|
HC APPL TISS GLUE REPAIR EYE WND
|
Facility
|
OP
|
$5,672.00
|
|
|
Service Code
|
CPT 65286
|
| Hospital Charge Code |
900501481
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.82 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$1,134.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,617.28
|
| Rate for Payer: Cash Price |
$3,119.60
|
| Rate for Payer: Cash Price |
$3,119.60
|
| Rate for Payer: Cash Price |
$3,119.60
|
| Rate for Payer: Cash Price |
$3,119.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,537.60
|
| Rate for Payer: Cigna of CA HMO |
$3,630.08
|
| Rate for Payer: Cigna of CA PPO |
$4,197.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,912.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,897.90
|
| Rate for Payer: Galaxy Health WC |
$4,821.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,403.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,104.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,752.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: InnovAge PACE Commercial |
$4,346.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,783.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,897.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,134.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,883.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,883.19
|
| Rate for Payer: Multiplan Commercial |
$4,254.00
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$3,686.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Preferred Health Network WC |
$4,711.51
|
| Rate for Payer: Prime Health Services Commercial |
$4,821.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,071.77
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,187.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,403.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,836.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,836.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,836.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,897.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC APP OF FIGURE EIGHT
|
Facility
|
IP
|
$2,011.00
|
|
|
Service Code
|
CPT 29049
|
| Hospital Charge Code |
900501411
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$402.20 |
| Max. Negotiated Rate |
$1,809.90 |
| Rate for Payer: Adventist Health Commercial |
$402.20
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,608.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$804.40
|
| Rate for Payer: EPIC Health Plan Senior |
$804.40
|
| Rate for Payer: Galaxy Health WC |
$1,709.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,206.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,809.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,341.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$766.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,244.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$402.20
|
| Rate for Payer: Multiplan Commercial |
$1,508.25
|
| Rate for Payer: Networks By Design Commercial |
$1,307.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,709.35
|
|
|
HC APP OF FIGURE EIGHT
|
Facility
|
OP
|
$2,011.00
|
|
|
Service Code
|
CPT 29049
|
| Hospital Charge Code |
900501411
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$229.90 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$402.20
|
| 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 |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$537.66
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,608.80
|
| Rate for Payer: Cigna of CA HMO |
$1,287.04
|
| Rate for Payer: Cigna of CA PPO |
$1,488.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$1,709.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,206.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,809.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,341.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$402.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$1,508.25
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$1,307.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$1,709.35
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,206.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,005.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,005.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,005.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,005.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
HC APP OF FIGURE EIGHT
|
Facility
|
OP
|
$2,011.00
|
|
|
Service Code
|
CPT 29049
|
| Hospital Charge Code |
900501411
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$229.90 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$824.51
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,221.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,181.06
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$537.66
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,608.80
|
| Rate for Payer: Cigna of CA HMO |
$1,287.04
|
| Rate for Payer: Cigna of CA PPO |
$1,488.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$1,709.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,206.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,809.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,341.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$402.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$1,508.25
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$1,307.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$1,709.35
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,206.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,206.60
|
| 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 |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
HC APP OF FIGURE EIGHT
|
Facility
|
IP
|
$2,011.00
|
|
|
Service Code
|
CPT 29049
|
| Hospital Charge Code |
900501411
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$402.20 |
| Max. Negotiated Rate |
$1,809.90 |
| Rate for Payer: Adventist Health Commercial |
$402.20
|
| Rate for Payer: Cash Price |
$1,106.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,608.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$804.40
|
| Rate for Payer: EPIC Health Plan Senior |
$804.40
|
| Rate for Payer: Galaxy Health WC |
$1,709.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,206.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,809.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,341.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$766.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,244.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$402.20
|
| Rate for Payer: Multiplan Commercial |
$1,508.25
|
| Rate for Payer: Networks By Design Commercial |
$1,307.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,709.35
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
903208876
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.80
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
903208876
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Adventist Health Commercial |
$405.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$600.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: Cigna of CA HMO |
$632.96
|
| Rate for Payer: Cigna of CA PPO |
$731.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
903200190
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.80
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
903200190
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Adventist Health Commercial |
$405.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$600.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: Cigna of CA HMO |
$632.96
|
| Rate for Payer: Cigna of CA PPO |
$731.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC MCAL
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
901300011
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Adventist Health Commercial |
$405.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$600.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: Cigna of CA HMO |
$632.96
|
| Rate for Payer: Cigna of CA PPO |
$731.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC APP OF FINGER SPLINT-DYNAMIC MCAL
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT 29131
|
| Hospital Charge Code |
901300011
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$890.10 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Central Health Plan Commercial |
$791.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$890.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.80
|
| Rate for Payer: Multiplan Commercial |
$741.75
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
|
OP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903200189
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.31 |
| Max. Negotiated Rate |
$1,409.40 |
| Rate for Payer: Adventist Health Commercial |
$642.06
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$951.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: Cigna of CA HMO |
$1,002.24
|
| Rate for Payer: Cigna of CA PPO |
$1,158.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$642.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$939.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
|
OP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$65.31 |
| Max. Negotiated Rate |
$1,409.40 |
| Rate for Payer: Adventist Health Commercial |
$642.06
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$951.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: Cigna of CA HMO |
$1,002.24
|
| Rate for Payer: Cigna of CA PPO |
