|
HC CL TREAT SCAPULAR FX, W/O MANI
|
Facility
|
IP
|
$2,604.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
900501452
|
|
Hospital Revenue Code
|
456
|
| 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 SC/TC HMRL FX W/MANIP
|
Facility
|
IP
|
$5,026.00
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
900501229
|
|
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 SC/TC HMRL FX W/MANIP
|
Facility
|
OP
|
$5,026.00
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
900501229
|
|
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 |
$3,192.16
|
| 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 SC/TC HMRL FX W/MANIP
|
Facility
|
IP
|
$5,026.00
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
900501229
|
|
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 SC/TC HMRL FX W/MANIP
|
Facility
|
OP
|
$5,026.00
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
900501229
|
|
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 SHLDR DISLOC W/ANES
|
Facility
|
OP
|
$9,903.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Adventist Health Commercial |
$4,060.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,193.08
|
| 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 |
$4,456.35
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: Cigna of CA HMO |
$6,337.92
|
| Rate for Payer: Cigna of CA PPO |
$7,328.22
|
| 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 |
$6,932.10
|
| 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 |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| 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 |
$6,288.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$7,427.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| 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 |
$8,417.55
|
| 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 |
$5,941.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,941.80
|
| 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 |
$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 SHLDR DISLOC W/ANES
|
Facility
|
IP
|
$9,903.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,980.60 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Adventist Health Commercial |
$1,980.60
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,932.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,961.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,961.20
|
| Rate for Payer: Galaxy Health WC |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,288.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,842.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| Rate for Payer: Multiplan Commercial |
$7,427.25
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,417.55
|
|
|
HC CL TREAT SHLDR DISLOC W/ANES
|
Facility
|
OP
|
$9,903.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Adventist Health Commercial |
$1,980.60
|
| 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 |
$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 |
$4,456.35
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: Cigna of CA HMO |
$6,337.92
|
| Rate for Payer: Cigna of CA PPO |
$7,328.22
|
| 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 |
$6,932.10
|
| 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 |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| 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 |
$6,288.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$7,427.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| 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 |
$8,417.55
|
| 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 |
$5,941.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,951.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,951.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,951.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,951.50
|
| 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 SHLDR DISLOC W/ANES
|
Facility
|
IP
|
$9,903.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,980.60 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Adventist Health Commercial |
$1,980.60
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,932.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,961.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,961.20
|
| Rate for Payer: Galaxy Health WC |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,288.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,842.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| Rate for Payer: Multiplan Commercial |
$7,427.25
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,417.55
|
|
|
HC CL TREAT SHLDR DISLO/FX W/MANI
|
Facility
|
IP
|
$5,026.00
|
|
|
Service Code
|
CPT 23665
|
| Hospital Charge Code |
900501501
|
|
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 SHLDR DISLO/FX W/MANI
|
Facility
|
OP
|
$5,026.00
|
|
|
Service Code
|
CPT 23665
|
| Hospital Charge Code |
900501501
|
|
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 SHOULDER DISLOC W/MAN
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
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 SHOULDER DISLOC W/MAN
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,587.00 |
| 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 |
$2,801.68
|
| 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 |
$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 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 SHOULDER DISLOC W/MAN
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
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 SHOULDER DISLOC W/MAN
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,587.00 |
| 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 |
$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 |
$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 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 TA ANKLE FX W/O MANIP
|
Facility
|
OP
|
$2,656.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
900501560
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| 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 |
$1,195.20
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: Cigna of CA HMO |
$1,699.84
|
| Rate for Payer: Cigna of CA PPO |
$1,965.44
|
| 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 |
$1,859.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| 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 |
$1,686.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$347.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| 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 |
$2,257.60
|
| 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 |
$1,593.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,328.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,328.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,328.00
|
| 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 TA ANKLE FX W/O MANIP
|
Facility
|
IP
|
$2,656.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
900501560
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$531.20 |
| Max. Negotiated Rate |
$2,390.40 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| Rate for Payer: Cash Price |
$1,195.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,859.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,062.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,062.40
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,686.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,567.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
|
|
HC CL TREAT TALUS FRAC,W/MANIP
|
Facility
|
OP
|
$8,120.00
|
|
|
Service Code
|
CPT 28435
|
| Hospital Charge Code |
900501235
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$343.79 |
| Max. Negotiated Rate |
$7,308.00 |
| Rate for Payer: Adventist Health Commercial |
$1,624.00
|
| 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 |
$3,654.00
|
| Rate for Payer: Cash Price |
$3,654.00
|
| Rate for Payer: Cash Price |
$3,654.00
|
| Rate for Payer: Cash Price |
$3,654.00
|
| Rate for Payer: Central Health Plan Commercial |
$6,496.00
|
| Rate for Payer: Cigna of CA HMO |
$5,196.80
|
| Rate for Payer: Cigna of CA PPO |
$6,008.80
|
| 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 |
$5,684.00
|
| 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 |
$6,902.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,872.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,308.00
|
| 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 |
$5,156.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$343.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,624.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$6,090.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,278.00
|
| 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 |
$6,902.00
|
| 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 |
