|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
OP
|
$1,339.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$61.54 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$803.40
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$602.55
|
| Rate for Payer: Cash Price |
$602.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,071.20
|
| Rate for Payer: Cigna of CA PPO |
$990.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,138.15
|
| Rate for Payer: Global Benefits Group Commercial |
$803.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,205.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,004.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$893.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$61.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$1,004.25
|
| Rate for Payer: Networks By Design Commercial |
$870.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,138.15
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$803.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
IP
|
$1,339.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.80 |
| Max. Negotiated Rate |
$1,205.10 |
| Rate for Payer: Cash Price |
$602.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,071.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$535.60
|
| Rate for Payer: Galaxy Health WC |
$1,138.15
|
| Rate for Payer: Global Benefits Group Commercial |
$803.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,205.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$893.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$510.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.80
|
| Rate for Payer: Multiplan Commercial |
$1,004.25
|
| Rate for Payer: Networks By Design Commercial |
$870.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,138.15
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
IP
|
$1,339.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$267.80 |
| Max. Negotiated Rate |
$1,205.10 |
| Rate for Payer: Cash Price |
$602.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,071.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$535.60
|
| Rate for Payer: Galaxy Health WC |
$1,138.15
|
| Rate for Payer: Global Benefits Group Commercial |
$803.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,205.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$893.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$510.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.80
|
| Rate for Payer: Multiplan Commercial |
$1,004.25
|
| Rate for Payer: Networks By Design Commercial |
$870.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,138.15
|
|
|
HC ARTHRITIS SERIES
|
Facility
|
OP
|
$2,723.00
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
909001604
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$2,450.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$425.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$300.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$366.33
|
| Rate for Payer: Blue Distinction Transplant |
$1,633.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,682.81
|
| Rate for Payer: Blue Shield of California EPN |
$1,323.38
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$1,225.35
|
| Rate for Payer: Cash Price |
$1,225.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,178.40
|
| Rate for Payer: Cigna of CA HMO |
$1,742.72
|
| Rate for Payer: Cigna of CA PPO |
$2,015.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$2,314.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,633.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,450.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,042.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,816.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$544.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$2,042.25
|
| Rate for Payer: Networks By Design Commercial |
$1,769.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,314.55
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,633.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,633.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$193.23
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$193.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC ARTHRITIS SERIES
|
Facility
|
IP
|
$2,723.00
|
|
|
Service Code
|
CPT 77075
|
| Hospital Charge Code |
909001604
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$544.60 |
| Max. Negotiated Rate |
$2,450.70 |
| Rate for Payer: Cash Price |
$1,225.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,178.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,089.20
|
| Rate for Payer: Galaxy Health WC |
$2,314.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,633.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,450.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,816.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,037.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$544.60
|
| Rate for Payer: Multiplan Commercial |
$2,042.25
|
| Rate for Payer: Networks By Design Commercial |
$1,769.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,314.55
|
|
|
HC ARTHRODESIS SACROILIAC JOINT
|
Facility
|
OP
|
$40,774.00
|
|
|
Service Code
|
CPT 27279
|
| Hospital Charge Code |
909027279
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$184.62 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$23,284.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,926.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,612.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,284.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$31,833.27
|
| Rate for Payer: Blue Distinction Transplant |
$24,464.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$23,284.52
|
| Rate for Payer: Cash Price |
$18,348.30
|
| Rate for Payer: Cash Price |
$18,348.30
|
| Rate for Payer: Central Health Plan Commercial |
$32,619.20
|
| Rate for Payer: Cigna of CA PPO |
$30,172.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,926.78
|
| Rate for Payer: Dignity Health Media |
$23,284.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,612.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,434.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$23,284.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$23,284.52
|
| Rate for Payer: Galaxy Health WC |
$34,657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$24,464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,696.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$30,580.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,186.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38,419.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,284.52
|
| Rate for Payer: InnovAge PACE Commercial |
