|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
IP
|
$1,771.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,593.90 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,044.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
IP
|
$1,771.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,593.90 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,044.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
OP
|
$1,771.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$55.71 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Cigna of CA HMO |
$1,133.44
|
| Rate for Payer: Cigna of CA PPO |
$1,310.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$55.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$61.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,062.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$885.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ARTHRITIS SERIES
|
Facility
|
OP
|
$3,023.00
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
909001604
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.46 |
| Max. Negotiated Rate |
$2,720.70 |
| Rate for Payer: Adventist Health Commercial |
$604.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$481.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$300.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$417.53
|
| Rate for Payer: Blue Shield of California Commercial |
$1,904.49
|
| Rate for Payer: Blue Shield of California EPN |
$1,200.13
|
| Rate for Payer: Cash Price |
$1,360.35
|
| Rate for Payer: Cash Price |
$1,360.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,418.40
|
| Rate for Payer: Cigna of CA HMO |
$1,934.72
|
| Rate for Payer: Cigna of CA PPO |
$2,237.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,116.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$2,569.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,813.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,720.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$135.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,919.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$149.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$604.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$2,267.25
|
| Rate for Payer: Networks By Design Commercial |
$1,964.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$2,569.55
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,813.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,813.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$193.23
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$193.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC ARTHRITIS SERIES
|
Facility
|
IP
|
$3,023.00
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
909001604
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$604.60 |
| Max. Negotiated Rate |
$2,720.70 |
| Rate for Payer: Adventist Health Commercial |
$604.60
|
| Rate for Payer: Cash Price |
$1,360.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,418.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,116.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,209.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,209.20
|
| Rate for Payer: Galaxy Health WC |
$2,569.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,813.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,720.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,919.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,783.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$604.60
|
| Rate for Payer: Multiplan Commercial |
$2,267.25
|
| Rate for Payer: Networks By Design Commercial |
$1,964.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,569.55
|
|
|
HC ARTHRODESIS SACROILIAC JOINT
|
Facility
|
OP
|
$53,924.00
|
|
|
Service Code
|
CPT 27279
|
| Hospital Charge Code |
909027279
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$167.13 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$10,784.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,551.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33,827.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,806.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,551.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$37,230.18
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$24,265.80
|
| Rate for Payer: Cash Price |
$24,265.80
|
| Rate for Payer: Cash Price |
$24,265.80
|
| Rate for Payer: Central Health Plan Commercial |
$43,139.20
|
| Rate for Payer: Cigna of CA HMO |
$34,511.36
|
| Rate for Payer: Cigna of CA PPO |
$39,903.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33,827.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,806.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,551.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37,746.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,209.84
|
| Rate for Payer: EPIC Health Plan Senior |
$24,806.56
|
| Rate for Payer: Galaxy Health WC |
$45,835.40
|
| Rate for Payer: Global Benefits Group Commercial |
$32,354.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,531.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36,984.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$167.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,551.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34,241.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31,571.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,784.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$30,218.90
|
| Rate for Payer: Multiplan Commercial |
$40,443.00
|
| Rate for Payer: Multiplan WC |
$37,230.18
|
| Rate for Payer: Networks By Design Commercial |
$35,050.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,551.42
|
| Rate for Payer: Preferred Health Network WC |
$37,989.98
|
| Rate for Payer: Prime Health Services Commercial |
$45,835.40
|
| Rate for Payer: Prime Health Services Medicare |
$23,904.51
|
| Rate for Payer: Prime Health Services WC |
$36,850.28
|
| Rate for Payer: Riverside University Health System MISP |
