|
HC SUPPORT ELBOW MEDIUM
|
Facility
OP
|
$42.15
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
901607792
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$14.75 |
| Max. Negotiated Rate |
$1,042.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,042.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$23.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.90
|
| Rate for Payer: BCBS Transplant Transplant |
$25.29
|
| Rate for Payer: Blue Shield of California Commercial |
$31.61
|
| Rate for Payer: Blue Shield of California EPN |
$22.93
|
| Rate for Payer: Cash Price |
$18.97
|
| Rate for Payer: Cash Price |
$18.97
|
| Rate for Payer: Central Health Plan Commercial |
$33.72
|
| Rate for Payer: Cigna of CA HMO |
$29.50
|
| Rate for Payer: Cigna of CA PPO |
$29.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.86
|
| Rate for Payer: Galaxy Health WC |
$35.83
|
| Rate for Payer: Global Benefits Group Commercial |
$25.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.94
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$31.61
|
| Rate for Payer: IEHP medi-cal |
$14.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.28
|
| Rate for Payer: Multiplan Commercial |
$31.61
|
| Rate for Payer: Networks By Design Commercial |
$21.08
|
| Rate for Payer: Prime Health Services Commercial |
$35.83
|
| Rate for Payer: Riverside University Health MISP |
$16.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.08
|
| Rate for Payer: United Healthcare All Other HMO |
$21.08
|
| Rate for Payer: United Healthcare HMO Rider |
$21.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.83
|
| Rate for Payer: Vantage Medical Group Senior |
$35.83
|
|
|
HC SUPPORT ELBOW MEDIUM
|
Facility
IP
|
$42.15
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
901607792
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.43 |
| Max. Negotiated Rate |
$37.94 |
| Rate for Payer: Blue Shield of California EPN |
$22.51
|
| Rate for Payer: Cash Price |
$18.97
|
| Rate for Payer: Central Health Plan Commercial |
$33.72
|
| Rate for Payer: Cigna of CA HMO |
$29.50
|
| Rate for Payer: Cigna of CA PPO |
$29.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.86
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.86
|
| Rate for Payer: Galaxy Health WC |
$35.83
|
| Rate for Payer: Global Benefits Group Commercial |
$25.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.43
|
| Rate for Payer: Multiplan Commercial |
$31.61
|
| Rate for Payer: Networks By Design Commercial |
$21.08
|
| Rate for Payer: Prime Health Services Commercial |
$35.83
|
|
|
HC SUPPORT ELBOW XLARGE
|
Facility
OP
|
$36.90
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
901607794
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$12.92 |
| Max. Negotiated Rate |
$1,042.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,042.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.36
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.80
|
| Rate for Payer: BCBS Transplant Transplant |
$22.14
|
| Rate for Payer: Blue Shield of California Commercial |
$27.68
|
| Rate for Payer: Blue Shield of California EPN |
$20.07
|
| Rate for Payer: Cash Price |
$16.61
|
| Rate for Payer: Cash Price |
$16.61
|
| Rate for Payer: Central Health Plan Commercial |
$29.52
|
| Rate for Payer: Cigna of CA HMO |
$25.83
|
| Rate for Payer: Cigna of CA PPO |
$25.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.76
|
| Rate for Payer: Galaxy Health WC |
$31.36
|
| Rate for Payer: Global Benefits Group Commercial |
$22.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.21
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27.68
|
| Rate for Payer: IEHP medi-cal |
$12.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.13
|
| Rate for Payer: Multiplan Commercial |
$27.68
|
| Rate for Payer: Networks By Design Commercial |
$18.45
|
| Rate for Payer: Prime Health Services Commercial |
$31.36
|
| Rate for Payer: Riverside University Health MISP |
$14.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.45
|
| Rate for Payer: United Healthcare All Other HMO |
$18.45
|
| Rate for Payer: United Healthcare HMO Rider |
$18.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.36
|
| Rate for Payer: Vantage Medical Group Senior |
$31.36
|
|
|
HC SUPPORT ELBOW XLARGE
|
Facility
IP
|
$36.90
