|
HC CL TREAT THIGH FX W/O MANIPULA
|
Facility
|
IP
|
$1,240.00
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
900501448
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$248.00 |
| Max. Negotiated Rate |
$1,116.00 |
| Rate for Payer: Adventist Health Commercial |
$248.00
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Central Health Plan Commercial |
$992.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$868.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$496.00
|
| Rate for Payer: EPIC Health Plan Senior |
$496.00
|
| Rate for Payer: Galaxy Health WC |
$1,054.00
|
| Rate for Payer: Global Benefits Group Commercial |
$744.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,116.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$787.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.00
|
| Rate for Payer: Multiplan Commercial |
$930.00
|
| Rate for Payer: Networks By Design Commercial |
$806.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,054.00
|
|
|
HC CL TREAT THIGH FX W/O MANIPULA
|
Facility
|
OP
|
$1,240.00
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
900501448
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.51 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$248.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Cash Price |
$558.00
|
| Rate for Payer: Central Health Plan Commercial |
$992.00
|
| Rate for Payer: Cigna of CA HMO |
$793.60
|
| Rate for Payer: Cigna of CA PPO |
$917.60
|
| 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 |
$868.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,054.00
|
| Rate for Payer: Global Benefits Group Commercial |
$744.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,116.00
|
| 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 |
$787.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$136.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$930.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$806.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,054.00
|
| 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 |
$744.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$620.00
|
| Rate for Payer: United Healthcare All Other HMO |
$620.00
|
| Rate for Payer: United Healthcare HMO Rider |
$620.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$620.00
|
| 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 TIBIAL FX W/O MANIPUL
|
Facility
|
IP
|
$2,604.00
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
900501367
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$520.80 |
| Max. Negotiated Rate |
$2,343.60 |
| Rate for Payer: Adventist Health Commercial |
$520.80
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,083.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,822.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,041.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,041.60
|
| Rate for Payer: Galaxy Health WC |
$2,213.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,562.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,343.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,653.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,536.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.80
|
| Rate for Payer: Multiplan Commercial |
$1,953.00
|
| Rate for Payer: Networks By Design Commercial |
$1,692.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,213.40
|
|
|
HC CL TREAT TIBIAL FX W/O MANIPUL
|
Facility
|
OP
|
$2,604.00
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
900501367
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$520.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Cash Price |
$1,171.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,083.20
|
| Rate for Payer: Cigna of CA HMO |
$1,666.56
|
| Rate for Payer: Cigna of CA PPO |
$1,926.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,822.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,213.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,562.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,343.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,653.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,953.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,692.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,213.40
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,562.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,302.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,302.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,302.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,302.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT TIBIAL FX W/SKELETAL
|
Facility
|
OP
|
$8,791.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
900501554
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,911.90 |
| Rate for Payer: Adventist Health Commercial |
$1,758.20
|
| 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 |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$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 |
$6,568.63
|
| Rate for Payer: Cash Price |
$3,955.95
|
| Rate for Payer: Cash Price |
$3,955.95
|
| Rate for Payer: Cash Price |
$3,955.95
|
| Rate for Payer: Cash Price |
$3,955.95
|
| Rate for Payer: Central Health Plan Commercial |
$7,032.80
|
| Rate for Payer: Cigna of CA HMO |
$5,626.24
|
| Rate for Payer: Cigna of CA PPO |
$6,505.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,153.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$7,472.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,274.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,911.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,582.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$475.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,758.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$6,593.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$5,714.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$7,472.35
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,274.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,395.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,395.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,395.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,395.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC CL TREAT TIBIAL FX W/SKELETAL
|
Facility
|
IP
|
$8,791.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
900501554
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,758.20 |
| Max. Negotiated Rate |
$7,911.90 |
| Rate for Payer: Adventist Health Commercial |
$1,758.20
|
| Rate for Payer: Cash Price |
$3,955.95
|
| Rate for Payer: Central Health Plan Commercial |
