|
HC CL TREAT RADIUS/ULNA FX,W/O MA
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 25560
|
| Hospital Charge Code |
900501390
|
|
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 RAD SHAFT FRX W/MANIP
|
Facility
|
IP
|
$4,256.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
900501067
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$851.20 |
| Max. Negotiated Rate |
$3,830.40 |
| Rate for Payer: Adventist Health Commercial |
$851.20
|
| Rate for Payer: Cash Price |
$2,340.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,404.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,702.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,702.40
|
| Rate for Payer: Galaxy Health WC |
$3,617.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,553.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,830.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,838.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,621.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,634.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$851.20
|
| Rate for Payer: Multiplan Commercial |
$3,192.00
|
| Rate for Payer: Networks By Design Commercial |
$2,766.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,617.60
|
|
|
HC CL TREAT RAD SHAFT FRX W/MANIP
|
Facility
|
OP
|
$4,256.00
|
|
|
Service Code
|
CPT 25505
|
| Hospital Charge Code |
900501067
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$3,830.40 |
| Rate for Payer: Adventist Health Commercial |
$851.20
|
| 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 |
$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 |
$2,340.80
|
| Rate for Payer: Cash Price |
$2,340.80
|
| Rate for Payer: Cash Price |
$2,340.80
|
| Rate for Payer: Cash Price |
$2,340.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,404.80
|
| Rate for Payer: Cigna of CA HMO |
$2,723.84
|
| Rate for Payer: Cigna of CA PPO |
$3,149.44
|
| 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 |
$3,617.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,553.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,830.40
|
| 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 |
$2,838.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$478.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$851.20
|
| 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 |
$3,192.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$2,766.40
|
| 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 |
$3,617.60
|
| 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 |
$2,553.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,128.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,128.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,128.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,128.00
|
| 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 SCAPULAR FX, W/O MANI
|
Facility
|
OP
|
$2,604.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
900501452
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$182.00 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,067.64
|
| 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 |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,432.20
|
| 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 |
$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 |
$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 |
$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 |
$1,736.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.80
|
| 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 |
$1,953.00
|
| 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 |
$304.79
|
| 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 |
$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 |
$1,562.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,562.40
|
| 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 |
$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 SCAPULAR FX, W/O MANI
|
Facility
|
OP
|
$2,604.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
900501452
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$182.00 |
| Max. Negotiated Rate |
$2,901.00 |
| 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 |
$2,901.00
|
| 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 |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Cash Price |
$1,432.20
|
| 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 |
$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 |
$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 |
$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 |
$1,736.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.80
|
| 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 |
$1,953.00
|
| 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 |
$304.79
|
| 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 |
$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 |
$1,562.40
|
| 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 |
$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 SCAPULAR FX, W/O MANI
|
Facility
|
IP
|
$2,604.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
900501452
|
|
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 |
$1,432.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,083.20
|
| 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 Permanente of CA Commercial/Self Funded |
$1,736.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$992.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,611.88
|
| 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 SCAPULAR FX, W/O MANI
|
Facility
|
IP
|
$2,604.00
|
|
|
Service Code
|
CPT 23570
|
| Hospital Charge Code |
900501452
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$520.80 |
| Max. Negotiated Rate |
$2,343.60 |
| Rate for Payer: Adventist Health Commercial |
$520.80
|
| Rate for Payer: Cash Price |
$1,432.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,083.20
|
| 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 Permanente of CA Commercial/Self Funded |
$1,736.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$992.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,611.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.80
|
| Rate for Payer: Multiplan Commercial |
$1,953.00
|
| Rate for Payer: Networks By Design Commercial |
$1,692.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,213.40
|
|
|
HC CL TREAT SC/TC HMRL FX W/MANIP
|
Facility
|
IP
|
$5,026.00
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
900501229
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,005.20 |
| Max. Negotiated Rate |
$4,523.40 |
| Rate for Payer: Adventist Health Commercial |
$1,005.20
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,010.40
|
| Rate for Payer: Galaxy Health WC |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,352.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,914.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,111.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| Rate for Payer: Multiplan Commercial |
$3,769.50
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,272.10
|
|
|
HC CL TREAT SC/TC HMRL FX W/MANIP
|
Facility
|
IP
|
$5,026.00
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
900501229
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,005.20 |
| Max. Negotiated Rate |
$4,523.40 |
| Rate for Payer: Adventist Health Commercial |
$1,005.20
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,010.40
|