$4,872.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,060.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,060.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,060.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,060.00
|
| 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 TALUS FRAC,W/MANIP
|
Facility
|
IP
|
$8,120.00
|
|
|
Service Code
|
CPT 28435
|
| Hospital Charge Code |
900501235
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,624.00 |
| Max. Negotiated Rate |
$7,308.00 |
| Rate for Payer: Adventist Health Commercial |
$1,624.00
|
| Rate for Payer: Cash Price |
$3,654.00
|
| Rate for Payer: Central Health Plan Commercial |
$6,496.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,684.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,248.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,248.00
|
| Rate for Payer: Galaxy Health WC |
$6,902.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,872.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,308.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,156.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,790.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,624.00
|
| Rate for Payer: Multiplan Commercial |
$6,090.00
|
| Rate for Payer: Networks By Design Commercial |
$5,278.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,902.00
|
|
|
HC CL TREAT TALUS FX, W/O MANIPUL
|
Facility
|
OP
|
$2,354.00
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
900501475
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$470.80
|
| 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 |
$1,059.30
|
| Rate for Payer: Cash Price |
$1,059.30
|
| Rate for Payer: Cash Price |
$1,059.30
|
| Rate for Payer: Cash Price |
$1,059.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,883.20
|
| Rate for Payer: Cigna of CA HMO |
$1,506.56
|
| Rate for Payer: Cigna of CA PPO |
$1,741.96
|
| 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 |
$1,647.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,000.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,412.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,118.60
|
| 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 |
$1,494.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$544.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,765.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,530.10
|
| 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 |
$2,000.90
|
| 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 |
$1,412.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,177.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,177.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,177.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,177.00
|
| 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 TALUS FX, W/O MANIPUL
|
Facility
|
IP
|
$2,354.00
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
900501475
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$470.80 |
| Max. Negotiated Rate |
$2,118.60 |
| Rate for Payer: Adventist Health Commercial |
$470.80
|
| Rate for Payer: Cash Price |
$1,059.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,883.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,647.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$941.60
|
| Rate for Payer: EPIC Health Plan Senior |
$941.60
|
| Rate for Payer: Galaxy Health WC |
$2,000.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,412.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,118.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,494.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,388.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.80
|
| Rate for Payer: Multiplan Commercial |
$1,765.50
|
| Rate for Payer: Networks By Design Commercial |
$1,530.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,000.90
|
|
|
HC CL TREAT THIGH FX
|
Facility
|
IP
|
$6,462.00
|
|
|
Service Code
|
CPT 27238
|
| Hospital Charge Code |
900501436
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,292.40 |
| Max. Negotiated Rate |
$5,815.80 |
| Rate for Payer: Adventist Health Commercial |
$1,292.40
|
| Rate for Payer: Cash Price |
$2,907.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,169.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,523.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,584.80
|
| Rate for Payer: Galaxy Health WC |
$5,492.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,815.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,103.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,812.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,292.40
|
| Rate for Payer: Multiplan Commercial |
$4,846.50
|
| Rate for Payer: Networks By Design Commercial |
$4,200.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,492.70
|
|
|
HC CL TREAT THIGH FX
|
Facility
|
OP
|
$6,462.00
|
|
|
Service Code
|
CPT 27238
|
| Hospital Charge Code |
900501436
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,815.80 |
| Rate for Payer: Adventist Health Commercial |
$1,292.40
|
| 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 |
$2,907.90
|
| Rate for Payer: Cash Price |
$2,907.90
|
| Rate for Payer: Cash Price |
$2,907.90
|
| Rate for Payer: Cash Price |
$2,907.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,169.60
|
| Rate for Payer: Cigna of CA HMO |
$4,135.68
|
| Rate for Payer: Cigna of CA PPO |
$4,781.88
|
| 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 |
$4,523.40
|
| 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 |
$5,492.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,815.80
|
| 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 |
$4,103.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$465.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,292.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$4,846.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$4,200.30
|
| 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 |
$5,492.70
|
| 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 |
$3,877.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,231.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,231.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,231.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,231.00
|
| 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 THIGH FX W/MANIP
|
Facility
|
OP
|
$6,031.00
|
|
|
Service Code
|
CPT 27517
|
| Hospital Charge Code |
900501685
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,206.20
|
| 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 |
$2,713.95
|
| Rate for Payer: Cash Price |
$2,713.95
|
| Rate for Payer: Cash Price |
$2,713.95
|
| Rate for Payer: Cash Price |
$2,713.95
|
| Rate for Payer: Central Health Plan Commercial |
$4,824.80
|
| Rate for Payer: Cigna of CA HMO |
$3,859.84
|
| Rate for Payer: Cigna of CA PPO |
$4,462.94
|
| 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 |
$4,221.70
|
| 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 |
$5,126.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,618.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,427.90
|
| 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 |
$3,829.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,206.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$4,523.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,920.15
|
| 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 |
$5,126.35
|
| 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 |
$3,618.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,015.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,015.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,015.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,015.50
|
| 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 THIGH FX W/MANIP
|
Facility
|
IP
|
$6,031.00
|
|
|
Service Code
|
CPT 27517
|
| Hospital Charge Code |
900501685
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,206.20 |
| Max. Negotiated Rate |
$5,427.90 |
| Rate for Payer: Adventist Health Commercial |
$1,206.20
|
| Rate for Payer: Cash Price |
$2,713.95
|
| Rate for Payer: Central Health Plan Commercial |
$4,824.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,221.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,412.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,412.40
|
| Rate for Payer: Galaxy Health WC |
$5,126.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,618.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,427.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,829.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,558.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,206.20
|
| Rate for Payer: Multiplan Commercial |
$4,523.25
|
| Rate for Payer: Networks By Design Commercial |
$3,920.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,126.35
|
|
