|
HC HIV RAPID TESTING
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900912325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.11 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.58
|
| Rate for Payer: Blue Shield of California Commercial |
$180.63
|
| Rate for Payer: Blue Shield of California EPN |
$119.34
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Cigna of CA HMO |
$172.80
|
| Rate for Payer: Cigna of CA PPO |
$199.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.51
|
| Rate for Payer: EPIC Health Plan Senior |
$13.71
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$22.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.37
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$162.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.08
|
| Rate for Payer: Vantage Medical Group Senior |
$13.71
|
|
|
HC HIV RAPID TESTING
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 86703
|
| Hospital Charge Code |
900912325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$167.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.80
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
|
|
HC HKAFO ROTATION STRAPS
|
Facility
|
OP
|
$287.00
|
|
|
Service Code
|
CPT L2040
|
| Hospital Charge Code |
905352040
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$68.88 |
| Max. Negotiated Rate |
$243.95 |
| Rate for Payer: Adventist Health Commercial |
$117.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$157.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$215.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$166.23
|
| Rate for Payer: Blue Shield of California Commercial |
$211.81
|
| Rate for Payer: Blue Shield of California EPN |
$139.48
|
| Rate for Payer: Cash Price |
$157.85
|
| Rate for Payer: Cash Price |
$157.85
|
| Rate for Payer: Cigna of CA HMO |
$200.90
|
| Rate for Payer: Cigna of CA PPO |
$200.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$243.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$243.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$243.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$115.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$130.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$177.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$200.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$200.90
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$143.50
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.71
|
| Rate for Payer: United Healthcare All Other HMO |
$104.84
|
| Rate for Payer: United Healthcare HMO Rider |
$102.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$93.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$243.95
|
| Rate for Payer: Vantage Medical Group Senior |
$243.95
|
|
|
HC HKAFO ROTATION STRAPS
|
Facility
|
IP
|
$287.00
|
|
|
Service Code
|
CPT L2040
|
| Hospital Charge Code |
905352040
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$57.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$57.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$157.85
|
| Rate for Payer: Cash Price |
$157.85
|
| Rate for Payer: Cigna of CA HMO |
$200.90
|
| Rate for Payer: Cigna of CA PPO |
$200.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$177.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$143.50
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.71
|
| Rate for Payer: United Healthcare All Other HMO |
$104.84
|
| Rate for Payer: United Healthcare HMO Rider |
$102.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$93.99
|
|
|
HC HKAFO ROTATION STRAPS
|
Facility
|
OP
|
$287.00
|
|
|
Service Code
|
CPT L2040
|
| Hospital Charge Code |
915352040
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$68.88 |
| Max. Negotiated Rate |
$243.95 |
| Rate for Payer: Adventist Health Commercial |
$117.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$157.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$215.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$166.23
|
| Rate for Payer: Blue Shield of California Commercial |
$211.81
|
| Rate for Payer: Blue Shield of California EPN |
$139.48
|
| Rate for Payer: Cash Price |
$157.85
|
| Rate for Payer: Cash Price |
$157.85
|
| Rate for Payer: Cigna of CA HMO |
$200.90
|
| Rate for Payer: Cigna of CA PPO |
$200.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$243.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$243.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$243.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$115.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$130.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$177.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$200.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$200.90
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$143.50
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.71
|
| Rate for Payer: United Healthcare All Other HMO |
$104.84
|
| Rate for Payer: United Healthcare HMO Rider |
$102.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$93.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$243.95
|
| Rate for Payer: Vantage Medical Group Senior |
$243.95
|
|
|
HC HKAFO ROTATION STRAPS
|
Facility
|
IP
|
$287.00
|
|
|
Service Code
|
CPT L2040
|
| Hospital Charge Code |
915352040
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$57.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$57.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$157.85
|
| Rate for Payer: Cash Price |
$157.85
|
| Rate for Payer: Cigna of CA HMO |
$200.90
|
| Rate for Payer: Cigna of CA PPO |
$200.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$177.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$143.50
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.71
|
| Rate for Payer: United Healthcare All Other HMO |
$104.84
|
| Rate for Payer: United Healthcare HMO Rider |
