|
HC CL TREAT OF DIS RAD FX W/O MAN
|
Facility
|
OP
|
$2,943.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,206.63
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,473.37
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,354.40
|
| Rate for Payer: Cigna of CA HMO |
$1,883.52
|
| Rate for Payer: Cigna of CA PPO |
$2,177.82
|
| 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 |
$2,060.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,501.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,765.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,648.70
|
| 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 |
$1,868.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,207.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,912.95
|
| 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 |
$2,501.55
|
| 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 |
$1,765.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,765.80
|
| 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 OF DIS RAD FX W/O MAN
|
Facility
|
IP
|
$2,943.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$588.60 |
| Max. Negotiated Rate |
$2,648.70 |
| Rate for Payer: Adventist Health Commercial |
$588.60
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,354.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,060.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,177.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,177.20
|
| Rate for Payer: Galaxy Health WC |
$2,501.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,765.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,648.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,868.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,736.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.60
|
| Rate for Payer: Multiplan Commercial |
$2,207.25
|
| Rate for Payer: Networks By Design Commercial |
$1,912.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,501.55
|
|
|
HC CL TREAT OF DIS RAD FX W/O MAN
|
Facility
|
IP
|
$2,943.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$588.60 |
| Max. Negotiated Rate |
$2,648.70 |
| Rate for Payer: Adventist Health Commercial |
$588.60
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,354.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,060.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,177.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,177.20
|
| Rate for Payer: Galaxy Health WC |
$2,501.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,765.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,648.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,868.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,736.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.60
|
| Rate for Payer: Multiplan Commercial |
$2,207.25
|
| Rate for Payer: Networks By Design Commercial |
$1,912.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,501.55
|
|
|
HC CL TREAT OF ELB DISLOC W/ANEST
|
Facility
|
OP
|
$8,630.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$328.93 |
| Max. Negotiated Rate |
$7,767.00 |
| Rate for Payer: Adventist Health Commercial |
$3,538.30
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,611.11
|
| 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 |
$3,883.50
|
| Rate for Payer: Cash Price |
$3,883.50
|
| Rate for Payer: Cash Price |
$3,883.50
|
| Rate for Payer: Cash Price |
$3,883.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,904.00
|
| Rate for Payer: Cigna of CA HMO |
$5,523.20
|
| Rate for Payer: Cigna of CA PPO |
$6,386.20
|
| 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 |
$6,041.00
|
| 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 |
$7,335.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,178.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,767.00
|
| 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 |
$5,480.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$328.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,726.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$6,472.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,609.50
|
| 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 |
$7,335.50
|
| 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 |
$5,178.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,178.00
|
| 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 |
$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 OF ELB DISLOC W/ANEST
|
Facility
|
OP
|
$8,630.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$328.93 |
| Max. Negotiated Rate |
$7,767.00 |
| Rate for Payer: Adventist Health Commercial |
$1,726.00
|
| 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 |
$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 |
$3,883.50
|
| Rate for Payer: Cash Price |
$3,883.50
|
| Rate for Payer: Cash Price |
$3,883.50
|
| Rate for Payer: Cash Price |
$3,883.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,904.00
|
| Rate for Payer: Cigna of CA HMO |
$5,523.20
|
| Rate for Payer: Cigna of CA PPO |
$6,386.20
|
| 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 |
$6,041.00
|
| 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 |
$7,335.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,178.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,767.00
|
| 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 |
$5,480.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$328.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,726.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$6,472.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,609.50
|
| 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 |
$7,335.50
|
| 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 |
$5,178.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,315.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,315.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,315.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,315.00
|
| 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 OF ELB DISLOC W/ANEST
|
Facility
|
IP
|
$8,630.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,726.00 |
| Max. Negotiated Rate |
$7,767.00 |
| Rate for Payer: Adventist Health Commercial |
$1,726.00
|
| Rate for Payer: Cash Price |
$3,883.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,904.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,041.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,452.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,452.00
|
| Rate for Payer: Galaxy Health WC |
$7,335.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,178.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,767.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,480.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,091.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,726.00
|
| Rate for Payer: Multiplan Commercial |
$6,472.50
|
| Rate for Payer: Networks By Design Commercial |
$5,609.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,335.50
|
|
|
HC CL TREAT OF ELB DISLOC W/ANEST
|
Facility
|
IP
|
$8,630.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,726.00 |
| Max. Negotiated Rate |
$7,767.00 |
| Rate for Payer: Adventist Health Commercial |
$1,726.00
|
| Rate for Payer: Cash Price |
$3,883.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,904.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,041.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,452.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,452.00
|
| Rate for Payer: Galaxy Health WC |
$7,335.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,178.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,767.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,480.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,091.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,726.00
|
| Rate for Payer: Multiplan Commercial |
$6,472.50
|
| Rate for Payer: Networks By Design Commercial |
$5,609.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,335.50
|
|
|
HC CL TREAT OF ELBOW FRAC W/MANIP
|
Facility
|
IP
|
$6,633.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
900501359
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,326.60 |
| Max. Negotiated Rate |
$5,969.70 |
| Rate for Payer: Adventist Health Commercial |
$1,326.60
