|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
IP
|
$4,063.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$812.60 |
| Max. Negotiated Rate |
$3,656.70 |
| Rate for Payer: Adventist Health Commercial |
$812.60
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,250.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,625.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,625.20
|
| Rate for Payer: Galaxy Health WC |
$3,453.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,437.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,656.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,710.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,548.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,515.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$812.60
|
| Rate for Payer: Multiplan Commercial |
$3,047.25
|
| Rate for Payer: Networks By Design Commercial |
$2,640.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,453.55
|
|
|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
OP
|
$4,063.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$3,656.70 |
| Rate for Payer: Adventist Health Commercial |
$1,665.83
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,467.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,386.20
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,324.78
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,250.40
|
| Rate for Payer: Cigna of CA HMO |
$2,600.32
|
| Rate for Payer: Cigna of CA PPO |
$3,006.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| Rate for Payer: Galaxy Health WC |
$3,453.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,437.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,656.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: InnovAge PACE Commercial |
$1,247.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,710.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$812.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,114.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| Rate for Payer: Multiplan Commercial |
$3,047.25
|
| Rate for Payer: Multiplan WC |
$1,324.78
|
| Rate for Payer: Networks By Design Commercial |
$2,640.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$831.46
|
| Rate for Payer: Preferred Health Network WC |
$1,351.82
|
| Rate for Payer: Prime Health Services Commercial |
$3,453.55
|
| Rate for Payer: Prime Health Services Medicare |
$881.35
|
| Rate for Payer: Prime Health Services WC |
$1,311.27
|
| Rate for Payer: Riverside University Health System MISP |
$914.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,437.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,437.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
IP
|
$4,063.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$812.60 |
| Max. Negotiated Rate |
$3,656.70 |
| Rate for Payer: Adventist Health Commercial |
$812.60
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,250.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,625.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,625.20
|
| Rate for Payer: Galaxy Health WC |
$3,453.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,437.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,656.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,710.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,548.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,515.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$812.60
|
| Rate for Payer: Multiplan Commercial |
$3,047.25
|
| Rate for Payer: Networks By Design Commercial |
$2,640.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,453.55
|
|
|
HC TEMP TRANSCUTANEOUS PACING
|
Facility
|
OP
|
$4,063.00
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
906811141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$3,656.70 |
| Rate for Payer: Adventist Health Commercial |
$812.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$831.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,324.78
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Cash Price |
$2,234.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,250.40
|
| Rate for Payer: Cigna of CA HMO |
$2,600.32
|
| Rate for Payer: Cigna of CA PPO |
$3,006.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$914.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$831.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,122.47
|
| Rate for Payer: EPIC Health Plan Senior |
$831.46
|
| Rate for Payer: Galaxy Health WC |
$3,453.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,437.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,656.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,363.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$831.46
|
| Rate for Payer: InnovAge PACE Commercial |
$1,247.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,710.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$831.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$812.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,114.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,114.16
|
| Rate for Payer: Multiplan Commercial |
$3,047.25
|
| Rate for Payer: Multiplan WC |
$1,324.78
|
| Rate for Payer: Networks By Design Commercial |
$2,640.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$831.46
|
| Rate for Payer: Preferred Health Network WC |
$1,351.82
|
| Rate for Payer: Prime Health Services Commercial |
$3,453.55
|
| Rate for Payer: Prime Health Services Medicare |
$881.35
|
| Rate for Payer: Prime Health Services WC |
$1,311.27
|
| Rate for Payer: Riverside University Health System MISP |
$914.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,437.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,031.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,031.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,031.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,031.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$831.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,247.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$914.61
|
| Rate for Payer: Vantage Medical Group Senior |
$831.46
|
|
|
HC TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
IP
|
$8,714.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,742.80 |
| Max. Negotiated Rate |
$7,842.60 |
| Rate for Payer: Adventist Health Commercial |
$1,742.80
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,971.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,485.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,485.60
|
| Rate for Payer: Galaxy Health WC |
