
| Rate for Payer: Networks By Design Commercial |
$5,222.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,829.75
|
|
|
HC HEAVY DUTY ELBOW FEATURE
|
Facility
|
IP
|
$2,573.00
|
|
|
Service Code
|
CPT L6639
|
| Hospital Charge Code |
905356639
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$514.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$514.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,415.15
|
| Rate for Payer: Cash Price |
$1,415.15
|
| Rate for Payer: Cigna of CA HMO |
$1,801.10
|
| Rate for Payer: Cigna of CA PPO |
$1,801.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,029.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,029.20
|
| Rate for Payer: Galaxy Health WC |
$2,187.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,543.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,716.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$980.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,592.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.52
|
| Rate for Payer: Multiplan Commercial |
$2,058.40
|
| Rate for Payer: Networks By Design Commercial |
$1,286.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,187.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$965.65
|
| Rate for Payer: United Healthcare All Other HMO |
$939.92
|
| Rate for Payer: United Healthcare HMO Rider |
$919.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$842.66
|
|
|
HC HEAVY DUTY ELBOW FEATURE
|
Facility
|
OP
|
$2,573.00
|
|
|
Service Code
|
CPT L6639
|
| Hospital Charge Code |
905356639
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$617.52 |
| Max. Negotiated Rate |
$2,187.05 |
| Rate for Payer: Adventist Health Commercial |
$1,054.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,187.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,415.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,929.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,490.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,898.87
|
| Rate for Payer: Blue Shield of California EPN |
$1,250.48
|
| Rate for Payer: Cash Price |
$1,415.15
|
| Rate for Payer: Cigna of CA HMO |
$1,801.10
|
| Rate for Payer: Cigna of CA PPO |
$1,801.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,187.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,187.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,187.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,029.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,029.20
|
| Rate for Payer: Galaxy Health WC |
$2,187.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,543.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,716.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$980.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,592.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$617.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,801.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,801.10
|
| Rate for Payer: Multiplan Commercial |
$2,058.40
|
| Rate for Payer: Networks By Design Commercial |
$1,286.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,187.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,543.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,543.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$965.65
|
| Rate for Payer: United Healthcare All Other HMO |
$939.92
|
| Rate for Payer: United Healthcare HMO Rider |
$919.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$842.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,187.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,187.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,187.05
|
|
|
HC HEEL COUNTER LEATHER
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT L3440
|
| Hospital Charge Code |
915353440
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cigna of CA HMO |
$105.00
|
| Rate for Payer: Cigna of CA PPO |
$105.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$120.00
|
| Rate for Payer: Networks By Design Commercial |
$75.00
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.30
|
| Rate for Payer: United Healthcare All Other HMO |
$54.80
|
| Rate for Payer: United Healthcare HMO Rider |
$53.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.12
|
|
|
HC HEEL COUNTER LEATHER
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT L3440
|
| Hospital Charge Code |
905353440
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cigna of CA HMO |
$105.00
|
| Rate for Payer: Cigna of CA PPO |
$105.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$120.00
|
| Rate for Payer: Networks By Design Commercial |
$75.00
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.30
|
| Rate for Payer: United Healthcare All Other HMO |
$54.80
|
| Rate for Payer: United Healthcare HMO Rider |
$53.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.12
|
|
|
HC HEEL COUNTER LEATHER
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT L3440
|
| Hospital Charge Code |
905353440
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Adventist Health Commercial |
$61.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$127.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$82.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$112.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.88
|
| Rate for Payer: Blue Shield of California Commercial |
$110.70
|
| Rate for Payer: Blue Shield of California EPN |
$72.90
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cigna of CA HMO |
$105.00
|
| Rate for Payer: Cigna of CA PPO |
$105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$127.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$127.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$105.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$105.00
|
| Rate for Payer: Multiplan Commercial |
$120.00
|
| Rate for Payer: Networks By Design Commercial |
$75.00
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.30
|
| Rate for Payer: United Healthcare All Other HMO |
$54.80
|
| Rate for Payer: United Healthcare HMO Rider |
$53.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$127.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$127.50
|
| Rate for Payer: Vantage Medical Group Senior |