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
901607794
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$33.21 |
| Rate for Payer: Blue Shield of California EPN |
$19.70
|
| Rate for Payer: Cash Price |
$16.61
|
| Rate for Payer: Central Health Plan Commercial |
$29.52
|
| Rate for Payer: Cigna of CA HMO |
$25.83
|
| Rate for Payer: Cigna of CA PPO |
$25.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.76
|
| Rate for Payer: Galaxy Health WC |
$31.36
|
| Rate for Payer: Global Benefits Group Commercial |
$22.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.38
|
| Rate for Payer: Multiplan Commercial |
$27.68
|
| Rate for Payer: Networks By Design Commercial |
$18.45
|
| Rate for Payer: Prime Health Services Commercial |
$31.36
|
|
|
HC SUPPORTER ATHLETIC LRG 38-44"
|
Facility
IP
|
$40.92
|
|
| Hospital Charge Code |
901698455
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$36.83 |
| Rate for Payer: Cash Price |
$18.41
|
| Rate for Payer: Central Health Plan Commercial |
$32.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.37
|
| Rate for Payer: Galaxy Health WC |
$34.78
|
| Rate for Payer: Global Benefits Group Commercial |
$24.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.18
|
| Rate for Payer: Multiplan Commercial |
$30.69
|
| Rate for Payer: Networks By Design Commercial |
$26.60
|
| Rate for Payer: Prime Health Services Commercial |
$34.78
|
|
|
HC SUPPORTER ATHLETIC LRG 38-44"
|
Facility
OP
|
$40.92
|
|
| Hospital Charge Code |
901698455
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$36.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.18
|
| Rate for Payer: BCBS Transplant Transplant |
$24.55
|
| Rate for Payer: Blue Shield of California Commercial |
$25.74
|
| Rate for Payer: Blue Shield of California EPN |
$20.01
|
| Rate for Payer: Cash Price |
$18.41
|
| Rate for Payer: Central Health Plan Commercial |
$32.74
|
| Rate for Payer: Cigna of CA HMO |
$26.19
|
| Rate for Payer: Cigna of CA PPO |
$30.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.37
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.37
|
| Rate for Payer: Galaxy Health WC |
$34.78
|
| Rate for Payer: Global Benefits Group Commercial |
$24.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.69
|
| Rate for Payer: IEHP medi-cal |
$14.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.18
|
| Rate for Payer: Multiplan Commercial |
$30.69
|
| Rate for Payer: Networks By Design Commercial |
$26.60
|
| Rate for Payer: Prime Health Services Commercial |
$34.78
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.55
|
| Rate for Payer: Riverside University Health MISP |
$16.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.78
|
| Rate for Payer: Vantage Medical Group Senior |
$34.78
|
|
|
HC SUPPORTER ATHLETIC MED 32-38"
|
Facility
OP
|
$40.92
|
|
| Hospital Charge Code |
901698454
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$36.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.18
|
| Rate for Payer: BCBS Transplant Transplant |
$24.55
|
| Rate for Payer: Blue Shield of California Commercial |
$25.74
|
| Rate for Payer: Blue Shield of California EPN |
$20.01
|
| Rate for Payer: Cash Price |
$18.41
|
| Rate for Payer: Central Health Plan Commercial |
$32.74
|
| Rate for Payer: Cigna of CA HMO |
$26.19
|
| Rate for Payer: Cigna of CA PPO |
$30.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.37
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.37
|
| Rate for Payer: Galaxy Health WC |
$34.78
|
| Rate for Payer: Global Benefits Group Commercial |
$24.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.69
|
| Rate for Payer: IEHP medi-cal |
$14.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.18
|
| Rate for Payer: Multiplan Commercial |
$30.69
|
| Rate for Payer: Networks By Design Commercial |
$26.60
|
| Rate for Payer: Prime Health Services Commercial |
$34.78
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.55
|
| Rate for Payer: Riverside University Health MISP |
$16.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.78
|
| Rate for Payer: Vantage Medical Group Senior |
$34.78
|
|
|
HC SUPPORTER ATHLETIC MED 32-38"
|
Facility
IP
|
$40.92
|
|
| Hospital Charge Code |
901698454
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$36.83 |
| Rate for Payer: Cash Price |
$18.41
|
| Rate for Payer: Central Health Plan Commercial |
