|
HC CL TREAT CARPAL SCAPHOID FX W/
|
Facility
|
IP
|
$5,442.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
900501381
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,088.40 |
| Max. Negotiated Rate |
$4,897.80 |
| Rate for Payer: Adventist Health Commercial |
$1,088.40
|
| Rate for Payer: Cash Price |
$2,448.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,353.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,809.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,176.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,176.80
|
| Rate for Payer: Galaxy Health WC |
$4,625.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,265.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,897.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,455.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,210.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,088.40
|
| Rate for Payer: Multiplan Commercial |
$4,081.50
|
| Rate for Payer: Networks By Design Commercial |
$3,537.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,625.70
|
|
|
HC CL TREAT CARPAL SCAPHOID FX W/
|
Facility
|
OP
|
$5,442.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
900501381
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,088.40
|
| 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 |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$2,448.90
|
| Rate for Payer: Cash Price |
$2,448.90
|
| Rate for Payer: Cash Price |
$2,448.90
|
| Rate for Payer: Cash Price |
$2,448.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,353.60
|
| Rate for Payer: Cigna of CA HMO |
$3,482.88
|
| Rate for Payer: Cigna of CA PPO |
$4,027.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,809.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| Rate for Payer: Galaxy Health WC |
$4,625.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,265.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,897.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,455.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$448.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,088.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$4,081.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,537.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$4,625.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,192.24
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,274.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,265.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,721.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,721.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,721.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,721.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
OP
|
$1,831.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$750.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,825.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,464.80
|
| Rate for Payer: Cigna of CA HMO |
$1,171.84
|
| Rate for Payer: Cigna of CA PPO |
$1,354.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,281.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,556.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,098.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,647.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,162.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$393.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$366.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,190.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,556.35
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,098.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,098.60
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
IP
|
$1,831.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$366.20 |
| Max. Negotiated Rate |
$1,647.90 |
| Rate for Payer: Adventist Health Commercial |
$366.20
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,464.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,281.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.40
|
| Rate for Payer: EPIC Health Plan Senior |
$732.40
|
| Rate for Payer: Galaxy Health WC |
$1,556.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,098.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,647.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,162.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,080.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$366.20
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: Networks By Design Commercial |
$1,190.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,556.35
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
OP
|
$1,831.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$366.20
|
| 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 |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,464.80
|
| Rate for Payer: Cigna of CA HMO |
$1,171.84
|
| Rate for Payer: Cigna of CA PPO |
$1,354.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,281.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,556.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,098.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,647.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,162.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$393.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$366.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,190.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,556.35
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,098.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$915.50
|
| Rate for Payer: United Healthcare All Other HMO |
$915.50
|
| Rate for Payer: United Healthcare HMO Rider |
$915.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$915.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
IP
|
$1,831.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$366.20 |
| Max. Negotiated Rate |
$1,647.90 |
| Rate for Payer: Adventist Health Commercial |
$366.20
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,464.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,281.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.40
|
| Rate for Payer: EPIC Health Plan Senior |
$732.40
|
| Rate for Payer: Galaxy Health WC |
$1,556.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,098.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,647.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,162.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,080.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$366.20
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: Networks By Design Commercial |
$1,190.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,556.35
|
|
|
HC CL TREAT DIST FIB FRAC W/O MAN
|
Facility
|
IP
|
$2,604.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
900501092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$520.80 |
| Max. Negotiated Rate |
$2,343.60 |
| Rate for Payer: Adventist Health Commercial |
$520.80
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,083.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,822.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,041.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,041.60
|
| Rate for Payer: Galaxy Health WC |
$2,213.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,562.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,343.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,653.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,536.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.80
|
| Rate for Payer: Multiplan Commercial |
$1,953.00
|
| Rate for Payer: Networks By Design Commercial |
$1,692.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,213.40
|
|
|
HC CL TREAT DIST FIB FRAC W/O MAN
|
Facility
|
OP
|
$2,604.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
900501092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$520.80
|
| 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 |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,083.20
|
| Rate for Payer: Cigna of CA HMO |
$1,666.56
|
| Rate for Payer: Cigna of CA PPO |
$1,926.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,822.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,213.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,562.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,343.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,653.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,953.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,692.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,213.40
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,562.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,302.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,302.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,302.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,302.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT DIST FIB FX W/MANIP
|
Facility
|
OP
|
$3,438.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,409.58