$24,806.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,354.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$26,962.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,551.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33,827.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,806.56
|
| Rate for Payer: Vantage Medical Group Senior |
$22,551.42
|
|
|
HC ARTHRODESIS SACROILIAC JOINT
|
Facility
|
IP
|
$53,924.00
|
|
|
Service Code
|
CPT 27279
|
| Hospital Charge Code |
909027279
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,784.80 |
| Max. Negotiated Rate |
$48,531.60 |
| Rate for Payer: Adventist Health Commercial |
$10,784.80
|
| Rate for Payer: Cash Price |
$24,265.80
|
| Rate for Payer: Central Health Plan Commercial |
$43,139.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37,746.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,569.60
|
| Rate for Payer: EPIC Health Plan Senior |
$21,569.60
|
| Rate for Payer: Galaxy Health WC |
$45,835.40
|
| Rate for Payer: Global Benefits Group Commercial |
$32,354.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,531.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34,241.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31,815.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,784.80
|
| Rate for Payer: Multiplan Commercial |
$40,443.00
|
| Rate for Payer: Networks By Design Commercial |
$35,050.60
|
| Rate for Payer: Prime Health Services Commercial |
$45,835.40
|
|
|
HC ARTHROGRAPH ANKLE
|
Facility
|
OP
|
$1,721.00
|
|
|
Service Code
|
CPT 73615
|
| Hospital Charge Code |
909001663
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$129.50 |
| Max. Negotiated Rate |
$1,548.90 |
| Rate for Payer: Adventist Health Commercial |
$344.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$485.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$605.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,084.23
|
| Rate for Payer: Blue Shield of California EPN |
$683.24
|
| Rate for Payer: Cash Price |
$774.45
|
| Rate for Payer: Cash Price |
$774.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,376.80
|
| Rate for Payer: Cigna of CA HMO |
$1,101.44
|
| Rate for Payer: Cigna of CA PPO |
$1,273.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,204.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$1,462.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,032.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,548.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$129.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,092.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$1,290.75
|
| Rate for Payer: Networks By Design Commercial |
$1,118.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$1,462.85
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,032.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,032.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC ARTHROGRAPH ANKLE
|
Facility
|
IP
|
$1,721.00
|
|
|
Service Code
|
CPT 73615
|
| Hospital Charge Code |
909001663
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$344.20 |
| Max. Negotiated Rate |
$1,548.90 |
| Rate for Payer: Adventist Health Commercial |
$344.20
|
| Rate for Payer: Cash Price |
$774.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,376.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,204.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.40
|
| Rate for Payer: EPIC Health Plan Senior |
$688.40
|
| Rate for Payer: Galaxy Health WC |
$1,462.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,032.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,548.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,092.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,015.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.20
|
| Rate for Payer: Multiplan Commercial |
$1,290.75
|
| Rate for Payer: Networks By Design Commercial |
$1,118.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,462.85
|
|
|
HC ARTHROGRAPH ELBOW
|
Facility
|
OP
|
$1,572.00
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
909001481
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$123.53 |
| Max. Negotiated Rate |
$1,414.80 |
| Rate for Payer: Adventist Health Commercial |
$314.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$448.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$605.12
|
| Rate for Payer: Blue Shield of California Commercial |
$990.36
|
| Rate for Payer: Blue Shield of California EPN |
$624.08
|
| Rate for Payer: Cash Price |
$707.40
|
| Rate for Payer: Cash Price |
$707.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,257.60
|
| Rate for Payer: Cigna of CA HMO |
$1,006.08
|
| Rate for Payer: Cigna of CA PPO |
$1,163.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,100.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$1,336.20
|
| Rate for Payer: Global Benefits Group Commercial |
$943.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,414.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$123.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$998.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$136.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$1,179.00
|
| Rate for Payer: Networks By Design Commercial |
$1,021.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$1,336.20
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$943.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$943.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC ARTHROGRAPH ELBOW
|
Facility
|
IP
|
$1,572.00
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
909001481
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$314.40 |
| Max. Negotiated Rate |
$1,414.80 |
| Rate for Payer: Adventist Health Commercial |
$314.40
|
| Rate for Payer: Cash Price |
$707.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,257.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,100.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$628.80
|
| Rate for Payer: EPIC Health Plan Senior |
$628.80
|
| Rate for Payer: Galaxy Health WC |
$1,336.20
|
| Rate for Payer: Global Benefits Group Commercial |