| Rate for Payer: Galaxy Health WC |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,352.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,914.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,111.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| Rate for Payer: Multiplan Commercial |
$3,769.50
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,272.10
|
|
|
HC CL TREAT SC/TC HMRL FX W/MANIP
|
Facility
|
OP
|
$5,026.00
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
900501229
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$4,523.40 |
| Rate for Payer: Adventist Health Commercial |
$1,005.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: Cigna of CA HMO |
$3,216.64
|
| Rate for Payer: Cigna of CA PPO |
$3,719.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| 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 |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| 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 |
$3,352.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| 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 |
$3,769.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$4,272.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| 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 |
$3,015.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,513.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,513.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,513.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,513.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| 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 SC/TC HMRL FX W/MANIP
|
Facility
|
OP
|
$5,026.00
|
|
|
Service Code
|
CPT 24535
|
| Hospital Charge Code |
900501229
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$2,060.66
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: Cigna of CA HMO |
$3,216.64
|
| Rate for Payer: Cigna of CA PPO |
$3,719.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| 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 |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| 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 |
$3,352.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| 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 |
$3,769.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$4,272.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| 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 |
$3,015.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,015.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| 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 SHLDR DISLOC W/ANES
|
Facility
|
OP
|
$9,903.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Adventist Health Commercial |
$1,980.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$5,446.65
|
| Rate for Payer: Cash Price |
$5,446.65
|
| Rate for Payer: Cash Price |
$5,446.65
|
| Rate for Payer: Cash Price |
$5,446.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: Cigna of CA HMO |
$6,337.92
|
| Rate for Payer: Cigna of CA PPO |
$7,328.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| 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 |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| 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 |
$6,605.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| 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 |
$7,427.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$8,417.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| 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 |
$5,941.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,951.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,951.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,951.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,951.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| 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 SHLDR DISLOC W/ANES
|
Facility
|
OP
|
$9,903.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Adventist Health Commercial |
$4,060.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$5,446.65
|
| Rate for Payer: Cash Price |
$5,446.65
|
| Rate for Payer: Cash Price |
$5,446.65
|
| Rate for Payer: Cash Price |
$5,446.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: Cigna of CA HMO |
$6,337.92
|
| Rate for Payer: Cigna of CA PPO |
$7,328.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| 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 |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| 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 |
$6,605.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| 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 |
$7,427.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$8,417.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| 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 |
$5,941.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,941.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| 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 SHLDR DISLOC W/ANES
|
Facility
|
IP
|
$9,903.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,980.60 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Adventist Health Commercial |
$1,980.60
|
| Rate for Payer: Cash Price |
$5,446.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,961.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,961.20
|
| Rate for Payer: Galaxy Health WC |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,605.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,773.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,129.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| Rate for Payer: Multiplan Commercial |
$7,427.25
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,417.55
|
|
|
HC CL TREAT SHLDR DISLOC W/ANES
|
Facility
|
IP
|
$9,903.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,980.60 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Adventist Health Commercial |
$1,980.60
|
| Rate for Payer: Cash Price |
$5,446.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,961.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,961.20
|
| Rate for Payer: Galaxy Health WC |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,605.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,773.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,129.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| Rate for Payer: Multiplan Commercial |
$7,427.25
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,417.55
|
|
|
HC CL TREAT SHLDR DISLO/FX W/MANI
|
Facility
|
IP
|
$5,026.00
|
|
|
Service Code
|
CPT 23665
|
| Hospital Charge Code |
900501501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,005.20 |
| Max. Negotiated Rate |
$4,523.40 |
| Rate for Payer: Adventist Health Commercial |
$1,005.20
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,010.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,010.40
|
| Rate for Payer: Galaxy Health WC |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,352.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,914.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,111.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| Rate for Payer: Multiplan Commercial |
$3,769.50
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,272.10
|
|
|
HC CL TREAT SHLDR DISLO/FX W/MANI
|
Facility
|
OP
|
$5,026.00
|
|
|
Service Code
|
CPT 23665
|
| Hospital Charge Code |
900501501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$1,005.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Cash Price |
$2,764.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,020.80
|
| Rate for Payer: Cigna of CA HMO |
