|
HC AK ADD PNEUMATIC SWING CONTROL
|
Facility
|
OP
|
$6,557.00
|
|
|
Service Code
|
CPT L5830
|
| Hospital Charge Code |
905355830
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,147.42 |
| Max. Negotiated Rate |
$5,901.30 |
| Rate for Payer: Adventist Health Commercial |
$2,688.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,573.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,606.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,917.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,850.93
|
| Rate for Payer: Blue Shield of California Commercial |
$5,068.56
|
| Rate for Payer: Blue Shield of California EPN |
$3,304.73
|
| Rate for Payer: Cash Price |
$3,606.35
|
| Rate for Payer: Cash Price |
$3,606.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,245.60
|
| Rate for Payer: Cigna of CA HMO |
$4,589.90
|
| Rate for Payer: Cigna of CA PPO |
$4,589.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,573.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,573.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,573.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,622.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,622.80
|
| Rate for Payer: Galaxy Health WC |
$5,573.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,934.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,901.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,791.92
|
| Rate for Payer: InnovAge PACE Commercial |
$3,278.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,373.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,084.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,058.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,688.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,589.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,589.90
|
| Rate for Payer: Multiplan Commercial |
$4,917.75
|
| Rate for Payer: Networks By Design Commercial |
$3,278.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,573.45
|
| Rate for Payer: Riverside University Health System MISP |
$2,622.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,934.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,934.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,460.84
|
| Rate for Payer: United Healthcare All Other HMO |
$2,395.27
|
| Rate for Payer: United Healthcare HMO Rider |
$2,343.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,147.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,573.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,573.45
|
| Rate for Payer: Vantage Medical Group Senior |
$5,573.45
|
|
|
HC AK ADD PNEUMATIC SWING CONTROL
|
Facility
|
OP
|
$6,557.00
|
|
|
Service Code
|
CPT L5830
|
| Hospital Charge Code |
915355830
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,147.42 |
| Max. Negotiated Rate |
$5,901.30 |
| Rate for Payer: Adventist Health Commercial |
$2,688.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,573.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,606.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,917.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,850.93
|
| Rate for Payer: Blue Shield of California Commercial |
$5,068.56
|
| Rate for Payer: Blue Shield of California EPN |
$3,304.73
|
| Rate for Payer: Cash Price |
$3,606.35
|
| Rate for Payer: Cash Price |
$3,606.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,245.60
|
| Rate for Payer: Cigna of CA HMO |
$4,589.90
|
| Rate for Payer: Cigna of CA PPO |
$4,589.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,573.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,573.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,573.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,622.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,622.80
|
| Rate for Payer: Galaxy Health WC |
$5,573.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,934.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,901.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,791.92
|
| Rate for Payer: InnovAge PACE Commercial |
$3,278.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,373.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,084.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,058.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,688.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,589.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,589.90
|
| Rate for Payer: Multiplan Commercial |
$4,917.75
|
| Rate for Payer: Networks By Design Commercial |
$3,278.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,573.45
|
| Rate for Payer: Riverside University Health System MISP |
$2,622.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,934.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,934.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,460.84
|
| Rate for Payer: United Healthcare All Other HMO |
$2,395.27
|
| Rate for Payer: United Healthcare HMO Rider |
$2,343.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,147.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,573.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,573.45
|
| Rate for Payer: Vantage Medical Group Senior |
$5,573.45
|
|
|
HC AK ADD POLYCENT FRICT SWG/STNC
|
Facility
|
OP
|
$2,671.00
|
|
|
Service Code
|
CPT L5818
|
| Hospital Charge Code |
905355818
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$874.75 |
| Max. Negotiated Rate |
$2,403.90 |
| Rate for Payer: Adventist Health Commercial |
$1,095.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,270.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,469.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,568.68
|
| Rate for Payer: Blue Shield of California Commercial |
$2,064.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,346.18
|
| Rate for Payer: Cash Price |
$1,469.05
|
| Rate for Payer: Cash Price |
$1,469.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,136.80
|
| Rate for Payer: Cigna of CA HMO |
$1,869.70
|
| Rate for Payer: Cigna of CA PPO |
$1,869.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,270.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,270.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,270.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,068.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,068.40
|
| Rate for Payer: Galaxy Health WC |