$1,158.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$642.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$939.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
|
IP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.20 |
| Max. Negotiated Rate |
$1,409.40 |
| Rate for Payer: Adventist Health Commercial |
$313.20
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$626.40
|
| Rate for Payer: EPIC Health Plan Senior |
$626.40
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$596.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$969.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.20
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
|
IP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$313.20 |
| Max. Negotiated Rate |
$1,409.40 |
| Rate for Payer: Adventist Health Commercial |
$313.20
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$626.40
|
| Rate for Payer: EPIC Health Plan Senior |
$626.40
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$596.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$969.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.20
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
|
IP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$313.20 |
| Max. Negotiated Rate |
$1,409.40 |
| Rate for Payer: Adventist Health Commercial |
$313.20
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$626.40
|
| Rate for Payer: EPIC Health Plan Senior |
$626.40
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$596.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$969.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.20
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
|
OP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$72.14 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$642.06
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$951.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$919.71
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: Cigna of CA HMO |
$1,002.24
|
| Rate for Payer: Cigna of CA PPO |
$1,158.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$939.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$939.60
|
| 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 |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
|
OP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903208875
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$72.14 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$313.20
|
| 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 |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$260.96
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: Cigna of CA HMO |
$1,002.24
|
| Rate for Payer: Cigna of CA PPO |
$1,158.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Preferred Health Network WC |
$266.29
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$939.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$783.00
|
| Rate for Payer: United Healthcare All Other HMO |
$783.00
|
| Rate for Payer: United Healthcare HMO Rider |
$783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$783.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC APP OF FINGER SPLINT-STATIC
|
Facility
|
IP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
903200189
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$313.20 |
| Max. Negotiated Rate |
$1,409.40 |
| Rate for Payer: Adventist Health Commercial |
$313.20
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$626.40
|
| Rate for Payer: EPIC Health Plan Senior |
$626.40
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$596.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$969.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.20
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
|
|
HC APP OF FINGER SPLINT-STATIC MCAL
|
Facility
|
OP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
901300009
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$65.31 |
| Max. Negotiated Rate |
$1,409.40 |
| Rate for Payer: Adventist Health Commercial |
$642.06
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$951.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: Cigna of CA HMO |
$1,002.24
|
| Rate for Payer: Cigna of CA PPO |
$1,158.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$642.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$939.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC APP OF FINGER SPLINT-STATIC MCAL
|
Facility
|
IP
|
$1,566.00
|
|
|
Service Code
|
CPT 29130
|
| Hospital Charge Code |
901300009
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$313.20 |
| Max. Negotiated Rate |
$1,409.40 |
| Rate for Payer: Adventist Health Commercial |
$313.20
|
| Rate for Payer: Cash Price |
$861.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$626.40
|
| Rate for Payer: EPIC Health Plan Senior |
$626.40
|
| Rate for Payer: Galaxy Health WC |
$1,331.10
|
| Rate for Payer: Global Benefits Group Commercial |
$939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,409.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,044.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$596.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$969.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.20
|
| Rate for Payer: Multiplan Commercial |
$1,174.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,331.10
|
|
|
HC APP OF HIP SPICA CAST
|
Facility
|
IP
|
$1,350.00
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
900501404
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Adventist Health Commercial |
$270.00
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,080.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$540.00
|
| Rate for Payer: EPIC Health Plan Senior |
$540.00
|
| Rate for Payer: Galaxy Health WC |
$1,147.50
|
| Rate for Payer: Global Benefits Group Commercial |
$810.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,215.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$900.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$835.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.00
|
| Rate for Payer: Multiplan Commercial |
$1,012.50
|
| Rate for Payer: Networks By Design Commercial |
$877.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,147.50
|
|
|
HC APP OF HIP SPICA CAST
|
Facility
|
OP
|
$1,350.00
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
900501404
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$553.50
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$792.86
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$537.66
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,080.00
|
| Rate for Payer: Cigna of CA HMO |
$864.00
|
| Rate for Payer: Cigna of CA PPO |
$999.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$1,147.50
|
| Rate for Payer: Global Benefits Group Commercial |
$810.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,215.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$900.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$389.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$1,012.50
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$877.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$1,147.50
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$810.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$810.00
|
| 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 |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
HC APP OF HIP SPICA CAST
|
Facility
|
IP
|
$1,350.00
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
900501404
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$1,215.00 |
| Rate for Payer: Adventist Health Commercial |
$270.00
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,080.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$540.00
|
| Rate for Payer: EPIC Health Plan Senior |
$540.00
|
| Rate for Payer: Galaxy Health WC |
$1,147.50
|
| Rate for Payer: Global Benefits Group Commercial |
$810.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,215.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$900.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$835.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.00
|
| Rate for Payer: Multiplan Commercial |
$1,012.50
|
| Rate for Payer: Networks By Design Commercial |
$877.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,147.50
|
|
|
HC APP OF HIP SPICA CAST
|
Facility
|
OP
|
$1,350.00
|
|
|
Service Code
|
CPT 29325
|
| Hospital Charge Code |
900501404
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$270.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$537.66
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Cash Price |
$742.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,080.00
|
| Rate for Payer: Cigna of CA HMO |
$864.00
|
| Rate for Payer: Cigna of CA PPO |
$999.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$1,147.50
|
| Rate for Payer: Global Benefits Group Commercial |
$810.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,215.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$900.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$389.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$1,012.50
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$877.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$1,147.50
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$810.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$675.00
|
| Rate for Payer: United Healthcare All Other HMO |
$675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$675.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$675.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