$7,032.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,153.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,516.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,516.40
|
| Rate for Payer: Galaxy Health WC |
$7,472.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,274.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,911.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,582.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,186.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,758.20
|
| Rate for Payer: Multiplan Commercial |
$6,593.25
|
| Rate for Payer: Networks By Design Commercial |
$5,714.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,472.35
|
|
|
HC CL TREAT TIBIA SHAFT FX W/MAN
|
Facility
|
OP
|
$8,742.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
900501090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,867.80 |
| Rate for Payer: Adventist Health Commercial |
$1,748.40
|
| 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 |
$3,933.90
|
| Rate for Payer: Cash Price |
$3,933.90
|
| Rate for Payer: Cash Price |
$3,933.90
|
| Rate for Payer: Cash Price |
$3,933.90
|
| Rate for Payer: Central Health Plan Commercial |
$6,993.60
|
| Rate for Payer: Cigna of CA HMO |
$5,594.88
|
| Rate for Payer: Cigna of CA PPO |
$6,469.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,119.40
|
| 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 |
$7,430.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,245.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,867.80
|
| 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 |
$5,551.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,748.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$6,556.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,682.30
|
| 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 |
$7,430.70
|
| 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 |
$5,245.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,371.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,371.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,371.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,371.00
|
| 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 TIBIA SHAFT FX W/MAN
|
Facility
|
IP
|
$8,742.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
900501090
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,748.40 |
| Max. Negotiated Rate |
$7,867.80 |
| Rate for Payer: Adventist Health Commercial |
$1,748.40
|
| Rate for Payer: Cash Price |
$3,933.90
|
| Rate for Payer: Central Health Plan Commercial |
$6,993.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,119.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,496.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,496.80
|
| Rate for Payer: Galaxy Health WC |
$7,430.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,245.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,867.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,551.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,157.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,748.40
|
| Rate for Payer: Multiplan Commercial |
$6,556.50
|
| Rate for Payer: Networks By Design Commercial |
$5,682.30
|
| Rate for Payer: Prime Health Services Commercial |
$7,430.70
|
|
|
HC CL TREAT TIBIA SHAFT FX W/MAN
|
Facility
|
OP
|
$8,742.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
900501090
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,867.80 |
| Rate for Payer: Adventist Health Commercial |
$3,584.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,792.17
|
| 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 |
$3,933.90
|
| Rate for Payer: Cash Price |
$3,933.90
|
| Rate for Payer: Cash Price |
$3,933.90
|
| Rate for Payer: Cash Price |
$3,933.90
|
| Rate for Payer: Central Health Plan Commercial |
$6,993.60
|
| Rate for Payer: Cigna of CA HMO |
$5,594.88
|
| Rate for Payer: Cigna of CA PPO |
$6,469.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,102.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,274.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,068.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,119.40
|
| 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 |
$7,430.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,245.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,867.80
|
| 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 |
$5,551.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,748.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$6,556.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,682.30
|
| 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 |
$7,430.70
|
| 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 |
$5,245.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,245.20
|
| 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 |
$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 TIBIA SHAFT FX W/MAN
|
Facility
|
IP
|
$8,742.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
900501090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,748.40 |
| Max. Negotiated Rate |
$7,867.80 |
| Rate for Payer: Adventist Health Commercial |
$1,748.40
|
| Rate for Payer: Cash Price |
$3,933.90
|
| Rate for Payer: Central Health Plan Commercial |
$6,993.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,119.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,496.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,496.80
|
| Rate for Payer: Galaxy Health WC |
$7,430.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,245.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,867.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,551.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,157.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,748.40
|
| Rate for Payer: Multiplan Commercial |
$6,556.50
|
| Rate for Payer: Networks By Design Commercial |
$5,682.30
|
| Rate for Payer: Prime Health Services Commercial |
$7,430.70
|
|
|
HC CL TREAT TOE DSLOCATN W/O ANES
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
900501409
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC CL TREAT TOE DSLOCATN W/O ANES
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
900501409
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$871.66
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$611.05
|
| 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 |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| 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 |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| 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 |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| 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 |