$102.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$93.99
|
|
|
HC HKAFO TORSION CABLES
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
CPT L2050
|
| Hospital Charge Code |
905352050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$384.00 |
| Max. Negotiated Rate |
$1,360.00 |
| Rate for Payer: Adventist Health Commercial |
$656.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,360.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$880.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,200.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$926.72
|
| Rate for Payer: Blue Shield of California Commercial |
$1,180.80
|
| Rate for Payer: Blue Shield of California EPN |
$777.60
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cigna of CA HMO |
$1,120.00
|
| Rate for Payer: Cigna of CA PPO |
$1,120.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,360.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,360.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$640.00
|
| Rate for Payer: EPIC Health Plan Senior |
$640.00
|
| Rate for Payer: Galaxy Health WC |
$1,360.00
|
| Rate for Payer: Global Benefits Group Commercial |
$960.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$419.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$990.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$384.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,120.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,120.00
|
| Rate for Payer: Multiplan Commercial |
$1,280.00
|
| Rate for Payer: Networks By Design Commercial |
$800.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,360.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$960.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$960.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$600.48
|
| Rate for Payer: United Healthcare All Other HMO |
$584.48
|
| Rate for Payer: United Healthcare HMO Rider |
$571.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$524.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,360.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,360.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,360.00
|
|
|
HC HKAFO TORSION CABLES
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
CPT L2050
|
| Hospital Charge Code |
915352050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$384.00 |
| Max. Negotiated Rate |
$1,360.00 |
| Rate for Payer: Adventist Health Commercial |
$656.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,360.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$880.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,200.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$926.72
|
| Rate for Payer: Blue Shield of California Commercial |
$1,180.80
|
| Rate for Payer: Blue Shield of California EPN |
$777.60
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cigna of CA HMO |
$1,120.00
|
| Rate for Payer: Cigna of CA PPO |
$1,120.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,360.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,360.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$640.00
|
| Rate for Payer: EPIC Health Plan Senior |
$640.00
|
| Rate for Payer: Galaxy Health WC |
$1,360.00
|
| Rate for Payer: Global Benefits Group Commercial |
$960.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$419.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$474.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$990.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$384.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,120.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,120.00
|
| Rate for Payer: Multiplan Commercial |
$1,280.00
|
| Rate for Payer: Networks By Design Commercial |
$800.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,360.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$960.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$960.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$600.48
|
| Rate for Payer: United Healthcare All Other HMO |
$584.48
|
| Rate for Payer: United Healthcare HMO Rider |
$571.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$524.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,360.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,360.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,360.00
|
|
|
HC HKAFO TORSION CABLES
|
Facility
|
IP
|
$1,600.00
|
|
|
Service Code
|
CPT L2050
|
| Hospital Charge Code |
905352050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$320.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$320.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cigna of CA HMO |
$1,120.00
|
| Rate for Payer: Cigna of CA PPO |
$1,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$640.00
|
| Rate for Payer: EPIC Health Plan Senior |
$640.00
|
| Rate for Payer: Galaxy Health WC |
$1,360.00
|
| Rate for Payer: Global Benefits Group Commercial |
$960.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$609.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$990.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$384.00
|
| Rate for Payer: Multiplan Commercial |
$1,280.00
|
| Rate for Payer: Networks By Design Commercial |
$800.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,360.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$600.48
|
| Rate for Payer: United Healthcare All Other HMO |
$584.48
|
| Rate for Payer: United Healthcare HMO Rider |
$571.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$524.00
|
|
|
HC HKAFO TORSION CABLES
|
Facility
|
IP
|
$1,600.00
|
|
|
Service Code
|
CPT L2050
|
| Hospital Charge Code |
915352050
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$320.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$320.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cash Price |
$880.00
|
| Rate for Payer: Cigna of CA HMO |
$1,120.00
|
| Rate for Payer: Cigna of CA PPO |
$1,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$640.00
