|
HC CL TREAT HUMERAL FX W/MANIPULA
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 24565
|
| Hospital Charge Code |
900501497
|
|
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 |
$2,210.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,215.20
|
| 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 Permanente of CA Commercial/Self Funded |
$2,680.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,531.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,487.76
|
| 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 HUMERAL SHAFT FX W/O
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
900501520
|
|
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 |
$1,169.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| 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 Permanente of CA Commercial/Self Funded |
$1,418.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$810.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,315.99
|
| 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 HUMERAL SHAFT FX W/O
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 24500
|
| Hospital Charge Code |
900501520
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$2,901.00 |
| 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 |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,169.30
|
| Rate for Payer: Cash Price |
$1,169.30
|
| Rate for Payer: Cash Price |
$1,169.30
|
| Rate for Payer: Cash Price |
$1,169.30
|
| 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 |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| 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 |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: InnovAge PACE Commercial |
$457.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,418.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$336.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| 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 |
$304.79
|
| 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 |
$323.08
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$335.27
|
| 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 |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT HUMERUS FX W/MANIPULA
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 24577
|
| Hospital Charge Code |
900501365
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$3,617.10 |
| 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 |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$2,210.45
|
| Rate for Payer: Cash Price |
$2,210.45
|
| Rate for Payer: Cash Price |
$2,210.45
|
| Rate for Payer: Cash Price |
$2,210.45
|
| 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 |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| 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 |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: InnovAge PACE Commercial |
$3,050.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,680.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$511.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$803.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,724.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| 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 |
$2,033.48
|
| 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 |
$2,155.49
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,236.83
|
| 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 |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT HUMERUS FX W/MANIPULA
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 24577
|
| Hospital Charge Code |
900501365
|
|
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 |
$2,210.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,215.20
|
| 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 Permanente of CA Commercial/Self Funded |
$2,680.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,531.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,487.76
|
| 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 HUMERUS FX W/O MANIPU
|
Facility
|
OP
|
$1,973.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
900501566
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.29 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$394.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,085.15
|
| Rate for Payer: Cash Price |
$1,085.15
|
| Rate for Payer: Cash Price |
$1,085.15
|
| Rate for Payer: Cash Price |
$1,085.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,578.40
|
| Rate for Payer: Cigna of CA HMO |
$1,262.72
|
| Rate for Payer: Cigna of CA PPO |
$1,460.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$1,677.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,775.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: InnovAge PACE Commercial |
$457.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,315.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,479.75
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,282.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.79
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,677.05
|
| Rate for Payer: Prime Health Services Medicare |
$323.08
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$335.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,183.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$986.50
|
| Rate for Payer: United Healthcare All Other HMO |
$986.50
|
| Rate for Payer: United Healthcare HMO Rider |
$986.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$986.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT HUMERUS FX W/O MANIPU
|
Facility
|
IP
|
$1,973.00
|
|
|
Service Code
|
CPT 24576
|
| Hospital Charge Code |
900501566
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$394.60 |
| Max. Negotiated Rate |
$1,775.70 |
| Rate for Payer: Adventist Health Commercial |
$394.60
|
| Rate for Payer: Cash Price |
$1,085.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,578.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$789.20
|
| Rate for Payer: EPIC Health Plan Senior |
$789.20
|
| Rate for Payer: Galaxy Health WC |
$1,677.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,775.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,315.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$751.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,221.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.60
|
| Rate for Payer: Multiplan Commercial |
$1,479.75
|
| Rate for Payer: Networks By Design Commercial |
$1,282.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,677.05
|
|
|
HC CL TREAT INTPHAL JOINT SIN W/A
|
Facility
|
OP
|
$8,219.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
900501080
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$337.45 |
| Max. Negotiated Rate |
$7,397.10 |
| Rate for Payer: Adventist Health Commercial |
$3,369.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,991.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$537.66
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,575.20
|
| Rate for Payer: Cigna of CA HMO |
$5,260.16
|
| Rate for Payer: Cigna of CA PPO |
$6,082.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$6,986.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,931.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,397.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,482.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,643.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$6,164.25
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$5,342.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$6,986.15
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,931.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,931.40