$34,926.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27,196.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,284.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,154.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,201.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,201.26
|
| Rate for Payer: Multiplan Commercial |
$30,580.50
|
| Rate for Payer: Multiplan WC |
$31,833.27
|
| Rate for Payer: Networks By Design Commercial |
$26,503.10
|
| Rate for Payer: Preferred Health Network WC |
$32,482.93
|
| Rate for Payer: Prime Health Services Commercial |
$34,657.90
|
| Rate for Payer: Prime Health Services Medicare |
$24,681.59
|
| Rate for Payer: Prime Health Services WC |
$31,508.44
|
| Rate for Payer: Riverside University Health System MISP |
$25,612.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,464.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,926.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,612.97
|
| Rate for Payer: Vantage Medical Group Senior |
$23,284.52
|
|
|
HC ARTHRODESIS SACROILIAC JOINT
|
Facility
|
IP
|
$40,774.00
|
|
|
Service Code
|
CPT 27279
|
| Hospital Charge Code |
909027279
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,154.80 |
| Max. Negotiated Rate |
$36,696.60 |
| Rate for Payer: Cash Price |
$18,348.30
|
| Rate for Payer: Central Health Plan Commercial |
$32,619.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,309.60
|
| Rate for Payer: Galaxy Health WC |
$34,657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$24,464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,696.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27,196.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,534.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,154.80
|
| Rate for Payer: Multiplan Commercial |
$30,580.50
|
| Rate for Payer: Networks By Design Commercial |
$26,503.10
|
| Rate for Payer: Prime Health Services Commercial |
$34,657.90
|
|
|
HC ARTHROGRAPH ANKLE
|
Facility
|
IP
|
$1,550.00
|
|
|
Service Code
|
CPT 73615
|
| Hospital Charge Code |
909001663
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$310.00 |
| Max. Negotiated Rate |
$1,395.00 |
| Rate for Payer: Cash Price |
$697.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$620.00
|
| Rate for Payer: Galaxy Health WC |
$1,317.50
|
| Rate for Payer: Global Benefits Group Commercial |
$930.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,395.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,033.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$590.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.00
|
| Rate for Payer: Multiplan Commercial |
$1,162.50
|
| Rate for Payer: Networks By Design Commercial |
$1,007.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,317.50
|
|
|
HC ARTHROGRAPH ANKLE
|
Facility
|
OP
|
$1,550.00
|
|
|
Service Code
|
CPT 73615
|
| Hospital Charge Code |
909001663
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$143.05 |
| Max. Negotiated Rate |
$1,395.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$480.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$428.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$530.91
|
| Rate for Payer: Blue Distinction Transplant |
$930.00
|
| Rate for Payer: Blue Shield of California Commercial |
$957.90
|
| Rate for Payer: Blue Shield of California EPN |
$753.30
|
| Rate for Payer: Caremore Medicare Advantage |
$480.50
|
| Rate for Payer: Cash Price |
$697.50
|
| Rate for Payer: Cash Price |
$697.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,240.00
|
| Rate for Payer: Cigna of CA HMO |
$992.00
|
| Rate for Payer: Cigna of CA PPO |
$1,147.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: Dignity Health Media |
$480.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$528.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$1,317.50
|
| Rate for Payer: Global Benefits Group Commercial |
$930.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,395.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,162.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$788.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$792.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$480.50
|
| Rate for Payer: InnovAge PACE Commercial |
$720.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,033.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$1,162.50
|
| Rate for Payer: Networks By Design Commercial |
$1,007.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,317.50
|
| Rate for Payer: Prime Health Services Medicare |
$509.33
|
| Rate for Payer: Riverside University Health System MISP |
$528.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$930.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$930.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC ARTHROGRAPH ELBOW
|
Facility
|
IP
|
$1,609.00
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
909001481
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$321.80 |
| Max. Negotiated Rate |
$1,448.10 |
| Rate for Payer: Cash Price |
$724.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,287.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.60
|
| Rate for Payer: Galaxy Health WC |
$1,367.65
|
| Rate for Payer: Global Benefits Group Commercial |
$965.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,448.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,073.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$613.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.80
|
| Rate for Payer: Multiplan Commercial |
$1,206.75
|
| Rate for Payer: Networks By Design Commercial |
$1,045.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,367.65
|
|
|
HC ARTHROGRAPH ELBOW
|
Facility
|
OP
|
$1,609.00
|
|
|
Service Code
|
CPT 73085
|
| Hospital Charge Code |
909001481
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$136.46 |
| Max. Negotiated Rate |
$1,448.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$480.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$396.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$530.91
|
| Rate for Payer: Blue Distinction Transplant |
$965.40
|
| Rate for Payer: Blue Shield of California Commercial |
$994.36
|
| Rate for Payer: Blue Shield of California EPN |
$781.97
|
| Rate for Payer: Caremore Medicare Advantage |
$480.50
|
| Rate for Payer: Cash Price |
$724.05
|
| Rate for Payer: Cash Price |
$724.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,287.20
|
| Rate for Payer: Cigna of CA HMO |
$1,029.76
|
| Rate for Payer: Cigna of CA PPO |
$1,190.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: Dignity Health Media |
$480.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$528.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$1,367.65
|
| Rate for Payer: Global Benefits Group Commercial |