|
| Rate for Payer: EPIC Health Plan Senior |
$640.00
|
| Rate for Payer: Galaxy Health WC |
$1,360.00
|
| Rate for Payer: Global Benefits Group Commercial |
$960.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$609.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$990.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$384.00
|
| Rate for Payer: Multiplan Commercial |
$1,280.00
|
| Rate for Payer: Networks By Design Commercial |
$800.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,360.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$600.48
|
| Rate for Payer: United Healthcare All Other HMO |
$584.48
|
| Rate for Payer: United Healthcare HMO Rider |
$571.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$524.00
|
|
|
HC HKAFO TORSION CBL BALL BEARING
|
Facility
|
IP
|
$1,730.00
|
|
|
Service Code
|
CPT L2060
|
| Hospital Charge Code |
915352060
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$346.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$346.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$951.50
|
| Rate for Payer: Cash Price |
$951.50
|
| Rate for Payer: Cigna of CA HMO |
$1,211.00
|
| Rate for Payer: Cigna of CA PPO |
$1,211.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$692.00
|
| Rate for Payer: EPIC Health Plan Senior |
$692.00
|
| Rate for Payer: Galaxy Health WC |
$1,470.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,038.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$659.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.20
|
| Rate for Payer: Multiplan Commercial |
$1,384.00
|
| Rate for Payer: Networks By Design Commercial |
$865.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,470.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$649.27
|
| Rate for Payer: United Healthcare All Other HMO |
$631.97
|
| Rate for Payer: United Healthcare HMO Rider |
$618.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$566.58
|
|
|
HC HKAFO TORSION CBL BALL BEARING
|
Facility
|
OP
|
$1,730.00
|
|
|
Service Code
|
CPT L2060
|
| Hospital Charge Code |
915352060
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$415.20 |
| Max. Negotiated Rate |
$1,470.50 |
| Rate for Payer: Adventist Health Commercial |
$709.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,470.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$951.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,297.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,002.02
|
| Rate for Payer: Blue Shield of California Commercial |
$1,276.74
|
| Rate for Payer: Blue Shield of California EPN |
$840.78
|
| Rate for Payer: Cash Price |
$951.50
|
| Rate for Payer: Cash Price |
$951.50
|
| Rate for Payer: Cigna of CA HMO |
$1,211.00
|
| Rate for Payer: Cigna of CA PPO |
$1,211.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,470.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,470.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,470.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$692.00
|
| Rate for Payer: EPIC Health Plan Senior |
$692.00
|
| Rate for Payer: Galaxy Health WC |
$1,470.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,038.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$718.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$812.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,211.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,211.00
|
| Rate for Payer: Multiplan Commercial |
$1,384.00
|
| Rate for Payer: Networks By Design Commercial |
$865.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,470.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,038.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,038.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$649.27
|
| Rate for Payer: United Healthcare All Other HMO |
$631.97
|
| Rate for Payer: United Healthcare HMO Rider |
$618.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$566.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,470.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,470.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,470.50
|
|
|
HC HKAFO TORSION CBL BALL BEARING
|
Facility
|
OP
|
$1,730.00
|
|
|
Service Code
|
CPT L2060
|
| Hospital Charge Code |
905352060
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$415.20 |
| Max. Negotiated Rate |
$1,470.50 |
| Rate for Payer: Adventist Health Commercial |
$709.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,470.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$951.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,297.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,002.02
|
| Rate for Payer: Blue Shield of California Commercial |
$1,276.74
|
| Rate for Payer: Blue Shield of California EPN |
$840.78
|
| Rate for Payer: Cash Price |
$951.50
|
| Rate for Payer: Cash Price |
$951.50
|
| Rate for Payer: Cigna of CA HMO |
$1,211.00
|
| Rate for Payer: Cigna of CA PPO |
$1,211.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,470.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,470.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,470.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$692.00
|
| Rate for Payer: EPIC Health Plan Senior |
$692.00
|
| Rate for Payer: Galaxy Health WC |
$1,470.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,038.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$718.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$812.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,211.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,211.00
|
| Rate for Payer: Multiplan Commercial |
$1,384.00
|
| Rate for Payer: Networks By Design Commercial |
$865.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,470.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,038.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,038.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$649.27