$127.50
|
|
|
HC HEEL COUNTER LEATHER
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT L3440
|
| Hospital Charge Code |
915353440
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Adventist Health Commercial |
$61.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$127.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$82.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$112.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.88
|
| Rate for Payer: Blue Shield of California Commercial |
$110.70
|
| Rate for Payer: Blue Shield of California EPN |
$72.90
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cigna of CA HMO |
$105.00
|
| Rate for Payer: Cigna of CA PPO |
$105.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$127.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$127.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$105.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$105.00
|
| Rate for Payer: Multiplan Commercial |
$120.00
|
| Rate for Payer: Networks By Design Commercial |
$75.00
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.30
|
| Rate for Payer: United Healthcare All Other HMO |
$54.80
|
| Rate for Payer: United Healthcare HMO Rider |
$53.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$127.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$127.50
|
| Rate for Payer: Vantage Medical Group Senior |
$127.50
|
|
|
HC HEEL COUNTER PLASTIC
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT L3430
|
| Hospital Charge Code |
905353430
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$34.68 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$103.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$189.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.96
|
| Rate for Payer: Blue Shield of California Commercial |
$185.98
|
| Rate for Payer: Blue Shield of California EPN |
$122.47
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cigna of CA HMO |
$176.40
|
| Rate for Payer: Cigna of CA PPO |
$176.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$214.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$214.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$176.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$176.40
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Networks By Design Commercial |
$126.00
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.58
|
| Rate for Payer: United Healthcare All Other HMO |
$92.06
|
| Rate for Payer: United Healthcare HMO Rider |
$90.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.20
|
| Rate for Payer: Vantage Medical Group Senior |
$214.20
|
|
|
HC HEEL COUNTER PLASTIC
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT L3430
|
| Hospital Charge Code |
915353430
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$34.68 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$103.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$189.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.96
|
| Rate for Payer: Blue Shield of California Commercial |
$185.98
|
| Rate for Payer: Blue Shield of California EPN |
$122.47
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cigna of CA HMO |
$176.40
|
| Rate for Payer: Cigna of CA PPO |
$176.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$214.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$214.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$176.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$176.40
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Networks By Design Commercial |
$126.00
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.58
|
| Rate for Payer: United Healthcare All Other HMO |
$92.06
|
| Rate for Payer: United Healthcare HMO Rider |
$90.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.20
|
| Rate for Payer: Vantage Medical Group Senior |
$214.20
|
|
|
HC HEEL COUNTER PLASTIC
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT L3430
|
| Hospital Charge Code |
905353430
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cigna of CA HMO |
$176.40
|
| Rate for Payer: Cigna of CA PPO |
$176.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.48
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Networks By Design Commercial |
$126.00
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.58
|
| Rate for Payer: United Healthcare All Other HMO |
$92.06
|
| Rate for Payer: United Healthcare HMO Rider |
$90.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.53
|
|
|
HC HEEL COUNTER PLASTIC
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT L3430
|
| Hospital Charge Code |
915353430
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cigna of CA HMO |
$176.40
|
| Rate for Payer: Cigna of CA PPO |
$176.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.48
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Networks By Design Commercial |
$126.00
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.58
|
| Rate for Payer: United Healthcare All Other HMO |
$92.06
|
| Rate for Payer: United Healthcare HMO Rider |
$90.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.53
|
|
|
HC HEEL NEW LEATHER
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT L3455
|
| Hospital Charge Code |
915353455
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$15.54 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Adventist Health Commercial |
$32.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.34
|
| Rate for Payer: Blue Shield of California Commercial |
$59.04
|
| Rate for Payer: Blue Shield of California EPN |
$38.88
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56.00
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$40.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.02
|
| Rate for Payer: United Healthcare All Other HMO |
$29.22
|
| Rate for Payer: United Healthcare HMO Rider |
$28.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.00
|
| Rate for Payer: Vantage Medical Group Senior |
$68.00
|
|
|
HC HEEL NEW LEATHER
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT L3455
|
| Hospital Charge Code |
905353455
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$16.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$40.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.02