$3,216.64
|
| Rate for Payer: Cigna of CA PPO |
$3,719.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| 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 |
$4,272.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,015.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,523.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| 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 |
$3,352.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,005.20
|
| 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 |
$3,769.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$3,266.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$4,272.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| 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 |
$3,015.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,513.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,513.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,513.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,513.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| 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 SHOULDER DISLOC W/MAN
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$803.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| 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 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 SHOULDER DISLOC W/MAN
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$803.80 |
| Max. Negotiated Rate |
$3,617.10 |
| Rate for Payer: Adventist Health Commercial |
$803.80
|
| Rate for Payer: Cash Price |
$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 SHOULDER DISLOC W/MAN
|
Facility
|
OP
|
$4,019.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$1,647.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| 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 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: TriValley Medical Group Commercial/Senior |
$2,411.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| 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 SHOULDER DISLOC W/MAN
|
Facility
|
IP
|
$4,019.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$803.80 |
| Max. Negotiated Rate |
$3,617.10 |
| Rate for Payer: Adventist Health Commercial |
$803.80
|
| Rate for Payer: Cash Price |
$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 TA ANKLE FX W/O MANIP
|
Facility
|
OP
|
$2,656.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
900501560
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: Cigna of CA HMO |
$1,699.84
|
| Rate for Payer: Cigna of CA PPO |
$1,965.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$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 |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$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 |
$1,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| 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 |
$1,992.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.79
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
| Rate for Payer: Prime Health Services Medicare |
$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 |
$1,593.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,328.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,328.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,328.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$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 TA ANKLE FX W/O MANIP
|
Facility
|
IP
|
$2,656.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
900501560
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$531.20 |
| Max. Negotiated Rate |
$2,390.40 |
| Rate for Payer: Adventist Health Commercial |
$531.20
|
| Rate for Payer: Cash Price |
$1,460.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,124.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,062.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,062.40
|
| Rate for Payer: Galaxy Health WC |
$2,257.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,593.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,390.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,771.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,011.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,644.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$531.20
|
| Rate for Payer: Multiplan Commercial |
$1,992.00
|
| Rate for Payer: Networks By Design Commercial |
$1,726.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,257.60
|
|
|
HC CL TREAT TALUS FRAC,W/MANIP
|
Facility
|
OP
|
$8,120.00
|
|
|
Service Code
|
CPT 28435
|
| Hospital Charge Code |
900501235
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$343.79 |
| Max. Negotiated Rate |
$7,308.00 |
| Rate for Payer: Adventist Health Commercial |
$1,624.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,240.00
|
| Rate for Payer: Cash Price |
$4,466.00
|
| Rate for Payer: Cash Price |
$4,466.00
|
| Rate for Payer: Cash Price |
$4,466.00
|
| Rate for Payer: Cash Price |
$4,466.00
|
| Rate for Payer: Central Health Plan Commercial |
$6,496.00
|
| Rate for Payer: Cigna of CA HMO |
$5,196.80
|
| Rate for Payer: Cigna of CA PPO |
$6,008.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| 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 |
$6,902.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,872.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,308.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,334.91
|
| 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 |
$5,416.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$343.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,033.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,624.00
|
| 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 |
$6,090.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: Networks By Design Commercial |
$5,278.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Preferred Health Network WC |
$3,306.12
|
| Rate for Payer: Prime Health Services Commercial |
$6,902.00
|
| Rate for Payer: Prime Health Services Medicare |
$2,155.49
|
| 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 |
$4,872.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,060.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,060.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,060.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,060.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,033.48
|
| 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 TALUS FRAC,W/MANIP
|
Facility
|
IP
|
$8,120.00
|
|
|
Service Code
|
CPT 28435
|
| Hospital Charge Code |
900501235
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,624.00 |
| Max. Negotiated Rate |
$7,308.00 |
| Rate for Payer: Adventist Health Commercial |
$1,624.00
|
| Rate for Payer: Cash Price |
$4,466.00
|
| Rate for Payer: Central Health Plan Commercial |
$6,496.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,248.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,248.00
|
| Rate for Payer: Galaxy Health WC |
$6,902.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,872.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,308.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,416.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,093.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,026.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,624.00
|
| Rate for Payer: Multiplan Commercial |
$6,090.00
|
| Rate for Payer: Networks By Design Commercial |
$5,278.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,902.00
|
|