$1,275.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT TOE DSLOCATN W/O ANES
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
900501409
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC CL TREAT TOE DSLOCATN W/O ANES
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
900501409
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.72 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| 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 |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| 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 |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| 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 |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| 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 |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,063.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,063.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,063.00
|
| 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 TOE FX WO MAN EA
|
Facility
|
OP
|
$2,203.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
900501489
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$99.69 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$440.60
|
| 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 |
$991.35
|
| Rate for Payer: Cash Price |
$991.35
|
| Rate for Payer: Cash Price |
$991.35
|
| Rate for Payer: Cash Price |
$991.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,762.40
|
| Rate for Payer: Cigna of CA HMO |
$1,409.92
|
| Rate for Payer: Cigna of CA PPO |
$1,630.22
|
| 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 |
$1,542.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,872.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,321.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,982.70
|
| 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 |
$1,398.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,652.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,431.95
|
| 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 |
$1,872.55
|
| 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 |
$1,321.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,101.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,101.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,101.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,101.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CL TREAT TOE FX WO MAN EA
|
Facility
|
IP
|
$2,203.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
900501489
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$440.60 |
| Max. Negotiated Rate |
$1,982.70 |
| Rate for Payer: Adventist Health Commercial |
$440.60
|
| Rate for Payer: Cash Price |
$991.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,762.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,542.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$881.20
|
| Rate for Payer: EPIC Health Plan Senior |
$881.20
|
| Rate for Payer: Galaxy Health WC |
$1,872.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,321.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,982.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,398.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,299.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.60
|
| Rate for Payer: Multiplan Commercial |
$1,652.25
|
| Rate for Payer: Networks By Design Commercial |
$1,431.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,872.55
|
|
|
HC CL TREAT TOE FX WO MAN EA
|
Facility
|
OP
|
$2,203.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
900501489
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$99.69 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$903.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$672.17
|
| 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 |
$991.35
|
| Rate for Payer: Cash Price |
$991.35
|
| Rate for Payer: Cash Price |
$991.35
|
| Rate for Payer: Cash Price |
$991.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,762.40
|
| Rate for Payer: Cigna of CA HMO |
$1,409.92
|
| Rate for Payer: Cigna of CA PPO |
$1,630.22
|
| 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 |
$1,542.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,872.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,321.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,982.70
|
| 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 |
$1,398.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,652.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,431.95
|
| 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 |
$1,872.55
|
| 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 |
$1,321.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,321.80
|
| 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 TOE FX WO MAN EA
|
Facility
|
IP
|
$2,203.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
900501489
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$440.60 |
| Max. Negotiated Rate |
$1,982.70 |
| Rate for Payer: Adventist Health Commercial |
$440.60
|
| Rate for Payer: Cash Price |
$991.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,762.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,542.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$881.20
|
| Rate for Payer: EPIC Health Plan Senior |
$881.20
|
| Rate for Payer: Galaxy Health WC |
$1,872.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,321.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,982.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,398.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,299.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.60
|
| Rate for Payer: Multiplan Commercial |
$1,652.25
|
| Rate for Payer: Networks By Design Commercial |
$1,431.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,872.55
|
|
|
HC CL TREAT TRIMALLOR FX W/MANIPU
|
Facility
|
IP
|
$5,790.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
900501094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,158.00 |
| Max. Negotiated Rate |
$5,211.00 |
| Rate for Payer: Adventist Health Commercial |
$1,158.00
|
| Rate for Payer: Cash Price |
$2,605.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,632.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,053.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,316.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,316.00
|
| Rate for Payer: Galaxy Health WC |
$4,921.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,474.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,211.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,676.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,416.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,158.00