|
| 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 |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
HC CL TREAT INTPHAL JOINT SIN W/A
|
Facility
|
IP
|
$8,219.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
900501080
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,643.80 |
| Max. Negotiated Rate |
$7,397.10 |
| Rate for Payer: Adventist Health Commercial |
$1,643.80
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,575.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,287.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,287.60
|
| Rate for Payer: Galaxy Health WC |
$6,986.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,931.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,397.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,482.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,131.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,087.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,643.80
|
| Rate for Payer: Multiplan Commercial |
$6,164.25
|
| Rate for Payer: Networks By Design Commercial |
$5,342.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,986.15
|
|
|
HC CL TREAT INTPHAL JOINT SIN W/A
|
Facility
|
OP
|
$8,219.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
900501080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$337.45 |
| Max. Negotiated Rate |
$7,397.10 |
| Rate for Payer: Adventist Health Commercial |
$1,643.80
|
| 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 |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$537.66
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,575.20
|
| Rate for Payer: Cigna of CA HMO |
$5,260.16
|
| Rate for Payer: Cigna of CA PPO |
$6,082.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$6,986.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,931.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,397.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,482.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,643.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$6,164.25
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$5,342.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$6,986.15
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,931.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,109.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,109.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,109.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,109.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
HC CL TREAT INTPHAL JOINT SIN W/A
|
Facility
|
IP
|
$8,219.00
|
|
|
Service Code
|
CPT 26775
|
| Hospital Charge Code |
900501080
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,643.80 |
| Max. Negotiated Rate |
$7,397.10 |
| Rate for Payer: Adventist Health Commercial |
$1,643.80
|
| Rate for Payer: Cash Price |
$4,520.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,575.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,287.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,287.60
|
| Rate for Payer: Galaxy Health WC |
$6,986.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,931.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,397.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,482.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,131.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,087.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,643.80
|
| Rate for Payer: Multiplan Commercial |
$6,164.25
|
| Rate for Payer: Networks By Design Commercial |
$5,342.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,986.15
|
|
|
HC CL TREAT KNEE FRACTURES
|
Facility
|
OP
|
$2,240.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
900501533
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$172.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$448.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,792.00
|
| Rate for Payer: Cigna of CA HMO |
$1,433.60
|
| Rate for Payer: Cigna of CA PPO |
$1,657.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$1,904.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,344.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,016.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: InnovAge PACE Commercial |
$457.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,494.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,680.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,456.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.79
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,904.00
|
| Rate for Payer: Prime Health Services Medicare |
$323.08
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$335.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,344.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,120.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,120.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,120.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,120.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT KNEE FRACTURES
|
Facility
|
IP
|
$2,240.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
900501533
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$448.00 |
| Max. Negotiated Rate |
$2,016.00 |
| Rate for Payer: Adventist Health Commercial |
$448.00
|
| Rate for Payer: Cash Price |
$1,232.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,792.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$896.00
|
| Rate for Payer: EPIC Health Plan Senior |
$896.00
|
| Rate for Payer: Galaxy Health WC |
$1,904.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,344.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,016.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,494.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$853.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,386.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.00
|
| Rate for Payer: Multiplan Commercial |
$1,680.00
|
| Rate for Payer: Networks By Design Commercial |
$1,456.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,904.00
|
|
|
HC CL TREAT LUNATE DISLOCA W/MANI
|
Facility
|
OP
|
$6,000.00
|
|
|
Service Code
|
CPT 25690
|
| Hospital Charge Code |
900501383
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,200.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,800.00
|
| Rate for Payer: Cigna of CA HMO |
$3,840.00
|
| Rate for Payer: Cigna of CA PPO |
$4,440.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$5,100.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,600.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,400.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: InnovAge PACE Commercial |
$3,050.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,002.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$440.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,200.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,724.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$4,500.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,900.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$5,100.00
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,236.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,600.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,000.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,000.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT LUNATE DISLOCA W/MANI
|
Facility
|
IP
|
$6,000.00
|
|
|
Service Code
|
CPT 25690
|
| Hospital Charge Code |
900501383
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,200.00 |
| Max. Negotiated Rate |
$5,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,200.00
|
| Rate for Payer: Cash Price |