$965.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,448.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,206.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$788.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$792.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$480.50
|
| Rate for Payer: InnovAge PACE Commercial |
$720.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,073.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$1,206.75
|
| Rate for Payer: Networks By Design Commercial |
$1,045.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,367.65
|
| Rate for Payer: Prime Health Services Medicare |
$509.33
|
| Rate for Payer: Riverside University Health System MISP |
$528.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$965.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$965.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC ARTHROGRAPH HIP
|
Facility
|
OP
|
$2,352.00
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
909001659
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$143.05 |
| Max. Negotiated Rate |
$2,116.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$480.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$407.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$530.91
|
| Rate for Payer: Blue Distinction Transplant |
$1,411.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,453.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,143.07
|
| Rate for Payer: Caremore Medicare Advantage |
$480.50
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,881.60
|
| Rate for Payer: Cigna of CA HMO |
$1,505.28
|
| Rate for Payer: Cigna of CA PPO |
$1,740.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: Dignity Health Media |
$480.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$528.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$1,999.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,411.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,116.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,764.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$788.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$792.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$480.50
|
| Rate for Payer: InnovAge PACE Commercial |
$720.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,568.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$1,764.00
|
| Rate for Payer: Networks By Design Commercial |
$1,528.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,999.20
|
| Rate for Payer: Prime Health Services Medicare |
$509.33
|
| Rate for Payer: Riverside University Health System MISP |
$528.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,411.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,411.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC ARTHROGRAPH HIP
|
Facility
|
IP
|
$2,352.00
|
|
|
Service Code
|
CPT 73525
|
| Hospital Charge Code |
909001659
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$470.40 |
| Max. Negotiated Rate |
$2,116.80 |
| Rate for Payer: Cash Price |
$1,058.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,881.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.80
|
| Rate for Payer: Galaxy Health WC |
$1,999.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,411.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,116.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,568.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$896.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.40
|
| Rate for Payer: Multiplan Commercial |
$1,764.00
|
| Rate for Payer: Networks By Design Commercial |
$1,528.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,999.20
|
|
|
HC ARTHROGRAPH KNEE
|
Facility
|
OP
|
$1,972.00
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
909001658
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$131.52 |
| Max. Negotiated Rate |
$1,774.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$480.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$579.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$545.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$665.26
|
| Rate for Payer: Blue Distinction Transplant |
$1,183.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,218.70
|
| Rate for Payer: Blue Shield of California EPN |
$958.39
|
| Rate for Payer: Caremore Medicare Advantage |
$480.50
|
| Rate for Payer: Cash Price |
$887.40
|
| Rate for Payer: Cash Price |
$887.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,577.60
|
| Rate for Payer: Cigna of CA HMO |
$1,262.08
|
| Rate for Payer: Cigna of CA PPO |
$1,459.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: Dignity Health Media |
$480.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$528.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$1,676.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,774.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,479.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$788.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$792.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$480.50
|
| Rate for Payer: InnovAge PACE Commercial |
$720.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,315.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$1,479.00
|
| Rate for Payer: Networks By Design Commercial |
$1,281.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,676.20
|
| Rate for Payer: Prime Health Services Medicare |
$509.33
|
| Rate for Payer: Riverside University Health System MISP |
$528.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,183.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,183.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC ARTHROGRAPH KNEE
|
Facility
|
IP
|
$1,972.00
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
909001658
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$394.40 |
| Max. Negotiated Rate |
$1,774.80 |
| Rate for Payer: Cash Price |
$887.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,577.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$788.80
|
| Rate for Payer: Galaxy Health WC |
$1,676.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,774.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,315.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$751.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.40
|
| Rate for Payer: Multiplan Commercial |
$1,479.00
|
| Rate for Payer: Networks By Design Commercial |
$1,281.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,676.20
|
|
|
HC ARTHROGRAPH SHOULDER
|
Facility
|
IP
|
$2,903.00
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
909001480
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$580.60 |
| Max. Negotiated Rate |
$2,612.70 |
| Rate for Payer: Cash Price |
$1,306.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,322.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,161.20