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,174.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,750.40
|
| Rate for Payer: Cigna of CA HMO |
$2,200.32
|
| Rate for Payer: Cigna of CA PPO |
$2,544.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,406.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,922.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,094.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,183.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$419.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,578.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$2,234.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,922.30
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,062.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,062.80
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT DIST FIB FX W/MANIP
|
Facility
|
IP
|
$3,438.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$3,094.20 |
| Rate for Payer: Adventist Health Commercial |
$687.60
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,750.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,406.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,375.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,375.20
|
| Rate for Payer: Galaxy Health WC |
$2,922.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,094.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,183.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,028.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.60
|
| Rate for Payer: Multiplan Commercial |
$2,578.50
|
| Rate for Payer: Networks By Design Commercial |
$2,234.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,922.30
|
|
|
HC CL TREAT DIST FIB FX W/MANIP
|
Facility
|
OP
|
$3,438.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$687.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,750.40
|
| Rate for Payer: Cigna of CA HMO |
$2,200.32
|
| Rate for Payer: Cigna of CA PPO |
$2,544.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,406.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,922.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,094.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,183.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$419.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,578.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$2,234.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,922.30
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,062.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,719.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,719.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,719.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,719.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT DIST FIB FX W/MANIP
|
Facility
|
IP
|
$3,438.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$687.60 |
| Max. Negotiated Rate |
$3,094.20 |
| Rate for Payer: Adventist Health Commercial |
$687.60
|
| Rate for Payer: Cash Price |
$1,547.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,750.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,406.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,375.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,375.20
|
| Rate for Payer: Galaxy Health WC |
$2,922.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,094.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,183.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,028.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$687.60
|
| Rate for Payer: Multiplan Commercial |
$2,578.50
|
| Rate for Payer: Networks By Design Commercial |
$2,234.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,922.30
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
OP
|
$3,325.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$243.33 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,363.25
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,508.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,660.00
|
| Rate for Payer: Cigna of CA HMO |
$2,128.00
|
| Rate for Payer: Cigna of CA PPO |
$2,460.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,327.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,826.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,995.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,992.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,111.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$243.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$665.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,493.75
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$2,161.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,826.25
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,995.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,995.00
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
OP
|
$3,325.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$243.33 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$665.00
|
| 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 |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,660.00
|
| Rate for Payer: Cigna of CA HMO |
$2,128.00
|
| Rate for Payer: Cigna of CA PPO |
$2,460.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,327.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,826.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,995.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,992.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,111.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$243.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$665.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,493.75
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$2,161.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,826.25
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,995.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,662.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,662.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,662.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,662.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
IP
|
$3,325.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$665.00 |
| Max. Negotiated Rate |
$2,992.50 |
| Rate for Payer: Adventist Health Commercial |
$665.00
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,660.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,327.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,330.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,330.00
|
| Rate for Payer: Galaxy Health WC |
$2,826.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,995.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,992.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,111.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,961.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$665.00
|
| Rate for Payer: Multiplan Commercial |
$2,493.75
|
| Rate for Payer: Networks By Design Commercial |
$2,161.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,826.25
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
IP
|
$3,325.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$665.00 |
| Max. Negotiated Rate |
$2,992.50 |
| Rate for Payer: Adventist Health Commercial |
$665.00
|
| Rate for Payer: Cash Price |
$1,496.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,660.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,327.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,330.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,330.00
|
| Rate for Payer: Galaxy Health WC |
$2,826.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,995.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,992.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,111.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,961.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$665.00
|
| Rate for Payer: Multiplan Commercial |
$2,493.75
|
| Rate for Payer: Networks By Design Commercial |
$2,161.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,826.25
|
|
|
HC CL TREAT DIST PHAL FX W/O MANI
|
Facility
|
IP
|
$2,683.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
900501362
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$536.60 |
| Max. Negotiated Rate |
$2,414.70 |
| Rate for Payer: Adventist Health Commercial |
$536.60
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,146.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,878.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,073.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,073.20
|
| Rate for Payer: Galaxy Health WC |
$2,280.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,609.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,414.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,703.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,582.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$536.60
|
| Rate for Payer: Multiplan Commercial |
$2,012.25
|
| Rate for Payer: Networks By Design Commercial |
$1,743.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,280.55
|
|
|