$943.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,414.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$998.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$927.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$314.40
|
| Rate for Payer: Multiplan Commercial |
$1,179.00
|
| Rate for Payer: Networks By Design Commercial |
$1,021.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,336.20
|
|
|
HC ARTHROGRAPH HIP
|
Facility
|
IP
|
$2,299.00
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
909001659
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$459.80 |
| Max. Negotiated Rate |
$2,069.10 |
| Rate for Payer: Adventist Health Commercial |
$459.80
|
| Rate for Payer: Cash Price |
$1,034.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,839.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,609.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$919.60
|
| Rate for Payer: EPIC Health Plan Senior |
$919.60
|
| Rate for Payer: Galaxy Health WC |
$1,954.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,379.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,069.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,459.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,356.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.80
|
| Rate for Payer: Multiplan Commercial |
$1,724.25
|
| Rate for Payer: Networks By Design Commercial |
$1,494.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,954.15
|
|
|
HC ARTHROGRAPH HIP
|
Facility
|
OP
|
$2,299.00
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
909001659
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$129.50 |
| Max. Negotiated Rate |
$2,069.10 |
| Rate for Payer: Adventist Health Commercial |
$459.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$461.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$605.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,448.37
|
| Rate for Payer: Blue Shield of California EPN |
$912.70
|
| Rate for Payer: Cash Price |
$1,034.55
|
| Rate for Payer: Cash Price |
$1,034.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,839.20
|
| Rate for Payer: Cigna of CA HMO |
$1,471.36
|
| Rate for Payer: Cigna of CA PPO |
$1,701.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,609.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$1,954.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,379.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,069.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$129.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,459.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$1,724.25
|
| Rate for Payer: Networks By Design Commercial |
$1,494.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$1,954.15
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,379.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,379.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC ARTHROGRAPH KNEE
|
Facility
|
IP
|
$2,189.00
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
909001658
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$437.80 |
| Max. Negotiated Rate |
$1,970.10 |
| Rate for Payer: Adventist Health Commercial |
$437.80
|
| Rate for Payer: Cash Price |
$985.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,751.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,532.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$875.60
|
| Rate for Payer: EPIC Health Plan Senior |
$875.60
|
| Rate for Payer: Galaxy Health WC |
$1,860.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,313.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,970.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,390.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,291.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$437.80
|
| Rate for Payer: Multiplan Commercial |
$1,641.75
|
| Rate for Payer: Networks By Design Commercial |
$1,422.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,860.65
|
|
|
HC ARTHROGRAPH KNEE
|
Facility
|
OP
|
$2,189.00
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
909001658
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$119.06 |
| Max. Negotiated Rate |
$1,970.10 |
| Rate for Payer: Adventist Health Commercial |
$437.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$656.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$545.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$758.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,379.07
|
| Rate for Payer: Blue Shield of California EPN |
$869.03
|
| Rate for Payer: Cash Price |
$985.05
|
| Rate for Payer: Cash Price |
$985.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,751.20
|
| Rate for Payer: Cigna of CA HMO |
$1,400.96
|
| Rate for Payer: Cigna of CA PPO |
$1,619.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,532.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$1,860.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,313.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,970.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$119.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,390.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$131.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$437.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$1,641.75
|
| Rate for Payer: Networks By Design Commercial |
$1,422.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$1,860.65
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,313.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,313.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC ARTHROGRAPH SHOULDER
|
Facility
|
OP
|
$2,837.00
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
909001480
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$87.19 |
| Max. Negotiated Rate |
$2,553.30 |
| Rate for Payer: Adventist Health Commercial |
$567.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$513.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$605.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,787.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,126.29
|
| Rate for Payer: Cash Price |
$1,276.65
|
| Rate for Payer: Cash Price |