|
| Rate for Payer: Galaxy Health WC |
$2,467.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,741.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,612.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,936.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,106.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.60
|
| Rate for Payer: Multiplan Commercial |
$2,177.25
|
| Rate for Payer: Networks By Design Commercial |
$1,886.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,467.55
|
|
|
HC ARTHROGRAPH SHOULDER
|
Facility
|
OP
|
$2,903.00
|
|
|
Service Code
|
CPT 73040
|
| Hospital Charge Code |
909001480
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$2,612.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$480.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$453.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$435.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$530.91
|
| Rate for Payer: Blue Distinction Transplant |
$1,741.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,794.05
|
| Rate for Payer: Blue Shield of California EPN |
$1,410.86
|
| Rate for Payer: Caremore Medicare Advantage |
$480.50
|
| Rate for Payer: Cash Price |
$1,306.35
|
| Rate for Payer: Cash Price |
$1,306.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,322.40
|
| Rate for Payer: Cigna of CA HMO |
$1,857.92
|
| Rate for Payer: Cigna of CA PPO |
$2,148.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: Dignity Health Media |
$480.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$528.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$2,467.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,741.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,612.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,177.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$788.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$792.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$480.50
|
| Rate for Payer: InnovAge PACE Commercial |
$720.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,936.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$580.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$2,177.25
|
| Rate for Payer: Networks By Design Commercial |
$1,886.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,467.55
|
| Rate for Payer: Prime Health Services Medicare |
$509.33
|
| Rate for Payer: Riverside University Health System MISP |
$528.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,741.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,741.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC ARTHROGRAPH WRIST
|
Facility
|
IP
|
$2,145.00
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
909001482
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$429.00 |
| Max. Negotiated Rate |
$1,930.50 |
| Rate for Payer: Cash Price |
$965.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,716.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$858.00
|
| Rate for Payer: Galaxy Health WC |
$1,823.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,287.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,930.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,430.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$817.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.00
|
| Rate for Payer: Multiplan Commercial |
$1,608.75
|
| Rate for Payer: Networks By Design Commercial |
$1,394.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,823.25
|
|
|
HC ARTHROGRAPH WRIST
|
Facility
|
OP
|
$2,145.00
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
909001482
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$78.17 |
| Max. Negotiated Rate |
$1,930.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$480.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$457.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$480.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$326.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$398.70
|
| Rate for Payer: Blue Distinction Transplant |
$1,287.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,325.61
|
| Rate for Payer: Blue Shield of California EPN |
$1,042.47
|
| Rate for Payer: Caremore Medicare Advantage |
$480.50
|
| Rate for Payer: Cash Price |
$965.25
|
| Rate for Payer: Cash Price |
$965.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,716.00
|
| Rate for Payer: Cigna of CA HMO |
$1,372.80
|
| Rate for Payer: Cigna of CA PPO |
$1,587.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.75
|
| Rate for Payer: Dignity Health Media |
$480.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$528.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$480.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$480.50
|
| Rate for Payer: Galaxy Health WC |
$1,823.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,287.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,930.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,608.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$788.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$792.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$480.50
|
| Rate for Payer: InnovAge PACE Commercial |
$720.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,430.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$480.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$643.87
|
| Rate for Payer: Multiplan Commercial |
$1,608.75
|
| Rate for Payer: Networks By Design Commercial |
$1,394.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,823.25
|
| Rate for Payer: Prime Health Services Medicare |
$509.33
|
| Rate for Payer: Riverside University Health System MISP |
$528.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,287.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,287.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$718.29
|
| Rate for Payer: United Healthcare All Other HMO |
$718.29
|
| Rate for Payer: United Healthcare HMO Rider |
$718.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$718.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$528.55
|
| Rate for Payer: Vantage Medical Group Senior |
$480.50
|
|
|
HC ARTHROTOMY ANKLE
|
Facility
|
OP
|
$12,132.00
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
900501781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$144.30 |
| Max. Negotiated Rate |
$10,918.80 |
| 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 |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,279.20
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| Rate for Payer: Cash Price |
$5,459.40
|
| Rate for Payer: Cash Price |
$5,459.40
|
| Rate for Payer: Cash Price |
$5,459.40
|
| Rate for Payer: Cash Price |
$5,459.40
|
| Rate for Payer: Central Health Plan Commercial |
$9,705.60
|
| Rate for Payer: Cigna of CA PPO |