$2,270.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,602.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,403.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,253.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1,335.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,781.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,384.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,653.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,095.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,869.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,869.70
|
| Rate for Payer: Multiplan Commercial |
$2,003.25
|
| Rate for Payer: Networks By Design Commercial |
$1,335.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,270.35
|
| Rate for Payer: Riverside University Health System MISP |
$1,068.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,602.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,602.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,002.43
|
| Rate for Payer: United Healthcare All Other HMO |
$975.72
|
| Rate for Payer: United Healthcare HMO Rider |
$954.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$874.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,270.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,270.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,270.35
|
|
|
HC AK ADD POLYCENT FRICT SWG/STNC
|
Facility
|
IP
|
$2,671.00
|
|
|
Service Code
|
CPT L5818
|
| Hospital Charge Code |
905355818
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$534.20 |
| Max. Negotiated Rate |
$2,403.90 |
| Rate for Payer: Adventist Health Commercial |
$534.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,064.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,346.18
|
| Rate for Payer: Cash Price |
$1,469.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,136.80
|
| Rate for Payer: Cigna of CA HMO |
$1,869.70
|
| Rate for Payer: Cigna of CA PPO |
$1,869.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,068.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,068.40
|
| Rate for Payer: Galaxy Health WC |
$2,270.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,602.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,403.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,781.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,017.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,653.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$534.20
|
| Rate for Payer: Multiplan Commercial |
$2,003.25
|
| Rate for Payer: Networks By Design Commercial |
$1,736.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,270.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,002.43
|
| Rate for Payer: United Healthcare All Other HMO |
$975.72
|
| Rate for Payer: United Healthcare HMO Rider |
$954.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$874.75
|
|
|
HC AK ADD POLYCENT FRICT SWG/STNC
|
Facility
|
IP
|
$2,671.00
|
|
|
Service Code
|
CPT L5818
|
| Hospital Charge Code |
915355818
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$534.20 |
| Max. Negotiated Rate |
$2,403.90 |
| Rate for Payer: Adventist Health Commercial |
$534.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,064.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,346.18
|
| Rate for Payer: Cash Price |
$1,469.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,136.80
|
| Rate for Payer: Cigna of CA HMO |
$1,869.70
|
| Rate for Payer: Cigna of CA PPO |
$1,869.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,068.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,068.40
|
| Rate for Payer: Galaxy Health WC |
$2,270.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,602.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,403.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,781.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,017.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,653.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$534.20
|
| Rate for Payer: Multiplan Commercial |
$2,003.25
|
| Rate for Payer: Networks By Design Commercial |
$1,736.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,270.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,002.43
|
| Rate for Payer: United Healthcare All Other HMO |
$975.72
|
| Rate for Payer: United Healthcare HMO Rider |
$954.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$874.75
|
|
|
HC AK ADD POLYCENT FRICT SWG/STNC
|
Facility
|
OP
|
$2,671.00
|
|
|
Service Code
|
CPT L5818
|
| Hospital Charge Code |
915355818
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$874.75 |
| Max. Negotiated Rate |
$2,403.90 |
| Rate for Payer: Adventist Health Commercial |
$1,095.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,270.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,469.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,568.68
|
| Rate for Payer: Blue Shield of California Commercial |
$2,064.68
|
| Rate for Payer: Blue Shield of California EPN |
$1,346.18
|
| Rate for Payer: Cash Price |
$1,469.05
|
| Rate for Payer: Cash Price |
$1,469.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,136.80
|
| Rate for Payer: Cigna of CA HMO |
$1,869.70
|
| Rate for Payer: Cigna of CA PPO |
$1,869.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,270.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,270.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,270.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,068.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,068.40
|
| Rate for Payer: Galaxy Health WC |
$2,270.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,602.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,403.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,253.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1,335.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,781.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,384.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,653.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,095.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,869.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,869.70
|
| Rate for Payer: Multiplan Commercial |
$2,003.25
|
| Rate for Payer: Networks By Design Commercial |
$1,335.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,270.35
|
| Rate for Payer: Riverside University Health System MISP |