$1,276.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,269.60
|
| Rate for Payer: Cigna of CA HMO |
$1,815.68
|
| Rate for Payer: Cigna of CA PPO |
$2,099.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,985.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$2,411.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,702.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,553.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,801.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$2,127.75
|
| Rate for Payer: Networks By Design Commercial |
$1,844.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$2,411.45
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,702.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,702.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC ARTHROGRAPH SHOULDER
|
Facility
|
IP
|
$2,837.00
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
909001480
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$567.40 |
| Max. Negotiated Rate |
$2,553.30 |
| Rate for Payer: Adventist Health Commercial |
$567.40
|
| Rate for Payer: Cash Price |
$1,276.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,269.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,985.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,134.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,134.80
|
| Rate for Payer: Galaxy Health WC |
$2,411.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,702.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,553.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,801.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,673.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$567.40
|
| Rate for Payer: Multiplan Commercial |
$2,127.75
|
| Rate for Payer: Networks By Design Commercial |
$1,844.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,411.45
|
|
|
HC ARTHROGRAPH WRIST
|
Facility
|
OP
|
$2,382.00
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
909001482
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$70.76 |
| Max. Negotiated Rate |
$2,143.80 |
| Rate for Payer: Adventist Health Commercial |
$476.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$517.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$326.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$454.43
|
| Rate for Payer: Blue Shield of California Commercial |
$1,500.66
|
| Rate for Payer: Blue Shield of California EPN |
$945.65
|
| Rate for Payer: Cash Price |
$1,071.90
|
| Rate for Payer: Cash Price |
$1,071.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,905.60
|
| Rate for Payer: Cigna of CA HMO |
$1,524.48
|
| Rate for Payer: Cigna of CA PPO |
$1,762.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,667.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$2,024.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,429.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,143.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$70.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,512.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$78.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$476.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$1,786.50
|
| Rate for Payer: Networks By Design Commercial |
$1,548.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$2,024.70
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,429.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,429.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC ARTHROGRAPH WRIST
|
Facility
|
IP
|
$2,382.00
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
909001482
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$476.40 |
| Max. Negotiated Rate |
$2,143.80 |
| Rate for Payer: Adventist Health Commercial |
$476.40
|
| Rate for Payer: Cash Price |
$1,071.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,905.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,667.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$952.80
|
| Rate for Payer: EPIC Health Plan Senior |
$952.80
|
| Rate for Payer: Galaxy Health WC |
$2,024.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,429.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,143.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,512.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,405.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$476.40
|
| Rate for Payer: Multiplan Commercial |
$1,786.50
|
| Rate for Payer: Networks By Design Commercial |
$1,548.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,024.70
|
|
|
HC ARTHROSCOPY KNEE DIAG W OR WO BX
|
Facility
|
OP
|
$10,307.00
|
|
|
Service Code
|
CPT 29870
|
| Hospital Charge Code |
906601870
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$478.99 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,061.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,208.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,245.60
|
| Rate for Payer: Cigna of CA HMO |
$6,596.48
|
| Rate for Payer: Cigna of CA PPO |
$7,627.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,214.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$8,760.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,184.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,276.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$478.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,544.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$529.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,891.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,061.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$7,730.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$6,699.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$8,760.95
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,184.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,153.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC ARTHROSCOPY KNEE DIAG W OR WO BX
|
Facility
|
IP
|
$10,307.00
|
|
|
Service Code
|
CPT 29870
|
| Hospital Charge Code |
906601870
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,061.40 |
| Max. Negotiated Rate |
$9,276.30 |
| Rate for Payer: Adventist Health Commercial |