$7,406.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,228.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,842.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,812.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,320.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,393.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,742.80
|
| Rate for Payer: Multiplan Commercial |
$6,535.50
|
| Rate for Payer: Networks By Design Commercial |
$5,664.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,406.90
|
|
|
HC TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
OP
|
$8,714.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$281.54 |
| Max. Negotiated Rate |
$7,842.60 |
| Rate for Payer: Adventist Health Commercial |
$3,572.74
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,971.20
|
| Rate for Payer: Cigna of CA HMO |
$5,576.96
|
| Rate for Payer: Cigna of CA PPO |
$6,448.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$7,406.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,228.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,842.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: InnovAge PACE Commercial |
$3,050.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,812.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$281.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,742.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,724.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$6,535.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,664.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$7,406.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,236.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,228.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,228.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
OP
|
$8,714.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.54 |
| Max. Negotiated Rate |
$7,842.60 |
| Rate for Payer: Adventist Health Commercial |
$1,742.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,971.20
|
| Rate for Payer: Cigna of CA HMO |
$5,576.96
|
| Rate for Payer: Cigna of CA PPO |
$6,448.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$7,406.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,228.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,842.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: InnovAge PACE Commercial |
$3,050.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,812.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$281.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,742.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,724.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$6,535.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,664.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$7,406.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,236.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,228.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,357.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,357.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,357.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,357.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC TENOTOMY PERCUT TOE SNGL TENDN
|
Facility
|
IP
|
$8,714.00
|
|
|
Service Code
|
CPT 28010
|
| Hospital Charge Code |
900501072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,742.80 |
| Max. Negotiated Rate |
$7,842.60 |
| Rate for Payer: Adventist Health Commercial |
$1,742.80
|
| Rate for Payer: Cash Price |
$4,792.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,971.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,485.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,485.60
|
| Rate for Payer: Galaxy Health WC |
$7,406.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,228.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,842.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,812.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,320.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,393.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,742.80
|
| Rate for Payer: Multiplan Commercial |
$6,535.50
|
| Rate for Payer: Networks By Design Commercial |
$5,664.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,406.90
|
|
|
HC TENSION BASED SCOLIOSIS & PADS
|
Facility
|
IP
|
$3,513.00
|
|
|
Service Code
|
CPT L1005
|
| Hospital Charge Code |
905351005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$702.60 |
| Max. Negotiated Rate |
$3,161.70 |
| Rate for Payer: Adventist Health Commercial |
$702.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,715.55
|
| Rate for Payer: Blue Shield of California EPN |
$1,770.55
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,810.40
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.20
|
| Rate for Payer: Galaxy Health WC |
$2,986.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,107.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,161.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,338.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,174.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$702.60
|
| Rate for Payer: Multiplan Commercial |
$2,634.75
|
| Rate for Payer: Networks By Design Commercial |
$2,283.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,318.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,283.30
|
| Rate for Payer: United Healthcare HMO Rider |
$1,255.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.51
|
|
|
HC TENSION BASED SCOLIOSIS & PADS
|
Facility
|
IP
|
$3,513.00
|
|
|
Service Code
|
CPT L1005
|
| Hospital Charge Code |
915351005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$702.60 |
| Max. Negotiated Rate |
$3,161.70 |
| Rate for Payer: Adventist Health Commercial |
$702.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,715.55
|
| Rate for Payer: Blue Shield of California EPN |
$1,770.55
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,810.40
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.20
|
| Rate for Payer: Galaxy Health WC |
$2,986.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,107.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,161.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,338.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,174.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$702.60
|
| Rate for Payer: Multiplan Commercial |
$2,634.75
|
| Rate for Payer: Networks By Design Commercial |
$2,283.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,318.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,283.30
|
| Rate for Payer: United Healthcare HMO Rider |
$1,255.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.51
|
|
|
HC TENSION BASED SCOLIOSIS & PADS