$32.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.37
|
| Rate for Payer: Galaxy Health WC |
$34.78
|
| Rate for Payer: Global Benefits Group Commercial |
$24.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.18
|
| Rate for Payer: Multiplan Commercial |
$30.69
|
| Rate for Payer: Networks By Design Commercial |
$26.60
|
| Rate for Payer: Prime Health Services Commercial |
$34.78
|
|
|
HC SUPPORT KNEE HINGED LARGE
|
Facility
OP
|
$185.29
|
|
|
Service Code
|
CPT L1832
|
| Hospital Charge Code |
901606731
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$2,524.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,524.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$101.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$101.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$89.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.47
|
| Rate for Payer: BCBS Transplant Transplant |
$111.17
|
| Rate for Payer: Blue Shield of California Commercial |
$138.97
|
| Rate for Payer: Blue Shield of California EPN |
$100.80
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: Cigna of CA HMO |
$129.70
|
| Rate for Payer: Cigna of CA PPO |
$129.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$157.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$138.97
|
| Rate for Payer: IEHP medi-cal |
$64.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.97
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$92.64
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
| Rate for Payer: Riverside University Health MISP |
$74.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$92.64
|
| Rate for Payer: United Healthcare All Other HMO |
$92.64
|
| Rate for Payer: United Healthcare HMO Rider |
$92.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$92.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$157.50
|
| Rate for Payer: Vantage Medical Group Senior |
$157.50
|
|
|
HC SUPPORT KNEE HINGED LARGE
|
Facility
IP
|
$185.29
|
|
|
Service Code
|
CPT L1832
|
| Hospital Charge Code |
901606731
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$166.76 |
| Rate for Payer: Blue Shield of California EPN |
$98.94
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: Cigna of CA HMO |
$129.70
|
| Rate for Payer: Cigna of CA PPO |
$129.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.06
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$92.64
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
|
|
HC SUPPORT KNEE HINGED MED.
|
Facility
OP
|
$217.28
|
|
|
Service Code
|
CPT L1832
|
| Hospital Charge Code |
901606730
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$76.05 |
| Max. Negotiated Rate |
$2,524.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,524.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$184.69
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$119.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$119.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.37
|
| Rate for Payer: BCBS Transplant Transplant |
$130.37
|
| Rate for Payer: Blue Shield of California Commercial |
$162.96
|
| Rate for Payer: Blue Shield of California EPN |
$118.20
|
| Rate for Payer: Cash Price |
$97.78
|
| Rate for Payer: Cash Price |
$97.78
|
| Rate for Payer: Central Health Plan Commercial |
$173.82
|
| Rate for Payer: Cigna of CA HMO |
$152.10
|
| Rate for Payer: Cigna of CA PPO |
$152.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$86.91
|
| Rate for Payer: Galaxy Health WC |
$184.69
|
| Rate for Payer: Global Benefits Group Commercial |
$130.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.55
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$162.96
|
| Rate for Payer: IEHP medi-cal |
$76.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.08
|
| Rate for Payer: Multiplan Commercial |
$162.96
|
| Rate for Payer: Networks By Design Commercial |
$108.64
|
| Rate for Payer: Prime Health Services Commercial |
$184.69
|
| Rate for Payer: Riverside University Health MISP |
$86.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.64
|
| Rate for Payer: United Healthcare All Other HMO |
$108.64
|
| Rate for Payer: United Healthcare HMO Rider |
$108.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.69
|
| Rate for Payer: Vantage Medical Group Senior |
$184.69
|
|
|
HC SUPPORT KNEE HINGED MED.