|
| Rate for Payer: United Healthcare All Other HMO |
$631.97
|
| Rate for Payer: United Healthcare HMO Rider |
$618.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$566.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,470.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,470.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,470.50
|
|
|
HC HKAFO TORSION CBL BALL BEARING
|
Facility
|
IP
|
$1,730.00
|
|
|
Service Code
|
CPT L2060
|
| Hospital Charge Code |
905352060
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$346.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$346.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$951.50
|
| Rate for Payer: Cash Price |
$951.50
|
| Rate for Payer: Cigna of CA HMO |
$1,211.00
|
| Rate for Payer: Cigna of CA PPO |
$1,211.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$692.00
|
| Rate for Payer: EPIC Health Plan Senior |
$692.00
|
| Rate for Payer: Galaxy Health WC |
$1,470.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,038.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$659.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$415.20
|
| Rate for Payer: Multiplan Commercial |
$1,384.00
|
| Rate for Payer: Networks By Design Commercial |
$865.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,470.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$649.27
|
| Rate for Payer: United Healthcare All Other HMO |
$631.97
|
| Rate for Payer: United Healthcare HMO Rider |
$618.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$566.58
|
|
|
HC HKAFO UNILAT ROTATION STRAP
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT L2070
|
| Hospital Charge Code |
915352070
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$38.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cigna of CA HMO |
$135.80
|
| Rate for Payer: Cigna of CA PPO |
$135.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: EPIC Health Plan Senior |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$120.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.56
|
| Rate for Payer: Multiplan Commercial |
$155.20
|
| Rate for Payer: Networks By Design Commercial |
$97.00
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.81
|
| Rate for Payer: United Healthcare All Other HMO |
$70.87
|
| Rate for Payer: United Healthcare HMO Rider |
$69.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.53
|
|
|
HC HKAFO UNILAT ROTATION STRAP
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT L2070
|
| Hospital Charge Code |
915352070
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$46.56 |
| Max. Negotiated Rate |
$164.90 |
| Rate for Payer: Adventist Health Commercial |
$79.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$164.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$106.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$145.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.36
|
| Rate for Payer: Blue Shield of California Commercial |
$143.17
|
| Rate for Payer: Blue Shield of California EPN |
$94.28
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cigna of CA HMO |
$135.80
|
| Rate for Payer: Cigna of CA PPO |
$135.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$164.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$164.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$164.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: EPIC Health Plan Senior |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$102.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$120.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$135.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$135.80
|
| Rate for Payer: Multiplan Commercial |
$155.20
|
| Rate for Payer: Networks By Design Commercial |
$97.00
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$116.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$116.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.81
|
| Rate for Payer: United Healthcare All Other HMO |
$70.87
|
| Rate for Payer: United Healthcare HMO Rider |
$69.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$164.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$164.90
|
| Rate for Payer: Vantage Medical Group Senior |
$164.90
|
|
|
HC HKAFO UNILAT ROTATION STRAP
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT L2070
|
| Hospital Charge Code |
905352070
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$38.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cigna of CA HMO |
$135.80
|
| Rate for Payer: Cigna of CA PPO |
$135.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: EPIC Health Plan Senior |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$120.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.56
|
| Rate for Payer: Multiplan Commercial |
$155.20
|
| Rate for Payer: Networks By Design Commercial |
$97.00
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.81
|
| Rate for Payer: United Healthcare All Other HMO |
$70.87
|
| Rate for Payer: United Healthcare HMO Rider |
$69.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.53
|
|
|
HC HKAFO UNILAT ROTATION STRAP
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT L2070
|
| Hospital Charge Code |
905352070
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$46.56 |
| Max. Negotiated Rate |
$164.90 |
| Rate for Payer: Adventist Health Commercial |
$79.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$164.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$106.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$145.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.36
|
| Rate for Payer: Blue Shield of California Commercial |
$143.17
|
| Rate for Payer: Blue Shield of California EPN |
$94.28
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cigna of CA HMO |
$135.80
|
| Rate for Payer: Cigna of CA PPO |