$1,068.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,602.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,602.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,002.43
|
| Rate for Payer: United Healthcare All Other HMO |
$975.72
|
| Rate for Payer: United Healthcare HMO Rider |
$954.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$874.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,270.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,270.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,270.35
|
|
|
HC AK ADD POLYCENT MECH STANCE
|
Facility
|
OP
|
$2,469.00
|
|
|
Service Code
|
CPT L5816
|
| Hospital Charge Code |
905355816
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$808.60 |
| Max. Negotiated Rate |
$2,222.10 |
| Rate for Payer: Adventist Health Commercial |
$1,012.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,098.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,357.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,851.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,450.04
|
| Rate for Payer: Blue Shield of California Commercial |
$1,908.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,244.38
|
| Rate for Payer: Cash Price |
$1,357.95
|
| Rate for Payer: Cash Price |
$1,357.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,975.20
|
| Rate for Payer: Cigna of CA HMO |
$1,728.30
|
| Rate for Payer: Cigna of CA PPO |
$1,728.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,098.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,098.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,098.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$987.60
|
| Rate for Payer: EPIC Health Plan Senior |
$987.60
|
| Rate for Payer: Galaxy Health WC |
$2,098.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,481.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,222.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,185.22
|
| Rate for Payer: InnovAge PACE Commercial |
$1,234.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,309.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,528.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,012.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,728.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,728.30
|
| Rate for Payer: Multiplan Commercial |
$1,851.75
|
| Rate for Payer: Networks By Design Commercial |
$1,234.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,098.65
|
| Rate for Payer: Riverside University Health System MISP |
$987.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,481.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,481.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$926.62
|
| Rate for Payer: United Healthcare All Other HMO |
$901.93
|
| Rate for Payer: United Healthcare HMO Rider |
$882.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$808.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,098.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,098.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,098.65
|
|
|
HC AK ADD POLYCENT MECH STANCE
|
Facility
|
OP
|
$2,469.00
|
|
|
Service Code
|
CPT L5816
|
| Hospital Charge Code |
915355816
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$808.60 |
| Max. Negotiated Rate |
$2,222.10 |
| Rate for Payer: Adventist Health Commercial |
$1,012.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,098.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,357.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,851.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,450.04
|
| Rate for Payer: Blue Shield of California Commercial |
$1,908.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,244.38
|
| Rate for Payer: Cash Price |
$1,357.95
|
| Rate for Payer: Cash Price |
$1,357.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,975.20
|
| Rate for Payer: Cigna of CA HMO |
$1,728.30
|
| Rate for Payer: Cigna of CA PPO |
$1,728.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,098.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,098.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,098.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$987.60
|
| Rate for Payer: EPIC Health Plan Senior |
$987.60
|
| Rate for Payer: Galaxy Health WC |
$2,098.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,481.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,222.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,185.22
|
| Rate for Payer: InnovAge PACE Commercial |
$1,234.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,309.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,528.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,012.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,728.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,728.30
|
| Rate for Payer: Multiplan Commercial |
$1,851.75
|
| Rate for Payer: Networks By Design Commercial |
$1,234.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,098.65
|
| Rate for Payer: Riverside University Health System MISP |
$987.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,481.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,481.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$926.62
|
| Rate for Payer: United Healthcare All Other HMO |
$901.93
|
| Rate for Payer: United Healthcare HMO Rider |
$882.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$808.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,098.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,098.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,098.65
|
|
|
HC AK ADD POLYCENT MECH STANCE
|
Facility
|
IP
|
$2,469.00
|
|
|
Service Code
|
CPT L5816
|
| Hospital Charge Code |
905355816
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$493.80 |
| Max. Negotiated Rate |
$2,222.10 |
| Rate for Payer: Adventist Health Commercial |
$493.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,908.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,244.38
|
| Rate for Payer: Cash Price |
$1,357.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,975.20
|
| Rate for Payer: Cigna of CA HMO |
$1,728.30
|
| Rate for Payer: Cigna of CA PPO |
$1,728.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$987.60
|
| Rate for Payer: EPIC Health Plan Senior |
$987.60
|
| Rate for Payer: Galaxy Health WC |