|
Facility
|
OP
|
$3,513.00
|
|
|
Service Code
|
CPT L1005
|
| Hospital Charge Code |
915351005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,150.51 |
| Max. Negotiated Rate |
$3,822.69 |
| Rate for Payer: Adventist Health Commercial |
$1,440.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,932.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,634.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,063.18
|
| Rate for Payer: Blue Shield of California Commercial |
$2,715.55
|
| Rate for Payer: Blue Shield of California EPN |
$1,770.55
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,810.40
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,986.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,986.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.20
|
| Rate for Payer: Galaxy Health WC |
$2,986.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,107.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,161.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,460.54
|
| Rate for Payer: InnovAge PACE Commercial |
$1,756.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,822.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,174.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,440.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,459.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,459.10
|
| Rate for Payer: Multiplan Commercial |
$2,634.75
|
| Rate for Payer: Networks By Design Commercial |
$1,756.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.05
|
| Rate for Payer: Riverside University Health System MISP |
$1,405.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,107.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,107.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,318.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,283.30
|
| Rate for Payer: United Healthcare HMO Rider |
$1,255.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,986.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,986.05
|
|
|
HC TENSION BASED SCOLIOSIS & PADS
|
Facility
|
OP
|
$3,513.00
|
|
|
Service Code
|
CPT L1005
|
| Hospital Charge Code |
905351005
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,150.51 |
| Max. Negotiated Rate |
$3,822.69 |
| Rate for Payer: Adventist Health Commercial |
$1,440.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,932.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,634.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,063.18
|
| Rate for Payer: Blue Shield of California Commercial |
$2,715.55
|
| Rate for Payer: Blue Shield of California EPN |
$1,770.55
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Cash Price |
$1,932.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,810.40
|
| Rate for Payer: Cigna of CA HMO |
$2,459.10
|
| Rate for Payer: Cigna of CA PPO |
$2,459.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,986.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,986.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,405.20
|
| Rate for Payer: Galaxy Health WC |
$2,986.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,107.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,161.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,460.54
|
| Rate for Payer: InnovAge PACE Commercial |
$1,756.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,343.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,822.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,174.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,440.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,459.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,459.10
|
| Rate for Payer: Multiplan Commercial |
$2,634.75
|
| Rate for Payer: Networks By Design Commercial |
$1,756.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,986.05
|
| Rate for Payer: Riverside University Health System MISP |
$1,405.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,107.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,107.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,318.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1,283.30
|
| Rate for Payer: United Healthcare HMO Rider |
$1,255.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,986.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,986.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,986.05
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
OP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
915356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,881.02 |
| Max. Negotiated Rate |
$7,917.30 |
| Rate for Payer: Adventist Health Commercial |
$3,606.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,838.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,597.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,166.48
|
| Rate for Payer: Blue Shield of California Commercial |
$6,800.08
|
| Rate for Payer: Blue Shield of California EPN |
$4,433.69
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,037.60
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,477.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,477.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,518.80
|
| Rate for Payer: Galaxy Health WC |
$7,477.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,917.30
|
| Rate for Payer: InnovAge PACE Commercial |
$4,398.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,867.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,445.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,606.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,157.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,157.90
|
| Rate for Payer: Multiplan Commercial |
$6,597.75
|
| Rate for Payer: Networks By Design Commercial |
$4,398.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,477.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,518.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,278.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,278.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,301.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3,213.54
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,477.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,477.45
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
OP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
905356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,881.02 |
| Max. Negotiated Rate |
$7,917.30 |
| Rate for Payer: Adventist Health Commercial |
$3,606.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,838.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,597.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,166.48