$8,977.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$10,312.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,279.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,918.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,099.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,092.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,426.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$9,099.00
|
| Rate for Payer: Networks By Design Commercial |
$7,885.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,312.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,279.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,066.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,066.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,066.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC ARTHROTOMY ANKLE
|
Facility
|
IP
|
$12,132.00
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
900501781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,426.40 |
| Max. Negotiated Rate |
$10,918.80 |
| Rate for Payer: Blue Shield of California Commercial |
$9,099.00
|
| Rate for Payer: Cash Price |
$5,459.40
|
| Rate for Payer: Central Health Plan Commercial |
$9,705.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,852.80
|
| Rate for Payer: Galaxy Health WC |
$10,312.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,279.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,918.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,092.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,622.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,426.40
|
| Rate for Payer: Multiplan Commercial |
$9,099.00
|
| Rate for Payer: Networks By Design Commercial |
$7,885.80
|
| Rate for Payer: Prime Health Services Commercial |
$10,312.20
|
|
|
HC ARTHROTOMY ANKLE W/JOINT EXPLO
|
Facility
|
IP
|
$9,325.00
|
|
|
Service Code
|
CPT 27620
|
| Hospital Charge Code |
902890296
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,865.00 |
| Max. Negotiated Rate |
$8,392.50 |
| Rate for Payer: Blue Shield of California Commercial |
$6,993.75
|
| Rate for Payer: Cash Price |
$4,196.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,460.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,730.00
|
| Rate for Payer: Galaxy Health WC |
$7,926.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,595.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,392.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,219.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,552.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,865.00
|
| Rate for Payer: Multiplan Commercial |
$6,993.75
|
| Rate for Payer: Networks By Design Commercial |
$6,061.25
|
| Rate for Payer: Prime Health Services Commercial |
$7,926.25
|
|
|
HC ARTHROTOMY ANKLE W/JOINT EXPLO
|
Facility
|
OP
|
$9,325.00
|
|
|
Service Code
|
CPT 27620
|
| Hospital Charge Code |
902890296
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$144.30 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,044.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,595.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,865.42
|
| Rate for Payer: Blue Shield of California EPN |
$4,559.92
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| Rate for Payer: Cash Price |
$4,196.25
|
| Rate for Payer: Cash Price |
$4,196.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,460.00
|
| Rate for Payer: Cigna of CA HMO |
$5,968.00
|
| Rate for Payer: Cigna of CA PPO |
$6,900.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$7,926.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,595.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,392.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,993.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,672.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,219.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$144.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,865.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$6,993.75
|
| Rate for Payer: Networks By Design Commercial |
$6,061.25
|
| Rate for Payer: Prime Health Services Commercial |
$7,926.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,595.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,595.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,662.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,662.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,662.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,662.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC ARWY MASK LMA UNIQUE SIZE 1
|
Facility
|
IP
|
$52.07
|
|
| Hospital Charge Code |
901698403
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.41 |
| Max. Negotiated Rate |
$46.86 |
| Rate for Payer: Cash Price |
$23.43
|
| Rate for Payer: Central Health Plan Commercial |
$41.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.83
|
| Rate for Payer: Galaxy Health WC |
$44.26
|
| Rate for Payer: Global Benefits Group Commercial |
$31.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.41
|
| Rate for Payer: Multiplan Commercial |
$39.05
|
| Rate for Payer: Networks By Design Commercial |
$33.85
|
| Rate for Payer: Prime Health Services Commercial |
$44.26
|
|
|
HC ARWY MASK LMA UNIQUE SIZE 1
|
Facility
|
OP
|
$52.07
|
|
| Hospital Charge Code |
901698403
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.41 |
| Max. Negotiated Rate |
$46.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.76
|
| Rate for Payer: Blue Distinction Transplant |
$31.24
|
| Rate for Payer: Blue Shield of California Commercial |
$32.75
|
| Rate for Payer: Blue Shield of California EPN |
$25.46
|
| Rate for Payer: Cash Price |
$23.43
|
| Rate for Payer: Central Health Plan Commercial |
$41.66
|
| Rate for Payer: Cigna of CA HMO |
$33.32
|
| Rate for Payer: Cigna of CA PPO |
$38.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.26
|
| Rate for Payer: Dignity Health Media |
$44.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.83
|
| Rate for Payer: Galaxy Health WC |
$44.26
|
| Rate for Payer: Global Benefits Group Commercial |
$31.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.86
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$39.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.41
|
| Rate for Payer: Multiplan Commercial |
$39.05
|
| Rate for Payer: Networks By Design Commercial |
$33.85
|
| Rate for Payer: Prime Health Services Commercial |
$44.26
|
| Rate for Payer: Riverside University Health System MISP |
$20.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.04
|
| Rate for Payer: United Healthcare All Other HMO |
$26.04
|
| Rate for Payer: United Healthcare HMO Rider |
$26.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.26
|
| Rate for Payer: Vantage Medical Group Senior |
$44.26
|
|