|
Facility
IP
|
$217.28
|
|
|
Service Code
|
CPT L1832
|
| Hospital Charge Code |
901606730
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$43.46 |
| Max. Negotiated Rate |
$195.55 |
| Rate for Payer: Blue Shield of California EPN |
$116.03
|
| Rate for Payer: Cash Price |
$97.78
|
| Rate for Payer: Central Health Plan Commercial |
$173.82
|
| Rate for Payer: Cigna of CA HMO |
$152.10
|
| Rate for Payer: Cigna of CA PPO |
$152.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$86.91
|
| Rate for Payer: Galaxy Health WC |
$184.69
|
| Rate for Payer: Global Benefits Group Commercial |
$130.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.46
|
| Rate for Payer: Multiplan Commercial |
$162.96
|
| Rate for Payer: Networks By Design Commercial |
$108.64
|
| Rate for Payer: Prime Health Services Commercial |
$184.69
|
|
|
HC SUPPORT KNEE HINGED X-LARGE
|
Facility
IP
|
$185.29
|
|
|
Service Code
|
CPT L1832
|
| Hospital Charge Code |
901606732
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$166.76 |
| Rate for Payer: Blue Shield of California EPN |
$98.94
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: Cigna of CA HMO |
$129.70
|
| Rate for Payer: Cigna of CA PPO |
$129.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.06
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$92.64
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
|
|
HC SUPPORT KNEE HINGED X-LARGE
|
Facility
OP
|
$185.29
|
|
|
Service Code
|
CPT L1832
|
| Hospital Charge Code |
901606732
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$64.85 |
| Max. Negotiated Rate |
$2,524.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,524.10
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$101.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$101.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$89.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.47
|
| Rate for Payer: BCBS Transplant Transplant |
$111.17
|
| Rate for Payer: Blue Shield of California Commercial |
$138.97
|
| Rate for Payer: Blue Shield of California EPN |
$100.80
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Central Health Plan Commercial |
$148.23
|
| Rate for Payer: Cigna of CA HMO |
$129.70
|
| Rate for Payer: Cigna of CA PPO |
$129.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$157.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$166.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$138.97
|
| Rate for Payer: IEHP medi-cal |
$64.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.97
|
| Rate for Payer: Multiplan Commercial |
$138.97
|
| Rate for Payer: Networks By Design Commercial |
$92.64
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
| Rate for Payer: Riverside University Health MISP |
$74.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$92.64
|
| Rate for Payer: United Healthcare All Other HMO |
$92.64
|
| Rate for Payer: United Healthcare HMO Rider |
$92.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$92.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$157.50
|
| Rate for Payer: Vantage Medical Group Senior |
$157.50
|
|
|
HC SUPPORT KNEE HINGE MD 18-20.5"
|
Facility
OP
|
$172.62
|
|
|
Service Code
|
CPT L1833
|
| Hospital Charge Code |
901698810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.42 |
| Max. Negotiated Rate |
$2,631.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,631.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$146.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$94.94
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$94.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$83.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.98
|
| Rate for Payer: BCBS Transplant Transplant |
$103.57
|
| Rate for Payer: Blue Shield of California Commercial |
$129.46
|
| Rate for Payer: Blue Shield of California EPN |
$93.91
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Central Health Plan Commercial |
$138.10
|
| Rate for Payer: Cigna of CA HMO |
$120.83
|
| Rate for Payer: Cigna of CA PPO |
$120.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$146.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$69.05
|
| Rate for Payer: Galaxy Health WC |
$146.73
|
| Rate for Payer: Global Benefits Group Commercial |
$103.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.36
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$129.46
|
| Rate for Payer: IEHP medi-cal |
$60.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$115.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.77
|
| Rate for Payer: Multiplan Commercial |
$129.46
|
| Rate for Payer: Networks By Design Commercial |
$86.31
|
| Rate for Payer: Prime Health Services Commercial |
$146.73
|
| Rate for Payer: Riverside University Health MISP |
$69.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$86.31
|
| Rate for Payer: United Healthcare All Other HMO |
$86.31
|
| Rate for Payer: United Healthcare HMO Rider |
$86.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$146.73
|
| Rate for Payer: Vantage Medical Group Senior |
$146.73
|
|
|
HC SUPPORT KNEE HINGE MD 18-20.5"