$2,061.40
|
| Rate for Payer: Cash Price |
$4,638.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,245.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,214.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,122.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.80
|
| Rate for Payer: Galaxy Health WC |
$8,760.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,184.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,276.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,544.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,081.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,061.40
|
| Rate for Payer: Multiplan Commercial |
$7,730.25
|
| Rate for Payer: Networks By Design Commercial |
$6,699.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,760.95
|
|
|
HC ARTHROTOMY ANKLE
|
Facility
|
IP
|
$16,045.00
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
900501781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,209.00 |
| Max. Negotiated Rate |
$14,440.50 |
| Rate for Payer: Adventist Health Commercial |
$3,209.00
|
| Rate for Payer: Cash Price |
$7,220.25
|
| Rate for Payer: Central Health Plan Commercial |
$12,836.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,231.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,418.00
|
| Rate for Payer: EPIC Health Plan Senior |
$6,418.00
|
| Rate for Payer: Galaxy Health WC |
$13,638.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,627.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,440.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,188.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,466.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,209.00
|
| Rate for Payer: Multiplan Commercial |
$12,033.75
|
| Rate for Payer: Networks By Design Commercial |
$10,429.25
|
| Rate for Payer: Prime Health Services Commercial |
$13,638.25
|
|
|
HC ARTHROTOMY ANKLE
|
Facility
|
OP
|
$16,045.00
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
900501781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$14,440.50 |
| Rate for Payer: Adventist Health Commercial |
$3,209.00
|
| 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 |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$7,220.25
|
| Rate for Payer: Cash Price |
$7,220.25
|
| Rate for Payer: Cash Price |
$7,220.25
|
| Rate for Payer: Cash Price |
$7,220.25
|
| Rate for Payer: Central Health Plan Commercial |
$12,836.00
|
| Rate for Payer: Cigna of CA HMO |
$10,268.80
|
| Rate for Payer: Cigna of CA PPO |
$11,873.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,231.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$13,638.25
|
| Rate for Payer: Global Benefits Group Commercial |
$9,627.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,440.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,188.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$144.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,209.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$12,033.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$10,429.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$13,638.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,627.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,022.50
|
| Rate for Payer: United Healthcare All Other HMO |
$8,022.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,022.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,022.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC ARTHROTOMY ANKLE W/JOINT EXPLO
|
Facility
|
IP
|
$12,333.00
|
|
|
Service Code
|
CPT 27620
|
| Hospital Charge Code |
902890296
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,466.60 |
| Max. Negotiated Rate |
$11,099.70 |
| Rate for Payer: Adventist Health Commercial |
$2,466.60
|
| Rate for Payer: Cash Price |
$5,549.85
|
| Rate for Payer: Central Health Plan Commercial |
$9,866.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,633.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,933.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,933.20
|
| Rate for Payer: Galaxy Health WC |
$10,483.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7,399.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,099.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,831.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,276.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,466.60
|
| Rate for Payer: Multiplan Commercial |
$9,249.75
|
| Rate for Payer: Networks By Design Commercial |
$8,016.45
|
| Rate for Payer: Prime Health Services Commercial |
$10,483.05
|
|
|
HC ARTHROTOMY ANKLE W/JOINT EXPLO
|
Facility
|
OP
|
$12,333.00
|
|
|
Service Code
|
CPT 27620
|
| Hospital Charge Code |
902890296
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$144.31 |
| Max. Negotiated Rate |
$11,099.70 |
| Rate for Payer: Adventist Health Commercial |
$5,056.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,602.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Cash Price |
$5,549.85
|
| Rate for Payer: Cash Price |
$5,549.85
|
| Rate for Payer: Cash Price |
$5,549.85
|
| Rate for Payer: Cash Price |
$5,549.85
|
| Rate for Payer: Central Health Plan Commercial |
$9,866.40
|
| Rate for Payer: Cigna of CA HMO |
$7,893.12
|
| Rate for Payer: Cigna of CA PPO |
$9,126.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,633.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$10,483.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7,399.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,099.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,831.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$144.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,466.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$9,249.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$8,016.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$10,483.05
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,399.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,399.80
|
| 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 |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