|
| Rate for Payer: Cash Price |
$2,984.85
|
| Rate for Payer: Central Health Plan Commercial |
$5,306.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,643.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,653.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,653.20
|
| Rate for Payer: Galaxy Health WC |
$5,638.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,969.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,211.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,913.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,326.60
|
| Rate for Payer: Multiplan Commercial |
$4,974.75
|
| Rate for Payer: Networks By Design Commercial |
$4,311.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,638.05
|
|
|
HC CL TREAT OF ELBOW FRAC W/MANIP
|
Facility
|
OP
|
$6,633.00
|
|
|
Service Code
|
CPT 24620
|
| Hospital Charge Code |
900501359
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,326.60
|
| 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 |
$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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$2,984.85
|
| Rate for Payer: Cash Price |
$2,984.85
|
| Rate for Payer: Cash Price |
$2,984.85
|
| Rate for Payer: Cash Price |
$2,984.85
|
| Rate for Payer: Central Health Plan Commercial |
$5,306.40
|
| Rate for Payer: Cigna of CA HMO |
$4,245.12
|
| Rate for Payer: Cigna of CA PPO |
$4,908.42
|
| 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 |
$4,643.10
|
| 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 |
$5,638.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,969.70
|
| 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 |
$4,211.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$435.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,326.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$4,974.75
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$4,311.45
|
| 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 |
$5,638.05
|
| 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 |
$3,979.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,316.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,316.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,316.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,316.50
|
| 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 OF FRAC OF PHAL W/MAN
|
Facility
|
OP
|
$2,712.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
900501099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$118.12 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$542.40
|
| 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 |
$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 |
$1,220.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,169.60
|
| Rate for Payer: Cigna of CA HMO |
$1,735.68
|
| Rate for Payer: Cigna of CA PPO |
$2,006.88
|
| 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 |
$1,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,305.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,627.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,440.80
|
| 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 |
$1,722.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$118.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,034.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,762.80
|
| 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 |
$2,305.20
|
| 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 |
$1,627.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,356.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,356.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,356.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,356.00
|
| 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 OF FRAC OF PHAL W/MAN
|
Facility
|
OP
|
$2,712.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
900501099
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$118.12 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,111.92
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$809.61
|
| 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 |
$1,220.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,169.60
|
| Rate for Payer: Cigna of CA HMO |
$1,735.68
|
| Rate for Payer: Cigna of CA PPO |
$2,006.88
|
| 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 |
$1,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,305.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,627.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,440.80
|
| 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 |
$1,722.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$118.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,034.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,762.80
|
| 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 |
$2,305.20
|
| 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 |
$1,627.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,627.20
|
| 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 OF FRAC OF PHAL W/MAN
|
Facility
|
IP
|
$2,712.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
900501099
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$542.40 |
| Max. Negotiated Rate |
$2,440.80 |
| Rate for Payer: Adventist Health Commercial |
$542.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,169.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,084.80
|
| Rate for Payer: Galaxy Health WC |
$2,305.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,627.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,440.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,722.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,600.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.40
|
| Rate for Payer: Multiplan Commercial |
$2,034.00
|
| Rate for Payer: Networks By Design Commercial |
$1,762.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,305.20
|
|
|
HC CL TREAT OF FRAC OF PHAL W/MAN
|
Facility
|
IP
|
$2,712.00
|
|
|
Service Code
|
CPT 28515
|
| Hospital Charge Code |
900501099
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$542.40 |
| Max. Negotiated Rate |
$2,440.80 |
| Rate for Payer: Adventist Health Commercial |
$542.40
|
| Rate for Payer: Cash Price |
$1,220.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,169.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,084.80
|
| Rate for Payer: Galaxy Health WC |
$2,305.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,627.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,440.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,722.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,600.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.40
|
| Rate for Payer: Multiplan Commercial |
$2,034.00
|
| Rate for Payer: Networks By Design Commercial |
$1,762.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,305.20
|
|
|
HC CL TREAT OF HEAD/NECK W/MANIPU
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
900501257
|
|
Hospital Revenue Code
|
456
|
| 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
|
|
|
HC CL TREAT OF HEAD/NECK W/MANIPU
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
900501257
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| 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 |
$2,214.50
|
| 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 |
$439.28
|
| 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 OF HEAD/NECK W/MANIPU
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
900501257
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| 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 |
$439.28
|
| 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 OF HEAD/NECK W/MANIPU
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 24655
|
| Hospital Charge Code |
900501257
|
|
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
|
|
|
HC CL TREAT OF HUM SHAFT FRAC
|
Facility
|
IP
|
$5,026.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
900501062
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,005.20 |
| Max. Negotiated Rate |
$4,523.40 |
| Rate for Payer: Adventist Health Commercial |
$1,005.20
|
| Rate for Payer: Cash Price |
$2,261.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,518.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,010.40
|