$2,098.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,481.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,222.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$940.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,528.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$493.80
|
| Rate for Payer: Multiplan Commercial |
$1,851.75
|
| Rate for Payer: Networks By Design Commercial |
$1,604.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,098.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$926.62
|
| Rate for Payer: United Healthcare All Other HMO |
$901.93
|
| Rate for Payer: United Healthcare HMO Rider |
$882.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$808.60
|
|
|
HC AK ADD POLYCENT MECH STANCE
|
Facility
|
IP
|
$2,469.00
|
|
|
Service Code
|
CPT L5816
|
| Hospital Charge Code |
915355816
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$493.80 |
| Max. Negotiated Rate |
$2,222.10 |
| Rate for Payer: Adventist Health Commercial |
$493.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,908.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,244.38
|
| Rate for Payer: Cash Price |
$1,357.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,975.20
|
| Rate for Payer: Cigna of CA HMO |
$1,728.30
|
| Rate for Payer: Cigna of CA PPO |
$1,728.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$987.60
|
| Rate for Payer: EPIC Health Plan Senior |
$987.60
|
| Rate for Payer: Galaxy Health WC |
$2,098.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,481.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,222.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,646.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$940.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,528.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$493.80
|
| Rate for Payer: Multiplan Commercial |
$1,851.75
|
| Rate for Payer: Networks By Design Commercial |
$1,604.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,098.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$926.62
|
| Rate for Payer: United Healthcare All Other HMO |
$901.93
|
| Rate for Payer: United Healthcare HMO Rider |
$882.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$808.60
|
|
|
HC AK ADD POLY PNEU SWNG FRIC STN
|
Facility
|
OP
|
$8,024.00
|
|
|
Service Code
|
CPT L5822
|
| Hospital Charge Code |
905355822
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,175.95 |
| Max. Negotiated Rate |
$7,221.60 |
| Rate for Payer: Adventist Health Commercial |
$3,289.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,820.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,413.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,018.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,712.50
|
| Rate for Payer: Blue Shield of California Commercial |
$6,202.55
|
| Rate for Payer: Blue Shield of California EPN |
$4,044.10
|
| Rate for Payer: Cash Price |
$4,413.20
|
| Rate for Payer: Cash Price |
$4,413.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,419.20
|
| Rate for Payer: Cigna of CA HMO |
$5,616.80
|
| Rate for Payer: Cigna of CA PPO |
$5,616.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,820.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,820.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,820.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,209.60
|
| Rate for Payer: Galaxy Health WC |
$6,820.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,814.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,175.95
|
| Rate for Payer: InnovAge PACE Commercial |
$4,012.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,352.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,299.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,966.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,289.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,616.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,616.80
|
| Rate for Payer: Multiplan Commercial |
$6,018.00
|
| Rate for Payer: Networks By Design Commercial |
$4,012.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,820.40
|
| Rate for Payer: Riverside University Health System MISP |
$3,209.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,814.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,814.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,011.41
|
| Rate for Payer: United Healthcare All Other HMO |
$2,931.17
|
| Rate for Payer: United Healthcare HMO Rider |
$2,867.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,627.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,820.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,820.40
|
| Rate for Payer: Vantage Medical Group Senior |
$6,820.40
|
|
|
HC AK ADD POLY PNEU SWNG FRIC STN
|
Facility
|
IP
|
$8,024.00
|
|
|
Service Code
|
CPT L5822
|
| Hospital Charge Code |
905355822
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,604.80 |
| Max. Negotiated Rate |
$7,221.60 |
| Rate for Payer: Adventist Health Commercial |
$1,604.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,202.55
|
| Rate for Payer: Blue Shield of California EPN |
$4,044.10
|
| Rate for Payer: Cash Price |
$4,413.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,419.20
|
| Rate for Payer: Cigna of CA HMO |
$5,616.80
|
| Rate for Payer: Cigna of CA PPO |
$5,616.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,209.60
|
| Rate for Payer: Galaxy Health WC |
$6,820.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,814.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,221.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,352.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,057.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,966.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,604.80
|
| Rate for Payer: Multiplan Commercial |
$6,018.00
|
| Rate for Payer: Networks By Design Commercial |
$5,215.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,820.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,011.41
|
| Rate for Payer: United Healthcare All Other HMO |
$2,931.17
|
| Rate for Payer: United Healthcare HMO Rider |
$2,867.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,627.86
|
|
|
HC AK ADD POLY PNEU SWNG FRIC STN
|
Facility
|
OP
|
$8,024.00
|
|
|
Service Code
|
CPT L5822
|
| Hospital Charge Code |
915355822
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,175.95 |
| Max. Negotiated Rate |
$7,221.60 |
| Rate for Payer: Adventist Health Commercial |