|
| Rate for Payer: Blue Shield of California Commercial |
$6,800.08
|
| Rate for Payer: Blue Shield of California EPN |
$4,433.69
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,037.60
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,477.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,477.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,518.80
|
| Rate for Payer: Galaxy Health WC |
$7,477.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,917.30
|
| Rate for Payer: InnovAge PACE Commercial |
$4,398.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,867.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,445.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,606.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,157.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,157.90
|
| Rate for Payer: Multiplan Commercial |
$6,597.75
|
| Rate for Payer: Networks By Design Commercial |
$4,398.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,477.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,518.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,278.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,278.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,301.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3,213.54
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,477.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,477.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,477.45
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
IP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
915356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,759.40 |
| Max. Negotiated Rate |
$7,917.30 |
| Rate for Payer: Adventist Health Commercial |
$1,759.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,800.08
|
| Rate for Payer: Blue Shield of California EPN |
$4,433.69
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,037.60
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,518.80
|
| Rate for Payer: Galaxy Health WC |
$7,477.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,917.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,867.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,351.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,445.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.40
|
| Rate for Payer: Multiplan Commercial |
$6,597.75
|
| Rate for Payer: Networks By Design Commercial |
$5,718.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,477.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,301.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3,213.54
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.02
|
|
|
HC TERM DEVICE, MULTI ART DIGIT
|
Facility
|
IP
|
$8,797.00
|
|
|
Service Code
|
CPT L6715
|
| Hospital Charge Code |
905356715
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,759.40 |
| Max. Negotiated Rate |
$7,917.30 |
| Rate for Payer: Adventist Health Commercial |
$1,759.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,800.08
|
| Rate for Payer: Blue Shield of California EPN |
$4,433.69
|
| Rate for Payer: Cash Price |
$4,838.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,037.60
|
| Rate for Payer: Cigna of CA HMO |
$6,157.90
|
| Rate for Payer: Cigna of CA PPO |
$6,157.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,518.80
|
| Rate for Payer: Galaxy Health WC |
$7,477.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,278.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,917.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,867.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,351.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,445.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.40
|
| Rate for Payer: Multiplan Commercial |
$6,597.75
|
| Rate for Payer: Networks By Design Commercial |
$5,718.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,477.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,301.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3,213.54
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.02
|
|
|
HC TERM DEV MECH HAND VOL CLOSE
|
Facility
|
OP
|
$2,705.00
|
|
|
Service Code
|
CPT L6709
|
| Hospital Charge Code |
915356709
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$885.89 |
| Max. Negotiated Rate |
$2,434.50 |
| Rate for Payer: Adventist Health Commercial |
$1,109.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,487.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,028.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,588.65
|
| Rate for Payer: Blue Shield of California Commercial |
$2,090.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,363.32
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,164.00
|
| Rate for Payer: Cigna of CA HMO |
$1,893.50
|
| Rate for Payer: Cigna of CA PPO |
$1,893.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,299.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,299.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,082.00
|
| Rate for Payer: Galaxy Health WC |
$2,299.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,623.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,434.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,859.22
|
| Rate for Payer: InnovAge PACE Commercial |
$1,352.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,053.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,674.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,109.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,893.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,893.50
|
| Rate for Payer: Multiplan Commercial |
$2,028.75
|
| Rate for Payer: Networks By Design Commercial |
$1,352.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,299.25
|
| Rate for Payer: Riverside University Health System MISP |
$1,082.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,623.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,623.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.19
|
| Rate for Payer: United Healthcare All Other HMO |
$988.14
|
| Rate for Payer: United Healthcare HMO Rider |
$966.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,299.25
|
| Rate for Payer: Vantage Medical Group Senior |
$2,299.25
|
|
|
HC TERM DEV MECH HAND VOL CLOSE
|
Facility
|
IP
|
$2,705.00
|
|
|
Service Code
|
CPT L6709
|
| Hospital Charge Code |
915356709
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$541.00 |
| Max. Negotiated Rate |
$2,434.50 |
| Rate for Payer: Adventist Health Commercial |
$541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,090.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,363.32
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,164.00