|
| Rate for Payer: United Healthcare All Other HMO |
$29.22
|
| Rate for Payer: United Healthcare HMO Rider |
$28.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.20
|
|
|
HC HEEL NEW LEATHER
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT L3455
|
| Hospital Charge Code |
915353455
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$16.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$40.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.02
|
| Rate for Payer: United Healthcare All Other HMO |
$29.22
|
| Rate for Payer: United Healthcare HMO Rider |
$28.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.20
|
|
|
HC HEEL NEW LEATHER
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT L3455
|
| Hospital Charge Code |
905353455
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$15.54 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Adventist Health Commercial |
$32.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.34
|
| Rate for Payer: Blue Shield of California Commercial |
$59.04
|
| Rate for Payer: Blue Shield of California EPN |
$38.88
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56.00
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$40.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.02
|
| Rate for Payer: United Healthcare All Other HMO |
$29.22
|
| Rate for Payer: United Healthcare HMO Rider |
$28.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.00
|
| Rate for Payer: Vantage Medical Group Senior |
$68.00
|
|
|
HC HEEL NEW RUBBER
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT L3460
|
| Hospital Charge Code |
905353460
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$59.50 |
| Rate for Payer: Adventist Health Commercial |
$28.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$59.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.54
|
| Rate for Payer: Blue Shield of California Commercial |
$51.66
|
| Rate for Payer: Blue Shield of California EPN |
$34.02
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cigna of CA HMO |
$49.00
|
| Rate for Payer: Cigna of CA PPO |
$49.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$59.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$59.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.00
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: Networks By Design Commercial |
$35.00
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.27
|
| Rate for Payer: United Healthcare All Other HMO |
$25.57
|
| Rate for Payer: United Healthcare HMO Rider |
$25.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$59.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$59.50
|
| Rate for Payer: Vantage Medical Group Senior |
$59.50
|
|
|
HC HEEL NEW RUBBER
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT L3460
|
| Hospital Charge Code |
915353460
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$59.50 |
| Rate for Payer: Adventist Health Commercial |
$28.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$59.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.54
|
| Rate for Payer: Blue Shield of California Commercial |
$51.66
|
| Rate for Payer: Blue Shield of California EPN |
$34.02
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cigna of CA HMO |
$49.00
|
| Rate for Payer: Cigna of CA PPO |
$49.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$59.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$59.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.00
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: Networks By Design Commercial |
$35.00
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.27
|
| Rate for Payer: United Healthcare All Other HMO |
$25.57
|
| Rate for Payer: United Healthcare HMO Rider |
$25.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$59.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$59.50
|
| Rate for Payer: Vantage Medical Group Senior |
$59.50
|
|
|
HC HEEL NEW RUBBER
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT L3460
|
| Hospital Charge Code |
905353460
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cigna of CA HMO |
$49.00
|
| Rate for Payer: Cigna of CA PPO |
$49.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: Networks By Design Commercial |
$35.00
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.27
|
| Rate for Payer: United Healthcare All Other HMO |
$25.57
|
| Rate for Payer: United Healthcare HMO Rider |
$25.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.93
|
|
|
HC HEEL NEW RUBBER
|
Facility
|
IP
|
$70.00
|
|
|
Service Code
|
CPT L3460
|
| Hospital Charge Code |
915353460
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cash Price |
$38.50
|
| Rate for Payer: Cigna of CA HMO |
$49.00
|
| Rate for Payer: Cigna of CA PPO |
$49.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: Networks By Design Commercial |
$35.00
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.27
|
| Rate for Payer: United Healthcare All Other HMO |
$25.57
|
| Rate for Payer: United Healthcare HMO Rider |
$25.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.93
|
|
|
HC HEEL PAD FOR SPUR
|
Facility
|
IP
|
$122.00
|
|
|
Service Code
|
CPT L3480
|
| Hospital Charge Code |
915353480
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$24.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cash Price |
$67.10
|
| Rate for Payer: Cigna of CA HMO |
$85.40
|
| Rate for Payer: Cigna of CA PPO |
$85.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.80
|
| Rate for Payer: EPIC Health Plan Senior |
$48.80
|
| Rate for Payer: Galaxy Health WC |
$103.70
|
| Rate for Payer: Global Benefits Group Commercial |
$73.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$81.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.28
|
| Rate for Payer: Multiplan Commercial |
$97.60
|
| Rate for Payer: Networks By Design Commercial |
$61.00
|
| Rate for Payer: Prime Health Services Commercial |
$103.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$45.79
|
| Rate for Payer: United Healthcare All Other HMO |
$44.57
|
| Rate for Payer: United Healthcare HMO Rider |
$43.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.95
|
|