|
Facility
IP
|
$172.62
|
|
|
Service Code
|
CPT L1833
|
| Hospital Charge Code |
901698810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$34.52 |
| Max. Negotiated Rate |
$155.36 |
| Rate for Payer: Blue Shield of California EPN |
$92.18
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Central Health Plan Commercial |
$138.10
|
| Rate for Payer: Cigna of CA HMO |
$120.83
|
| Rate for Payer: Cigna of CA PPO |
$120.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$69.05
|
| Rate for Payer: Galaxy Health WC |
$146.73
|
| Rate for Payer: Global Benefits Group Commercial |
$103.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$115.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.52
|
| Rate for Payer: Multiplan Commercial |
$129.46
|
| Rate for Payer: Networks By Design Commercial |
$86.31
|
| Rate for Payer: Prime Health Services Commercial |
$146.73
|
|
|
HC SUPPORT KNEE MED OPEN PATELLA
|
Facility
IP
|
$29.93
|
|
|
Service Code
|
CPT A4466
|
| Hospital Charge Code |
901607798
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
|
|
HC SUPPORT KNEE MED OPEN PATELLA
|
Facility
OP
|
$29.93
|
|
|
Service Code
|
CPT A4466
|
| Hospital Charge Code |
901607798
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
| Rate for Payer: BCBS Transplant Transplant |
$17.96
|
| Rate for Payer: Blue Shield of California Commercial |
$18.83
|
| Rate for Payer: Blue Shield of California EPN |
$14.64
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: Cigna of CA HMO |
$19.16
|
| Rate for Payer: Cigna of CA PPO |
$22.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.45
|
| Rate for Payer: IEHP medi-cal |
$10.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: Riverside University Health MISP |
$11.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.96
|
| Rate for Payer: United Healthcare All Other HMO |
$14.96
|
| Rate for Payer: United Healthcare HMO Rider |
$14.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.44
|
| Rate for Payer: Vantage Medical Group Senior |
$25.44
|
|
|
HC SUPPORT SACRO LUMBAR XLG
|
Facility
IP
|
$143.41
|
|
|
Service Code
|
CPT L0456
|
| Hospital Charge Code |
901603184
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$28.68 |
| Max. Negotiated Rate |
$129.07 |
| Rate for Payer: Blue Shield of California EPN |
$76.58
|
| Rate for Payer: Cash Price |
$64.53
|
| Rate for Payer: Central Health Plan Commercial |
$114.73
|
| Rate for Payer: Cigna of CA HMO |
$100.39
|
| Rate for Payer: Cigna of CA PPO |
$100.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$57.36
|
| Rate for Payer: Galaxy Health WC |
$121.90
|
| Rate for Payer: Global Benefits Group Commercial |
$86.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$129.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$95.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.68
|
| Rate for Payer: Multiplan Commercial |
$107.56
|
| Rate for Payer: Networks By Design Commercial |
$71.70
|
| Rate for Payer: Prime Health Services Commercial |
$121.90
|
|
|
HC SUPPORT SACRO LUMBAR XLG
|
Facility
OP
|
$143.41
|
|
|
Service Code
|
CPT L0456
|
| Hospital Charge Code |
901603184
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.19 |
| Max. Negotiated Rate |
$3,944.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,944.95
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$121.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$78.88
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$78.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.73
|
| Rate for Payer: BCBS Transplant Transplant |
$86.05
|
| Rate for Payer: Blue Shield of California Commercial |
$107.56
|
| Rate for Payer: Blue Shield of California EPN |
$78.02
|
| Rate for Payer: Cash Price |
$64.53
|
| Rate for Payer: Cash Price |
$64.53
|
| Rate for Payer: Central Health Plan Commercial |
$114.73
|
| Rate for Payer: Cigna of CA HMO |
$100.39
|
| Rate for Payer: Cigna of CA PPO |
$100.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$121.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$57.36
|
| Rate for Payer: Galaxy Health WC |
$121.90
|
| Rate for Payer: Global Benefits Group Commercial |
$86.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$129.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$107.56
|
| Rate for Payer: IEHP medi-cal |
$50.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$95.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.80
|
| Rate for Payer: Multiplan Commercial |
$107.56
|
| Rate for Payer: Networks By Design Commercial |
$71.70
|
| Rate for Payer: Prime Health Services Commercial |
$121.90
|
| Rate for Payer: Riverside University Health MISP |
$57.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$86.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$86.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$71.70
|
| Rate for Payer: United Healthcare All Other HMO |
$71.70
|
| Rate for Payer: United Healthcare HMO Rider |
$71.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$71.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$121.90
|