|
| Rate for Payer: Cigna of CA HMO |
$1,893.50
|
| Rate for Payer: Cigna of CA PPO |
$1,893.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,082.00
|
| Rate for Payer: Galaxy Health WC |
$2,299.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,623.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,434.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,030.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,674.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$541.00
|
| Rate for Payer: Multiplan Commercial |
$2,028.75
|
| Rate for Payer: Networks By Design Commercial |
$1,758.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,299.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.19
|
| Rate for Payer: United Healthcare All Other HMO |
$988.14
|
| Rate for Payer: United Healthcare HMO Rider |
$966.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.89
|
|
|
HC TERM DEV MECH HAND VOL CLOSE
|
Facility
|
IP
|
$2,705.00
|
|
|
Service Code
|
CPT L6709
|
| Hospital Charge Code |
905356709
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$541.00 |
| Max. Negotiated Rate |
$2,434.50 |
| Rate for Payer: Adventist Health Commercial |
$541.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,090.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,363.32
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,164.00
|
| Rate for Payer: Cigna of CA HMO |
$1,893.50
|
| Rate for Payer: Cigna of CA PPO |
$1,893.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,082.00
|
| Rate for Payer: Galaxy Health WC |
$2,299.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,623.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,434.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,030.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,674.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$541.00
|
| Rate for Payer: Multiplan Commercial |
$2,028.75
|
| Rate for Payer: Networks By Design Commercial |
$1,758.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,299.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.19
|
| Rate for Payer: United Healthcare All Other HMO |
$988.14
|
| Rate for Payer: United Healthcare HMO Rider |
$966.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.89
|
|
|
HC TERM DEV MECH HAND VOL CLOSE
|
Facility
|
OP
|
$2,705.00
|
|
|
Service Code
|
CPT L6709
|
| Hospital Charge Code |
905356709
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$885.89 |
| Max. Negotiated Rate |
$2,434.50 |
| Rate for Payer: Adventist Health Commercial |
$1,109.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,487.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,028.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,588.65
|
| Rate for Payer: Blue Shield of California Commercial |
$2,090.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,363.32
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Cash Price |
$1,487.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,164.00
|
| Rate for Payer: Cigna of CA HMO |
$1,893.50
|
| Rate for Payer: Cigna of CA PPO |
$1,893.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,299.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,299.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,082.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,082.00
|
| Rate for Payer: Galaxy Health WC |
$2,299.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,623.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,434.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,859.22
|
| Rate for Payer: InnovAge PACE Commercial |
$1,352.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,804.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,053.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,674.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,109.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,893.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,893.50
|
| Rate for Payer: Multiplan Commercial |
$2,028.75
|
| Rate for Payer: Networks By Design Commercial |
$1,352.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,299.25
|
| Rate for Payer: Riverside University Health System MISP |
$1,082.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,623.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,623.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.19
|
| Rate for Payer: United Healthcare All Other HMO |
$988.14
|
| Rate for Payer: United Healthcare HMO Rider |
$966.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,299.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,299.25
|
| Rate for Payer: Vantage Medical Group Senior |
$2,299.25
|
|
|
HC TERM DEV MECH HAND VOL OPEN
|
Facility
|
OP
|
$1,865.00
|
|
|
Service Code
|
CPT L6708
|
| Hospital Charge Code |
915356708
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$610.79 |
| Max. Negotiated Rate |
$1,678.50 |
| Rate for Payer: Adventist Health Commercial |
$764.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,025.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,398.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,095.31
|
| Rate for Payer: Blue Shield of California Commercial |
$1,441.64
|
| Rate for Payer: Blue Shield of California EPN |
$939.96
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,492.00
|
| Rate for Payer: Cigna of CA HMO |
$1,305.50
|
| Rate for Payer: Cigna of CA PPO |
$1,305.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,585.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,585.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$746.00
|
| Rate for Payer: EPIC Health Plan Senior |
$746.00
|
| Rate for Payer: Galaxy Health WC |
$1,585.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,119.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,678.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,283.64
|
| Rate for Payer: InnovAge PACE Commercial |
$932.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,243.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,417.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,305.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,305.50
|
| Rate for Payer: Multiplan Commercial |
$1,398.75
|
| Rate for Payer: Networks By Design Commercial |
$932.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,585.25
|
| Rate for Payer: Riverside University Health System MISP |
$746.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,119.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,119.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.93
|
| Rate for Payer: United Healthcare All Other HMO |
$681.28
|
| Rate for Payer: United Healthcare HMO Rider |