$3,300.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,800.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,400.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,400.00
|
| Rate for Payer: Galaxy Health WC |
$5,100.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,600.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,400.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,002.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,286.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,714.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,200.00
|
| Rate for Payer: Multiplan Commercial |
$4,500.00
|
| Rate for Payer: Networks By Design Commercial |
$3,900.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,100.00
|
|
|
HC CL TREAT MANDIBULAR FX
|
Facility
|
OP
|
$20,807.00
|
|
|
Service Code
|
CPT 21453
|
| Hospital Charge Code |
900501369
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$18,726.30 |
| Rate for Payer: Adventist Health Commercial |
$4,161.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,268.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,516.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,976.10
|
| Rate for Payer: Cash Price |
$11,443.85
|
| Rate for Payer: Cash Price |
$11,443.85
|
| Rate for Payer: Cash Price |
$11,443.85
|
| Rate for Payer: Cash Price |
$11,443.85
|
| Rate for Payer: Central Health Plan Commercial |
$16,645.60
|
| Rate for Payer: Cigna of CA HMO |
$13,316.48
|
| Rate for Payer: Cigna of CA PPO |
$15,397.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,268.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,516.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,147.19
|
| Rate for Payer: EPIC Health Plan Senior |
$7,516.44
|
| Rate for Payer: Galaxy Health WC |
$17,685.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,484.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,726.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,326.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,516.44
|
| Rate for Payer: InnovAge PACE Commercial |
$11,274.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,878.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$640.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,516.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,161.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,072.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,072.03
|
| Rate for Payer: Multiplan Commercial |
$15,605.25
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: Networks By Design Commercial |
$13,524.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,516.44
|
| Rate for Payer: Preferred Health Network WC |
$12,220.51
|
| Rate for Payer: Prime Health Services Commercial |
$17,685.95
|
| Rate for Payer: Prime Health Services Medicare |
$7,967.43
|
| Rate for Payer: Prime Health Services WC |
$11,853.89
|
| Rate for Payer: Riverside University Health System MISP |
$8,268.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,484.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,403.50
|
| Rate for Payer: United Healthcare All Other HMO |
$10,403.50
|
| Rate for Payer: United Healthcare HMO Rider |
$10,403.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10,403.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,516.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,268.08
|
| Rate for Payer: Vantage Medical Group Senior |
$7,516.44
|
|
|
HC CL TREAT MANDIBULAR FX
|
Facility
|
IP
|
$20,807.00
|
|
|
Service Code
|
CPT 21453
|
| Hospital Charge Code |
900501369
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,161.40 |
| Max. Negotiated Rate |
$18,726.30 |
| Rate for Payer: Adventist Health Commercial |
$4,161.40
|
| Rate for Payer: Cash Price |
$11,443.85
|
| Rate for Payer: Central Health Plan Commercial |
$16,645.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,322.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,322.80
|
| Rate for Payer: Galaxy Health WC |
$17,685.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,484.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,726.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,878.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,927.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,879.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,161.40
|
| Rate for Payer: Multiplan Commercial |
$15,605.25
|
| Rate for Payer: Networks By Design Commercial |
$13,524.55
|
| Rate for Payer: Prime Health Services Commercial |
$17,685.95
|
|
|
HC CL TREAT MANDIBULAR FX W/MANIP
|
Facility
|
OP
|
$14,874.00
|
|
|
Service Code
|
CPT 21451
|
| Hospital Charge Code |
900501420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$13,386.60 |
| Rate for Payer: Adventist Health Commercial |
$2,974.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,882.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,998.82
|
| Rate for Payer: Cash Price |
$8,180.70
|
| Rate for Payer: Cash Price |
$8,180.70
|
| Rate for Payer: Cash Price |
$8,180.70
|
| Rate for Payer: Cash Price |
$8,180.70
|
| Rate for Payer: Central Health Plan Commercial |
$11,899.20
|
| Rate for Payer: Cigna of CA HMO |
$9,519.36
|
| Rate for Payer: Cigna of CA PPO |
$11,006.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,070.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,882.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.85
|
| Rate for Payer: EPIC Health Plan Senior |
$1,882.11
|
| Rate for Payer: Galaxy Health WC |
$12,642.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8,924.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,386.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,086.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,882.11
|
| Rate for Payer: InnovAge PACE Commercial |
$2,823.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,920.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$720.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,882.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,974.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,522.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,522.03
|
| Rate for Payer: Multiplan Commercial |
$11,155.50
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$9,668.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,882.11
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$12,642.90
|
| Rate for Payer: Prime Health Services Medicare |
$1,995.04
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,070.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,924.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,437.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,437.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,437.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,882.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,882.11
|
|
|
HC CL TREAT MANDIBULAR FX W/MANIP
|
Facility
|
IP
|
$14,874.00
|
|
|
Service Code
|
CPT 21451
|
| Hospital Charge Code |
900501420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,974.80 |
| Max. Negotiated Rate |
$13,386.60 |
| Rate for Payer: Adventist Health Commercial |
$2,974.80
|
| Rate for Payer: Cash Price |
$8,180.70
|
| Rate for Payer: Central Health Plan Commercial |
$11,899.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,949.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,949.60
|
| Rate for Payer: Galaxy Health WC |
$12,642.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8,924.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,386.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,920.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,666.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,207.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,974.80