| Rate for Payer: Vantage Medical Group Senior |
$121.90
|
|
|
HC SUPPORT SWIMMER ADULT LG
|
Facility
IP
|
$38.21
|
|
| Hospital Charge Code |
901601319
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$34.39 |
| Rate for Payer: Cash Price |
$17.19
|
| Rate for Payer: Central Health Plan Commercial |
$30.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.28
|
| Rate for Payer: Galaxy Health WC |
$32.48
|
| Rate for Payer: Global Benefits Group Commercial |
$22.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$28.66
|
| Rate for Payer: Networks By Design Commercial |
$24.84
|
| Rate for Payer: Prime Health Services Commercial |
$32.48
|
|
|
HC SUPPORT SWIMMER ADULT LG
|
Facility
OP
|
$38.21
|
|
| Hospital Charge Code |
901601319
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$34.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.57
|
| Rate for Payer: BCBS Transplant Transplant |
$22.93
|
| Rate for Payer: Blue Shield of California Commercial |
$24.03
|
| Rate for Payer: Blue Shield of California EPN |
$18.68
|
| Rate for Payer: Cash Price |
$17.19
|
| Rate for Payer: Central Health Plan Commercial |
$30.57
|
| Rate for Payer: Cigna of CA HMO |
$24.45
|
| Rate for Payer: Cigna of CA PPO |
$28.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.28
|
| Rate for Payer: Galaxy Health WC |
$32.48
|
| Rate for Payer: Global Benefits Group Commercial |
$22.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.39
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.66
|
| Rate for Payer: IEHP medi-cal |
$13.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$28.66
|
| Rate for Payer: Networks By Design Commercial |
$24.84
|
| Rate for Payer: Prime Health Services Commercial |
$32.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22.93
|
| Rate for Payer: Riverside University Health MISP |
$15.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.10
|
| Rate for Payer: United Healthcare All Other HMO |
$19.10
|
| Rate for Payer: United Healthcare HMO Rider |
$19.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.48
|
| Rate for Payer: Vantage Medical Group Senior |
$32.48
|
|
|
HC SUPPORT SWIMMER ADULT MED
|
Facility
IP
|
$38.21
|
|
| Hospital Charge Code |
901601318
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$34.39 |
| Rate for Payer: Cash Price |
$17.19
|
| Rate for Payer: Central Health Plan Commercial |
$30.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.28
|
| Rate for Payer: Galaxy Health WC |
$32.48
|
| Rate for Payer: Global Benefits Group Commercial |
$22.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$28.66
|
| Rate for Payer: Networks By Design Commercial |
$24.84
|
| Rate for Payer: Prime Health Services Commercial |
$32.48
|
|
|
HC SUPPORT SWIMMER ADULT MED
|
Facility
OP
|
$38.21
|
|
| Hospital Charge Code |
901601318
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.64 |
| Max. Negotiated Rate |
$34.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.57
|
| Rate for Payer: BCBS Transplant Transplant |
$22.93
|
| Rate for Payer: Blue Shield of California Commercial |
$24.03
|
| Rate for Payer: Blue Shield of California EPN |
$18.68
|
| Rate for Payer: Cash Price |
$17.19
|
| Rate for Payer: Central Health Plan Commercial |
$30.57
|
| Rate for Payer: Cigna of CA HMO |
$24.45
|
| Rate for Payer: Cigna of CA PPO |
$28.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.28
|
| Rate for Payer: Galaxy Health WC |
$32.48
|
| Rate for Payer: Global Benefits Group Commercial |
$22.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.39
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.66
|
| Rate for Payer: IEHP medi-cal |
$13.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$28.66
|
| Rate for Payer: Networks By Design Commercial |
$24.84
|
| Rate for Payer: Prime Health Services Commercial |
$32.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22.93
|
| Rate for Payer: Riverside University Health MISP |
$15.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.10
|
| Rate for Payer: United Healthcare All Other HMO |
$19.10
|
| Rate for Payer: United Healthcare HMO Rider |
$19.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.48
|
| Rate for Payer: Vantage Medical Group Senior |
$32.48
|
|
|
HC SUPPORT WRIST 8IN UNIV LFT
|
Facility
IP
|
$96.75
|
|
|
Service Code
|
CPT L3908
|
| Hospital Charge Code |
901698314
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$19.35 |
| Max. Negotiated Rate |
$87.08 |
| Rate for Payer: Blue Shield of California EPN |
$51.66
|
| Rate for Payer: Cash Price |
$43.54
|
| Rate for Payer: Central Health Plan Commercial |
$77.40
|
| Rate for Payer: Cigna of CA HMO |
$67.72
|
| Rate for Payer: Cigna of CA PPO |
$67.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.70
|
| Rate for Payer: Galaxy Health WC |
$82.24
|
| Rate for Payer: Global Benefits Group Commercial |
$58.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.35
|
| Rate for Payer: Multiplan Commercial |
$72.56
|
| Rate for Payer: Networks By Design Commercial |
$48.38
|
| Rate for Payer: Prime Health Services Commercial |
$82.24
|
|