HC CL TREAT DIST PHAL FX W/O MANI
|
Facility
|
OP
|
$2,683.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
900501362
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$155.51 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$536.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Cash Price |
$1,207.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,146.40
|
| Rate for Payer: Cigna of CA HMO |
$1,717.12
|
| Rate for Payer: Cigna of CA PPO |
$1,985.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,878.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,280.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,609.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,414.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,703.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$155.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$536.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,012.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,743.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,280.55
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,609.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,341.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,341.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,341.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,341.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
IP
|
$2,968.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$593.60 |
| Max. Negotiated Rate |
$2,671.20 |
| Rate for Payer: Adventist Health Commercial |
$593.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,374.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,187.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,187.20
|
| Rate for Payer: Galaxy Health WC |
$2,522.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,780.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,671.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,884.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,751.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$593.60
|
| Rate for Payer: Multiplan Commercial |
$2,226.00
|
| Rate for Payer: Networks By Design Commercial |
$1,929.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,522.80
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
OP
|
$2,968.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,216.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,814.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,374.40
|
| Rate for Payer: Cigna of CA HMO |
$1,899.52
|
| Rate for Payer: Cigna of CA PPO |
$2,196.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,522.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,780.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,671.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,884.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$593.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,226.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,929.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,522.80
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,780.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,780.80
|
| 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 |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
OP
|
$2,968.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$593.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,374.40
|
| Rate for Payer: Cigna of CA HMO |
$1,899.52
|
| Rate for Payer: Cigna of CA PPO |
$2,196.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,522.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,780.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,671.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,884.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$593.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,226.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,929.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,522.80
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,780.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,484.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,484.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,484.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,484.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
IP
|
$2,968.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$593.60 |
| Max. Negotiated Rate |
$2,671.20 |
| Rate for Payer: Adventist Health Commercial |
$593.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,374.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,187.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,187.20
|
| Rate for Payer: Galaxy Health WC |
$2,522.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,780.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,671.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,884.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,751.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$593.60
|
| Rate for Payer: Multiplan Commercial |
$2,226.00
|
| Rate for Payer: Networks By Design Commercial |
$1,929.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,522.80
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$176.85 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,647.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,507.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,215.20
|
| Rate for Payer: Cigna of CA HMO |
$2,572.16
|
| Rate for Payer: Cigna of CA PPO |
$2,974.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,813.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| Rate for Payer: Galaxy Health WC |
$3,416.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,411.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,617.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,552.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$176.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$803.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$3,014.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$2,612.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$3,416.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,192.24
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,274.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,411.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,411.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.85 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$803.80
|
| 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 |
$3,102.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,068.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,215.20
|
| Rate for Payer: Cigna of CA HMO |
$2,572.16
|
| Rate for Payer: Cigna of CA PPO |
$2,974.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,813.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,412.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2,274.97
|
| Rate for Payer: Galaxy Health WC |
$3,416.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,411.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,617.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,391.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,552.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$176.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$803.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$3,014.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$2,612.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,068.15
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$3,416.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,192.24
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,274.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,411.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,009.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,009.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,009.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,009.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,068.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,274.97
|
| Rate for Payer: Vantage Medical Group Senior |
$2,068.15
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$803.80 |
| Max. Negotiated Rate |
$3,617.10 |
| Rate for Payer: Adventist Health Commercial |
$803.80
|
| Rate for Payer: Cash Price |
$1,808.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,215.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,813.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,607.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,607.60
|
| Rate for Payer: Galaxy Health WC |
$3,416.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,411.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,617.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,552.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,371.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$803.80
|
| Rate for Payer: Multiplan Commercial |
$3,014.25
|
| Rate for Payer: Networks By Design Commercial |
$2,612.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,416.15
|
|