|
| Rate for Payer: Multiplan Commercial |
$11,155.50
|
| Rate for Payer: Networks By Design Commercial |
$9,668.10
|
| Rate for Payer: Prime Health Services Commercial |
$12,642.90
|
|
|
HC CL TREAT MANDIBULAR RIDGE FRAC
|
Facility
|
OP
|
$11,769.00
|
|
|
Service Code
|
CPT 21440
|
| Hospital Charge Code |
900501330
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$252.53 |
| Max. Negotiated Rate |
$10,592.10 |
| Rate for Payer: Adventist Health Commercial |
$2,353.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Cash Price |
$6,472.95
|
| Rate for Payer: Cash Price |
$6,472.95
|
| Rate for Payer: Cash Price |
$6,472.95
|
| Rate for Payer: Cash Price |
$6,472.95
|
| Rate for Payer: Central Health Plan Commercial |
$9,415.20
|
| Rate for Payer: Cigna of CA HMO |
$7,532.16
|
| Rate for Payer: Cigna of CA PPO |
$8,709.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$10,003.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,061.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,592.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,849.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$252.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,353.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$8,826.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$7,649.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$10,003.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,061.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,884.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,884.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,884.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,884.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC CL TREAT MANDIBULAR RIDGE FRAC
|
Facility
|
IP
|
$11,769.00
|
|
|
Service Code
|
CPT 21440
|
| Hospital Charge Code |
900501330
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,353.80 |
| Max. Negotiated Rate |
$10,592.10 |
| Rate for Payer: Adventist Health Commercial |
$2,353.80
|
| Rate for Payer: Cash Price |
$6,472.95
|
| Rate for Payer: Central Health Plan Commercial |
$9,415.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,707.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,707.60
|
| Rate for Payer: Galaxy Health WC |
$10,003.65
|
| Rate for Payer: Global Benefits Group Commercial |
$7,061.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,592.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,849.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,483.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,285.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,353.80
|
| Rate for Payer: Multiplan Commercial |
$8,826.75
|
| Rate for Payer: Networks By Design Commercial |
$7,649.85
|
| Rate for Payer: Prime Health Services Commercial |
$10,003.65
|
|
|
HC CL TREAT MED MALL FX W/MANIPUL
|
Facility
|
IP
|
$8,050.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,610.00 |
| Max. Negotiated Rate |
$7,245.00 |
| Rate for Payer: Adventist Health Commercial |
$1,610.00
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,440.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,220.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,220.00
|
| Rate for Payer: Galaxy Health WC |
$6,842.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,830.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,245.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,369.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,067.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,982.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$6,037.50
|
| Rate for Payer: Networks By Design Commercial |
$5,232.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,842.50
|
|
|
HC CL TREAT MED MALL FX W/MANIPUL
|
Facility
|
OP
|
$8,050.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,245.00 |
| Rate for Payer: Adventist Health Commercial |
$3,300.50
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,440.00
|
| Rate for Payer: Cigna of CA HMO |
$5,152.00
|
| Rate for Payer: Cigna of CA PPO |
$5,957.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$6,842.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,830.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,245.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: InnovAge PACE Commercial |
$3,050.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,369.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$478.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,724.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$6,037.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,232.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$6,842.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,236.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,830.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,830.00
|
| 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 |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT MED MALL FX W/MANIPUL
|
Facility
|
IP
|
$8,050.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,610.00 |
| Max. Negotiated Rate |
$7,245.00 |
| Rate for Payer: Adventist Health Commercial |
$1,610.00
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,440.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,220.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,220.00
|
| Rate for Payer: Galaxy Health WC |
$6,842.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,830.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,245.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,369.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,067.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,982.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$6,037.50
|
| Rate for Payer: Networks By Design Commercial |
$5,232.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,842.50
|
|
|
HC CL TREAT MED MALL FX W/MANIPUL
|
Facility
|
OP
|
$8,050.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,245.00 |
| Rate for Payer: Adventist Health Commercial |
$1,610.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Cash Price |
$4,427.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,440.00
|
| Rate for Payer: Cigna of CA HMO |
$5,152.00
|
| Rate for Payer: Cigna of CA PPO |
$5,957.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,745.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,033.48
|
| Rate for Payer: Galaxy Health WC |
$6,842.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,830.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,245.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: InnovAge PACE Commercial |
$3,050.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,369.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$478.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,724.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,724.86
|
| Rate for Payer: Multiplan Commercial |
$6,037.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,232.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$6,842.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| Rate for Payer: Prime Health Services WC |
$3,206.94
|
| Rate for Payer: Riverside University Health System MISP |
$2,236.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,830.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,025.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,025.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,025.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,025.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