$3,289.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,820.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,413.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,018.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,712.50
|
| Rate for Payer: Blue Shield of California Commercial |
$6,202.55
|
| Rate for Payer: Blue Shield of California EPN |
$4,044.10
|
| Rate for Payer: Cash Price |
$4,413.20
|
| Rate for Payer: Cash Price |
$4,413.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,419.20
|
| Rate for Payer: Cigna of CA HMO |
$5,616.80
|
| Rate for Payer: Cigna of CA PPO |
$5,616.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,820.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,820.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,820.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,209.60
|
| Rate for Payer: Galaxy Health WC |
$6,820.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,814.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,175.95
|
| Rate for Payer: InnovAge PACE Commercial |
$4,012.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,352.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,299.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,966.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,289.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,616.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,616.80
|
| Rate for Payer: Multiplan Commercial |
$6,018.00
|
| Rate for Payer: Networks By Design Commercial |
$4,012.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,820.40
|
| Rate for Payer: Riverside University Health System MISP |
$3,209.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,814.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,814.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,011.41
|
| Rate for Payer: United Healthcare All Other HMO |
$2,931.17
|
| Rate for Payer: United Healthcare HMO Rider |
$2,867.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,627.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,820.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,820.40
|
| Rate for Payer: Vantage Medical Group Senior |
$6,820.40
|
|
|
HC AK ADD POLY PNEU SWNG FRIC STN
|
Facility
|
IP
|
$8,024.00
|
|
|
Service Code
|
CPT L5822
|
| Hospital Charge Code |
915355822
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,604.80 |
| Max. Negotiated Rate |
$7,221.60 |
| Rate for Payer: Adventist Health Commercial |
$1,604.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,202.55
|
| Rate for Payer: Blue Shield of California EPN |
$4,044.10
|
| Rate for Payer: Cash Price |
$4,413.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,419.20
|
| Rate for Payer: Cigna of CA HMO |
$5,616.80
|
| Rate for Payer: Cigna of CA PPO |
$5,616.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,209.60
|
| Rate for Payer: Galaxy Health WC |
$6,820.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,814.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,221.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,352.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,057.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,966.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,604.80
|
| Rate for Payer: Multiplan Commercial |
$6,018.00
|
| Rate for Payer: Networks By Design Commercial |
$5,215.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,820.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,011.41
|
| Rate for Payer: United Healthcare All Other HMO |
$2,931.17
|
| Rate for Payer: United Healthcare HMO Rider |
$2,867.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,627.86
|
|
|
HC AK ADD SINGLE AXIS MANUAL LOCK
|
Facility
|
OP
|
$3,130.00
|
|
|
Service Code
|
CPT L5810
|
| Hospital Charge Code |
905355810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$661.36 |
| Max. Negotiated Rate |
$2,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,283.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,660.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,721.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,347.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,838.25
|
| Rate for Payer: Blue Shield of California Commercial |
$2,419.49
|
| Rate for Payer: Blue Shield of California EPN |
$1,577.52
|
| Rate for Payer: Cash Price |
$1,721.50
|
| Rate for Payer: Cash Price |
$1,721.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,504.00
|
| Rate for Payer: Cigna of CA HMO |
$2,191.00
|
| Rate for Payer: Cigna of CA PPO |
$2,191.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,660.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,660.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,660.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,252.00
|
| Rate for Payer: Galaxy Health WC |
$2,660.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,878.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,817.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1,565.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,087.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$730.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,937.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,283.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,191.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,191.00
|
| Rate for Payer: Multiplan Commercial |
$2,347.50
|
| Rate for Payer: Networks By Design Commercial |
$1,565.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,660.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,252.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,878.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,878.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,174.69
|
| Rate for Payer: United Healthcare All Other HMO |
$1,143.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,118.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,025.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,660.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,660.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,660.50
|
|
|
HC AK ADD SINGLE AXIS MANUAL LOCK
|
Facility
|
IP
|
$3,130.00
|
|
|
Service Code
|
CPT L5810
|
| Hospital Charge Code |
915355810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$626.00 |
| Max. Negotiated Rate |
$2,817.00 |
| Rate for Payer: Adventist Health Commercial |