| Rate for Payer: Galaxy Health WC |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,191.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,965.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| Rate for Payer: Multiplan Commercial |
$3,769.50
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,272.10
|
|
|
HC CL TREAT OF HUM SHAFT FRAC
|
Facility
|
IP
|
$5,026.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
900501062
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,005.20 |
| Max. Negotiated Rate |
$4,523.40 |
| Rate for Payer: Adventist Health Commercial |
$1,005.20
|
| Rate for Payer: Cash Price |
$2,261.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,518.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,010.40
|
| Rate for Payer: Galaxy Health WC |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,191.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,965.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| Rate for Payer: Multiplan Commercial |
$3,769.50
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,272.10
|
|
|
HC CL TREAT OF HUM SHAFT FRAC
|
Facility
|
OP
|
$5,026.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
900501062
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,005.20
|
| 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 |
$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 |
$2,261.70
|
| Rate for Payer: Cash Price |
$2,261.70
|
| Rate for Payer: Cash Price |
$2,261.70
|
| Rate for Payer: Cash Price |
$2,261.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: Cigna of CA HMO |
$3,216.64
|
| Rate for Payer: Cigna of CA PPO |
$3,719.24
|
| 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 |
$3,518.20
|
| 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 |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| 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 |
$3,191.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$3,769.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| 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 |
$4,272.10
|
| 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 |
$3,015.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,513.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,513.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,513.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,513.00
|
| 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 OF HUM SHAFT FRAC
|
Facility
|
OP
|
$5,026.00
|
|
|
Service Code
|
CPT 24505
|
| Hospital Charge Code |
900501062
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$2,060.66
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,536.19
|
| 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 |
$2,261.70
|
| Rate for Payer: Cash Price |
$2,261.70
|
| Rate for Payer: Cash Price |
$2,261.70
|
| Rate for Payer: Cash Price |
$2,261.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: Cigna of CA HMO |
$3,216.64
|
| Rate for Payer: Cigna of CA PPO |
$3,719.24
|
| 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 |
$3,518.20
|
| 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 |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| 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 |
$3,191.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$3,769.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| 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 |
$4,272.10
|
| 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 |
$3,015.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,015.60
|
| 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 |
$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 OF INTPHAL JOINT SIN
|
Facility
|
OP
|
$2,943.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
900501079
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$236.97 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,206.63
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,364.58
|
| 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 |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,354.40
|
| Rate for Payer: Cigna of CA HMO |
$1,883.52
|
| Rate for Payer: Cigna of CA PPO |
$2,177.82
|
| 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 |
$2,060.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,501.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,765.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,648.70
|
| 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 |
$1,868.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,207.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,912.95
|
| 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 |
$2,501.55
|
| 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 |
$1,765.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,765.80
|
| 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 OF INTPHAL JOINT SIN
|
Facility
|
IP
|
$2,943.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
900501079
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$588.60 |
| Max. Negotiated Rate |
$2,648.70 |
| Rate for Payer: Adventist Health Commercial |
$588.60
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,354.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,060.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,177.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,177.20
|
| Rate for Payer: Galaxy Health WC |
$2,501.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,765.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,648.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,868.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,736.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.60
|
| Rate for Payer: Multiplan Commercial |
$2,207.25
|
| Rate for Payer: Networks By Design Commercial |
$1,912.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,501.55
|
|
|
HC CL TREAT OF INTPHAL JOINT SIN
|
Facility
|
IP
|
$2,943.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
900501079
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$588.60 |
| Max. Negotiated Rate |
$2,648.70 |
| Rate for Payer: Adventist Health Commercial |
$588.60
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,354.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,060.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,177.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,177.20
|
| Rate for Payer: Galaxy Health WC |
$2,501.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,765.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,648.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,868.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,736.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.60
|
| Rate for Payer: Multiplan Commercial |
$2,207.25
|
| Rate for Payer: Networks By Design Commercial |
$1,912.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,501.55
|
|
|
HC CL TREAT OF INTPHAL JOINT SIN
|
Facility
|
OP
|
$2,943.00
|
|
|
Service Code
|
CPT 26770
|
| Hospital Charge Code |
900501079
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$236.97 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$588.60
|
| 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 |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Cash Price |
$1,324.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,354.40
|
| Rate for Payer: Cigna of CA HMO |
$1,883.52
|
| Rate for Payer: Cigna of CA PPO |
$2,177.82
|
| 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 |
$2,060.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,501.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,765.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,648.70
|
| 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 |
$1,868.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$588.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$2,207.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,912.95
|
| 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 |
$2,501.55
|
| 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 |
$1,765.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,471.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,471.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,471.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,471.50
|
| 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
|
|