|
| Rate for Payer: Multiplan Commercial |
$4,342.50
|
| Rate for Payer: Networks By Design Commercial |
$3,763.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,921.50
|
|
|
HC CL TREAT TRIMALLOR FX W/MANIPU
|
Facility
|
IP
|
$5,790.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
900501094
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,158.00 |
| Max. Negotiated Rate |
$5,211.00 |
| Rate for Payer: Adventist Health Commercial |
$1,158.00
|
| Rate for Payer: Cash Price |
$2,605.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,632.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,053.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,316.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,316.00
|
| Rate for Payer: Galaxy Health WC |
$4,921.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,474.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,211.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,676.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,416.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,158.00
|
| Rate for Payer: Multiplan Commercial |
$4,342.50
|
| Rate for Payer: Networks By Design Commercial |
$3,763.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,921.50
|
|
|
HC CL TREAT TRIMALLOR FX W/MANIPU
|
Facility
|
OP
|
$5,790.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
900501094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,158.00
|
| 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 |
$2,605.50
|
| Rate for Payer: Cash Price |
$2,605.50
|
| Rate for Payer: Cash Price |
$2,605.50
|
| Rate for Payer: Cash Price |
$2,605.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,632.00
|
| Rate for Payer: Cigna of CA HMO |
$3,705.60
|
| Rate for Payer: Cigna of CA PPO |
$4,284.60
|
| 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 |
$4,053.00
|
| 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 |
$4,921.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,474.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,211.00
|
| 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 |
$3,676.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,158.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$4,342.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,763.50
|
| 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 |
$4,921.50
|
| 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 |
$3,474.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,895.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,895.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,895.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,895.00
|
| 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 TRIMALLOR FX W/MANIPU
|
Facility
|
OP
|
$5,790.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
900501094
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$2,373.90
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,440.11
|
| 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 |
$2,605.50
|
| Rate for Payer: Cash Price |
$2,605.50
|
| Rate for Payer: Cash Price |
$2,605.50
|
| Rate for Payer: Cash Price |
$2,605.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,632.00
|
| Rate for Payer: Cigna of CA HMO |
$3,705.60
|
| Rate for Payer: Cigna of CA PPO |
$4,284.60
|
| 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 |
$4,053.00
|
| 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 |
$4,921.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,474.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,211.00
|
| 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 |
$3,676.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,223.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,158.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,771.32
|
| Rate for Payer: Multiplan Commercial |
$4,342.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,763.50
|
| 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 |
$4,921.50
|
| 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 |
$3,474.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,474.00
|
| 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 TROCHANTERIC FX WO MAN
|
Facility
|
OP
|
$1,314.00
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
900527246
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$262.80 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$262.80
|
| 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 |
$591.30
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,051.20
|
| Rate for Payer: Cigna of CA HMO |
$840.96
|
| Rate for Payer: Cigna of CA PPO |
$972.36
|
| 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 |
$919.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$1,116.90
|
| Rate for Payer: Global Benefits Group Commercial |
$788.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,182.60
|
| 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 |
$834.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$703.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$985.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$854.10
|
| 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 |
$1,116.90
|
| 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 |
$788.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$657.00
|
| Rate for Payer: United Healthcare All Other HMO |
$657.00
|
| Rate for Payer: United Healthcare HMO Rider |
$657.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$657.00
|
| 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 TROCHANTERIC FX WO MAN
|
Facility
|
IP
|
$1,314.00
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
900527246
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$262.80 |
| Max. Negotiated Rate |
$1,182.60 |
| Rate for Payer: Adventist Health Commercial |
$262.80
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,051.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$919.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$525.60
|
| Rate for Payer: EPIC Health Plan Senior |
$525.60
|
| Rate for Payer: Galaxy Health WC |
$1,116.90
|
| Rate for Payer: Global Benefits Group Commercial |
$788.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,182.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$834.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$775.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.80
|
| Rate for Payer: Multiplan Commercial |
$985.50
|
| Rate for Payer: Networks By Design Commercial |
$854.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,116.90
|
|
|
HC CL TREAT ULNAR FX,PROXIMAL END
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
900501467
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