$626.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,419.49
|
| Rate for Payer: Blue Shield of California EPN |
$1,577.52
|
| Rate for Payer: Cash Price |
$1,721.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,504.00
|
| Rate for Payer: Cigna of CA HMO |
$2,191.00
|
| Rate for Payer: Cigna of CA PPO |
$2,191.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,252.00
|
| Rate for Payer: Galaxy Health WC |
$2,660.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,878.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,817.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,087.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,192.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,937.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$626.00
|
| Rate for Payer: Multiplan Commercial |
$2,347.50
|
| Rate for Payer: Networks By Design Commercial |
$2,034.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,660.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,174.69
|
| Rate for Payer: United Healthcare All Other HMO |
$1,143.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,118.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,025.08
|
|
|
HC AK ADD SINGLE AXIS MANUAL LOCK
|
Facility
|
IP
|
$3,130.00
|
|
|
Service Code
|
CPT L5810
|
| Hospital Charge Code |
905355810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$626.00 |
| Max. Negotiated Rate |
$2,817.00 |
| Rate for Payer: Adventist Health Commercial |
$626.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,419.49
|
| Rate for Payer: Blue Shield of California EPN |
$1,577.52
|
| Rate for Payer: Cash Price |
$1,721.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,504.00
|
| Rate for Payer: Cigna of CA HMO |
$2,191.00
|
| Rate for Payer: Cigna of CA PPO |
$2,191.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,252.00
|
| Rate for Payer: Galaxy Health WC |
$2,660.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,878.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,817.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,087.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,192.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,937.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$626.00
|
| Rate for Payer: Multiplan Commercial |
$2,347.50
|
| Rate for Payer: Networks By Design Commercial |
$2,034.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,660.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,174.69
|
| Rate for Payer: United Healthcare All Other HMO |
$1,143.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,118.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,025.08
|
|
|
HC AK ADD SINGLE AXIS MANUAL LOCK
|
Facility
|
OP
|
$3,130.00
|
|
|
Service Code
|
CPT L5810
|
| Hospital Charge Code |
915355810
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$661.36 |
| Max. Negotiated Rate |
$2,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,283.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,660.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,721.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,347.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,838.25
|
| Rate for Payer: Blue Shield of California Commercial |
$2,419.49
|
| Rate for Payer: Blue Shield of California EPN |
$1,577.52
|
| Rate for Payer: Cash Price |
$1,721.50
|
| Rate for Payer: Cash Price |
$1,721.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,504.00
|
| Rate for Payer: Cigna of CA HMO |
$2,191.00
|
| Rate for Payer: Cigna of CA PPO |
$2,191.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,660.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,660.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,660.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,252.00
|
| Rate for Payer: Galaxy Health WC |
$2,660.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,878.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,817.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1,565.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,087.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$730.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,937.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,283.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,191.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,191.00
|
| Rate for Payer: Multiplan Commercial |
$2,347.50
|
| Rate for Payer: Networks By Design Commercial |
$1,565.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,660.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,252.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,878.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,878.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,174.69
|
| Rate for Payer: United Healthcare All Other HMO |
$1,143.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,118.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,025.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,660.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,660.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,660.50
|
|
|
HC AK ADD SKT INSERT-PELITE LINER
|
Facility
|
IP
|
$647.00
|
|
|
Service Code
|
CPT L5658
|
| Hospital Charge Code |
915355658
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$129.40 |
| Max. Negotiated Rate |
$582.30 |
| Rate for Payer: Adventist Health Commercial |
$129.40
|
| Rate for Payer: Blue Shield of California Commercial |
$500.13
|
| Rate for Payer: Blue Shield of California EPN |
$326.09
|
| Rate for Payer: Cash Price |
$355.85
|
| Rate for Payer: Central Health Plan Commercial |
$517.60
|
| Rate for Payer: Cigna of CA HMO |
$452.90
|
| Rate for Payer: Cigna of CA PPO |
$452.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$258.80
|
| Rate for Payer: EPIC Health Plan Senior |
$258.80
|
| Rate for Payer: Galaxy Health WC |
$549.95
|
| Rate for Payer: Global Benefits Group Commercial |
$388.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$582.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$431.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$246.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.40
|
| Rate for Payer: Multiplan Commercial |
$485.25
|
| Rate for Payer: Networks By Design Commercial |
$420.55
|
| Rate for Payer: Prime Health Services Commercial |