$135.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$164.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$164.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$164.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: EPIC Health Plan Senior |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$102.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$120.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$135.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$135.80
|
| Rate for Payer: Multiplan Commercial |
$155.20
|
| Rate for Payer: Networks By Design Commercial |
$97.00
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$116.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$116.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.81
|
| Rate for Payer: United Healthcare All Other HMO |
$70.87
|
| Rate for Payer: United Healthcare HMO Rider |
$69.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$164.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$164.90
|
| Rate for Payer: Vantage Medical Group Senior |
$164.90
|
|
|
HC HKAFO UNILAT TORSION CABLE
|
Facility
|
OP
|
$773.00
|
|
|
Service Code
|
CPT L2080
|
| Hospital Charge Code |
915352080
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$185.52 |
| Max. Negotiated Rate |
$657.05 |
| Rate for Payer: Adventist Health Commercial |
$316.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$579.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.72
|
| Rate for Payer: Blue Shield of California Commercial |
$570.47
|
| Rate for Payer: Blue Shield of California EPN |
$375.68
|
| Rate for Payer: Cash Price |
$425.15
|
| Rate for Payer: Cash Price |
$425.15
|
| Rate for Payer: Cigna of CA HMO |
$541.10
|
| Rate for Payer: Cigna of CA PPO |
$541.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.20
|
| Rate for Payer: EPIC Health Plan Senior |
$309.20
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$292.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$478.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$541.10
|
| Rate for Payer: Multiplan Commercial |
$618.40
|
| Rate for Payer: Networks By Design Commercial |
$386.50
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$463.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$463.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.11
|
| Rate for Payer: United Healthcare All Other HMO |
$282.38
|
| Rate for Payer: United Healthcare HMO Rider |
$276.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$657.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.05
|
| Rate for Payer: Vantage Medical Group Senior |
$657.05
|
|
|
HC HKAFO UNILAT TORSION CABLE
|
Facility
|
OP
|
$773.00
|
|
|
Service Code
|
CPT L2080
|
| Hospital Charge Code |
905352080
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$185.52 |
| Max. Negotiated Rate |
$657.05 |
| Rate for Payer: Adventist Health Commercial |
$316.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$579.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.72
|
| Rate for Payer: Blue Shield of California Commercial |
$570.47
|
| Rate for Payer: Blue Shield of California EPN |
$375.68
|
| Rate for Payer: Cash Price |
$425.15
|
| Rate for Payer: Cash Price |
$425.15
|
| Rate for Payer: Cigna of CA HMO |
$541.10
|
| Rate for Payer: Cigna of CA PPO |
$541.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.20
|
| Rate for Payer: EPIC Health Plan Senior |
$309.20
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$292.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$478.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$541.10
|
| Rate for Payer: Multiplan Commercial |
$618.40
|
| Rate for Payer: Networks By Design Commercial |
$386.50
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$463.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$463.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.11
|
| Rate for Payer: United Healthcare All Other HMO |
$282.38
|
| Rate for Payer: United Healthcare HMO Rider |
$276.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$657.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.05
|
| Rate for Payer: Vantage Medical Group Senior |
$657.05
|
|
|
HC HKAFO UNILAT TORSION CABLE
|
Facility
|
IP
|
$773.00
|
|
|
Service Code
|
CPT L2080
|
| Hospital Charge Code |
905352080
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$154.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$154.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$425.15
|
| Rate for Payer: Cash Price |
$425.15
|
| Rate for Payer: Cigna of CA HMO |
$541.10
|
| Rate for Payer: Cigna of CA PPO |
$541.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.20
|
| Rate for Payer: EPIC Health Plan Senior |
$309.20
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$478.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.52
|
| Rate for Payer: Multiplan Commercial |
$618.40
|
| Rate for Payer: Networks By Design Commercial |
$386.50
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.11
|
| Rate for Payer: United Healthcare All Other HMO |
$282.38
|
| Rate for Payer: United Healthcare HMO Rider |
$276.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.16
|
|
|
HC HKAFO UNILAT TORSION CABLE
|
Facility
|
IP
|
$773.00
|
|
|
Service Code
|
CPT L2080
|
| Hospital Charge Code |
915352080
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$154.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$154.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$425.15
|
| Rate for Payer: Cash Price |
$425.15
|
| Rate for Payer: Cigna of CA HMO |
$541.10
|
| Rate for Payer: Cigna of CA PPO |
$541.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.20
|
| Rate for Payer: EPIC Health Plan Senior |
$309.20
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$515.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$478.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$185.52
|
| Rate for Payer: Multiplan Commercial |
$618.40
|
| Rate for Payer: Networks By Design Commercial |