$666.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$610.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,585.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,585.25
|
|
|
HC TERM DEV MECH HAND VOL OPEN
|
Facility
|
IP
|
$1,865.00
|
|
|
Service Code
|
CPT L6708
|
| Hospital Charge Code |
905356708
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$373.00 |
| Max. Negotiated Rate |
$1,678.50 |
| Rate for Payer: Adventist Health Commercial |
$373.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,441.64
|
| Rate for Payer: Blue Shield of California EPN |
$939.96
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,492.00
|
| Rate for Payer: Cigna of CA HMO |
$1,305.50
|
| Rate for Payer: Cigna of CA PPO |
$1,305.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$746.00
|
| Rate for Payer: EPIC Health Plan Senior |
$746.00
|
| Rate for Payer: Galaxy Health WC |
$1,585.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,119.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,678.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,243.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$710.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.00
|
| Rate for Payer: Multiplan Commercial |
$1,398.75
|
| Rate for Payer: Networks By Design Commercial |
$1,212.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,585.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.93
|
| Rate for Payer: United Healthcare All Other HMO |
$681.28
|
| Rate for Payer: United Healthcare HMO Rider |
$666.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$610.79
|
|
|
HC TERM DEV MECH HAND VOL OPEN
|
Facility
|
OP
|
$1,865.00
|
|
|
Service Code
|
CPT L6708
|
| Hospital Charge Code |
905356708
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$610.79 |
| Max. Negotiated Rate |
$1,678.50 |
| Rate for Payer: Adventist Health Commercial |
$764.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,025.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,398.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,095.31
|
| Rate for Payer: Blue Shield of California Commercial |
$1,441.64
|
| Rate for Payer: Blue Shield of California EPN |
$939.96
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,492.00
|
| Rate for Payer: Cigna of CA HMO |
$1,305.50
|
| Rate for Payer: Cigna of CA PPO |
$1,305.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,585.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,585.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$746.00
|
| Rate for Payer: EPIC Health Plan Senior |
$746.00
|
| Rate for Payer: Galaxy Health WC |
$1,585.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,119.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,678.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,283.64
|
| Rate for Payer: InnovAge PACE Commercial |
$932.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,243.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,417.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,305.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,305.50
|
| Rate for Payer: Multiplan Commercial |
$1,398.75
|
| Rate for Payer: Networks By Design Commercial |
$932.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,585.25
|
| Rate for Payer: Riverside University Health System MISP |
$746.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,119.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,119.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.93
|
| Rate for Payer: United Healthcare All Other HMO |
$681.28
|
| Rate for Payer: United Healthcare HMO Rider |
$666.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$610.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,585.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,585.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,585.25
|
|
|
HC TERM DEV MECH HAND VOL OPEN
|
Facility
|
IP
|
$1,865.00
|
|
|
Service Code
|
CPT L6708
|
| Hospital Charge Code |
915356708
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$373.00 |
| Max. Negotiated Rate |
$1,678.50 |
| Rate for Payer: Adventist Health Commercial |
$373.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,441.64
|
| Rate for Payer: Blue Shield of California EPN |
$939.96
|
| Rate for Payer: Cash Price |
$1,025.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,492.00
|
| Rate for Payer: Cigna of CA HMO |
$1,305.50
|
| Rate for Payer: Cigna of CA PPO |
$1,305.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$746.00
|
| Rate for Payer: EPIC Health Plan Senior |
$746.00
|
| Rate for Payer: Galaxy Health WC |
$1,585.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,119.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,678.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,243.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$710.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,154.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$373.00
|
| Rate for Payer: Multiplan Commercial |
$1,398.75
|
| Rate for Payer: Networks By Design Commercial |
$1,212.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,585.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$699.93
|
| Rate for Payer: United Healthcare All Other HMO |
$681.28
|
| Rate for Payer: United Healthcare HMO Rider |
$666.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$610.79
|
|
|
HC TERM DEV MECH HOOK VOL CLOSE
|
Facility
|
IP
|
$2,760.00
|
|
|
Service Code
|
CPT L6707
|
| Hospital Charge Code |
915356707
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$2,484.00 |
| Rate for Payer: Adventist Health Commercial |
$552.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,133.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,391.04
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,208.00
|
| Rate for Payer: Cigna of CA HMO |
$1,932.00
|
| Rate for Payer: Cigna of CA PPO |
$1,932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,104.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,104.00
|
| Rate for Payer: Galaxy Health WC |
$2,346.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,484.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,840.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,051.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,708.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$2,070.00
|
| Rate for Payer: Networks By Design Commercial |
$1,794.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,035.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1,008.23
|
| Rate for Payer: United Healthcare HMO Rider |
$986.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$903.90
|
|