$549.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$242.82
|
| Rate for Payer: United Healthcare All Other HMO |
$236.35
|
| Rate for Payer: United Healthcare HMO Rider |
$231.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.89
|
|
|
HC AK ADD SKT INSERT-PELITE LINER
|
Facility
|
OP
|
$647.00
|
|
|
Service Code
|
CPT L5658
|
| Hospital Charge Code |
915355658
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$211.89 |
| Max. Negotiated Rate |
$582.30 |
| Rate for Payer: Adventist Health Commercial |
$265.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$549.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$355.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$485.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$379.98
|
| Rate for Payer: Blue Shield of California Commercial |
$500.13
|
| Rate for Payer: Blue Shield of California EPN |
$326.09
|
| Rate for Payer: Cash Price |
$355.85
|
| Rate for Payer: Cash Price |
$355.85
|
| Rate for Payer: Central Health Plan Commercial |
$517.60
|
| Rate for Payer: Cigna of CA HMO |
$452.90
|
| Rate for Payer: Cigna of CA PPO |
$452.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$549.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$549.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$549.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$258.80
|
| Rate for Payer: EPIC Health Plan Senior |
$258.80
|
| Rate for Payer: Galaxy Health WC |
$549.95
|
| Rate for Payer: Global Benefits Group Commercial |
$388.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$582.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$235.85
|
| Rate for Payer: InnovAge PACE Commercial |
$323.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$431.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$260.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.90
|
| Rate for Payer: Multiplan Commercial |
$485.25
|
| Rate for Payer: Networks By Design Commercial |
$323.50
|
| Rate for Payer: Prime Health Services Commercial |
$549.95
|
| Rate for Payer: Riverside University Health System MISP |
$258.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$388.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$388.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$242.82
|
| Rate for Payer: United Healthcare All Other HMO |
$236.35
|
| Rate for Payer: United Healthcare HMO Rider |
$231.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$549.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$549.95
|
| Rate for Payer: Vantage Medical Group Senior |
$549.95
|
|
|
HC AK ADD SKT INSERT-PELITE LINER
|
Facility
|
IP
|
$647.00
|
|
|
Service Code
|
CPT L5658
|
| Hospital Charge Code |
905355658
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$129.40 |
| Max. Negotiated Rate |
$582.30 |
| Rate for Payer: Adventist Health Commercial |
$129.40
|
| Rate for Payer: Blue Shield of California Commercial |
$500.13
|
| Rate for Payer: Blue Shield of California EPN |
$326.09
|
| Rate for Payer: Cash Price |
$355.85
|
| Rate for Payer: Central Health Plan Commercial |
$517.60
|
| Rate for Payer: Cigna of CA HMO |
$452.90
|
| Rate for Payer: Cigna of CA PPO |
$452.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$258.80
|
| Rate for Payer: EPIC Health Plan Senior |
$258.80
|
| Rate for Payer: Galaxy Health WC |
$549.95
|
| Rate for Payer: Global Benefits Group Commercial |
$388.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$582.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$431.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$246.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.40
|
| Rate for Payer: Multiplan Commercial |
$485.25
|
| Rate for Payer: Networks By Design Commercial |
$420.55
|
| Rate for Payer: Prime Health Services Commercial |
$549.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$242.82
|
| Rate for Payer: United Healthcare All Other HMO |
$236.35
|
| Rate for Payer: United Healthcare HMO Rider |
$231.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.89
|
|
|
HC AK ADD SKT INSERT-PELITE LINER
|
Facility
|
OP
|
$647.00
|
|
|
Service Code
|
CPT L5658
|
| Hospital Charge Code |
905355658
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$211.89 |
| Max. Negotiated Rate |
$582.30 |
| Rate for Payer: Adventist Health Commercial |
$265.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$549.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$355.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$485.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$379.98
|
| Rate for Payer: Blue Shield of California Commercial |
$500.13
|
| Rate for Payer: Blue Shield of California EPN |
$326.09
|
| Rate for Payer: Cash Price |
$355.85
|
| Rate for Payer: Cash Price |
$355.85
|
| Rate for Payer: Central Health Plan Commercial |
$517.60
|
| Rate for Payer: Cigna of CA HMO |
$452.90
|
| Rate for Payer: Cigna of CA PPO |
$452.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$549.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$549.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$549.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$258.80
|
| Rate for Payer: EPIC Health Plan Senior |
$258.80
|
| Rate for Payer: Galaxy Health WC |
$549.95
|
| Rate for Payer: Global Benefits Group Commercial |
$388.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$582.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$235.85
|
| Rate for Payer: InnovAge PACE Commercial |
$323.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$431.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$260.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.90
|
| Rate for Payer: Multiplan Commercial |
$485.25
|
| Rate for Payer: Networks By Design Commercial |
$323.50
|
| Rate for Payer: Prime Health Services Commercial |
$549.95
|
| Rate for Payer: Riverside University Health System MISP |
$258.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$388.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$388.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$242.82
|
| Rate for Payer: United Healthcare All Other HMO |
$236.35
|
| Rate for Payer: United Healthcare HMO Rider |
$231.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$549.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$549.95
|
| Rate for Payer: Vantage Medical Group Senior |
$549.95
|
|
|
HC AK ADD SKT INSERT SILICONE GEL