$386.50
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.11
|
| Rate for Payer: United Healthcare All Other HMO |
$282.38
|
| Rate for Payer: United Healthcare HMO Rider |
$276.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.16
|
|
|
HC HKAFO UNILAT TRSN BALL BEARING
|
Facility
|
OP
|
$858.00
|
|
|
Service Code
|
CPT L2090
|
| Hospital Charge Code |
905352090
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$205.92 |
| Max. Negotiated Rate |
$729.30 |
| Rate for Payer: Adventist Health Commercial |
$351.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$729.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$471.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$643.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$496.95
|
| Rate for Payer: Blue Shield of California Commercial |
$633.20
|
| Rate for Payer: Blue Shield of California EPN |
$416.99
|
| Rate for Payer: Cash Price |
$471.90
|
| Rate for Payer: Cash Price |
$471.90
|
| Rate for Payer: Cigna of CA HMO |
$600.60
|
| Rate for Payer: Cigna of CA PPO |
$600.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$729.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$729.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$729.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$343.20
|
| Rate for Payer: EPIC Health Plan Senior |
$343.20
|
| Rate for Payer: Galaxy Health WC |
$729.30
|
| Rate for Payer: Global Benefits Group Commercial |
$514.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$443.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$572.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$502.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$531.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$600.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$600.60
|
| Rate for Payer: Multiplan Commercial |
$686.40
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$729.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$514.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$514.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$322.01
|
| Rate for Payer: United Healthcare All Other HMO |
$313.43
|
| Rate for Payer: United Healthcare HMO Rider |
$306.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$281.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$729.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$729.30
|
| Rate for Payer: Vantage Medical Group Senior |
$729.30
|
|
|
HC HKAFO UNILAT TRSN BALL BEARING
|
Facility
|
OP
|
$858.00
|
|
|
Service Code
|
CPT L2090
|
| Hospital Charge Code |
915352090
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$205.92 |
| Max. Negotiated Rate |
$729.30 |
| Rate for Payer: Adventist Health Commercial |
$351.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$729.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$471.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$643.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$496.95
|
| Rate for Payer: Blue Shield of California Commercial |
$633.20
|
| Rate for Payer: Blue Shield of California EPN |
$416.99
|
| Rate for Payer: Cash Price |
$471.90
|
| Rate for Payer: Cash Price |
$471.90
|
| Rate for Payer: Cigna of CA HMO |
$600.60
|
| Rate for Payer: Cigna of CA PPO |
$600.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$729.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$729.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$729.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$343.20
|
| Rate for Payer: EPIC Health Plan Senior |
$343.20
|
| Rate for Payer: Galaxy Health WC |
$729.30
|
| Rate for Payer: Global Benefits Group Commercial |
$514.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$443.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$572.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$502.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$531.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$600.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$600.60
|
| Rate for Payer: Multiplan Commercial |
$686.40
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$729.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$514.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$514.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$322.01
|
| Rate for Payer: United Healthcare All Other HMO |
$313.43
|
| Rate for Payer: United Healthcare HMO Rider |
$306.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$281.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$729.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$729.30
|
| Rate for Payer: Vantage Medical Group Senior |
$729.30
|
|
|
HC HKAFO UNILAT TRSN BALL BEARING
|
Facility
|
IP
|
$858.00
|
|
|
Service Code
|
CPT L2090
|
| Hospital Charge Code |
915352090
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$171.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$171.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$471.90
|
| Rate for Payer: Cash Price |
$471.90
|
| Rate for Payer: Cigna of CA HMO |
$600.60
|
| Rate for Payer: Cigna of CA PPO |
$600.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$343.20
|
| Rate for Payer: EPIC Health Plan Senior |
$343.20
|
| Rate for Payer: Galaxy Health WC |
$729.30
|
| Rate for Payer: Global Benefits Group Commercial |
$514.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$572.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$326.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$531.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$205.92
|
| Rate for Payer: Multiplan Commercial |
$686.40
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$729.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$322.01
|
| Rate for Payer: United Healthcare All Other HMO |
$313.43
|
| Rate for Payer: United Healthcare HMO Rider |
$306.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$281.00
|
|