|
Facility
|
OP
|
$1,400.00
|
|
|
Service Code
|
CPT L5664
|
| Hospital Charge Code |
905355664
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$458.50 |
| Max. Negotiated Rate |
$1,260.00 |
| Rate for Payer: Adventist Health Commercial |
$574.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,190.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$770.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,050.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$822.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,082.20
|
| Rate for Payer: Blue Shield of California EPN |
$705.60
|
| Rate for Payer: Cash Price |
$770.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,120.00
|
| Rate for Payer: Cigna of CA HMO |
$980.00
|
| Rate for Payer: Cigna of CA PPO |
$980.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,190.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,190.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,190.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$560.00
|
| Rate for Payer: Galaxy Health WC |
$1,190.00
|
| Rate for Payer: Global Benefits Group Commercial |
$840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,260.00
|
| Rate for Payer: InnovAge PACE Commercial |
$700.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$933.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$533.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$866.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$574.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$980.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$980.00
|
| Rate for Payer: Multiplan Commercial |
$1,050.00
|
| Rate for Payer: Networks By Design Commercial |
$700.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.00
|
| Rate for Payer: Riverside University Health System MISP |
$560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$840.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$840.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$525.42
|
| Rate for Payer: United Healthcare All Other HMO |
$511.42
|
| Rate for Payer: United Healthcare HMO Rider |
$500.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$458.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,190.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,190.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,190.00
|
|
|
HC AK ADD SKT INSERT SILICONE GEL
|
Facility
|
IP
|
$1,400.00
|
|
|
Service Code
|
CPT L5664
|
| Hospital Charge Code |
905355664
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$1,260.00 |
| Rate for Payer: Adventist Health Commercial |
$280.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,082.20
|
| Rate for Payer: Blue Shield of California EPN |
$705.60
|
| Rate for Payer: Cash Price |
$770.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,120.00
|
| Rate for Payer: Cigna of CA HMO |
$980.00
|
| Rate for Payer: Cigna of CA PPO |
$980.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$560.00
|
| Rate for Payer: Galaxy Health WC |
$1,190.00
|
| Rate for Payer: Global Benefits Group Commercial |
$840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,260.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$933.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$533.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$866.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.00
|
| Rate for Payer: Multiplan Commercial |
$1,050.00
|
| Rate for Payer: Networks By Design Commercial |
$910.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,190.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$525.42
|
| Rate for Payer: United Healthcare All Other HMO |
$511.42
|
| Rate for Payer: United Healthcare HMO Rider |
$500.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$458.50
|
|
|
HC AK ADD SNGL AXIS FLUID SWG CNT
|
Facility
|
OP
|
$6,895.00
|
|
|
Service Code
|
CPT L5824
|
| Hospital Charge Code |
915355824
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,138.42 |
| Max. Negotiated Rate |
$6,205.50 |
| Rate for Payer: Adventist Health Commercial |
$2,826.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,860.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,792.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,171.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,049.43
|
| Rate for Payer: Blue Shield of California Commercial |
$5,329.84
|
| Rate for Payer: Blue Shield of California EPN |
$3,475.08
|
| Rate for Payer: Cash Price |
$3,792.25
|
| Rate for Payer: Cash Price |
$3,792.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,516.00
|
| Rate for Payer: Cigna of CA HMO |
$4,826.50
|
| Rate for Payer: Cigna of CA PPO |
$4,826.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,860.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,860.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,860.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,758.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,758.00
|
| Rate for Payer: Galaxy Health WC |
$5,860.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,137.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,205.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,138.42
|
| Rate for Payer: InnovAge PACE Commercial |
$3,447.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,598.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,362.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,268.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,826.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,826.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,826.50
|
| Rate for Payer: Multiplan Commercial |
$5,171.25
|
| Rate for Payer: Networks By Design Commercial |
$3,447.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,860.75
|
| Rate for Payer: Riverside University Health System MISP |
$2,758.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,137.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,137.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,587.69
|
| Rate for Payer: United Healthcare All Other HMO |
$2,518.74
|
| Rate for Payer: United Healthcare HMO Rider |
$2,464.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,258.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,860.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,860.75
|
| Rate for Payer: Vantage Medical Group Senior |
$5,860.75
|
|
