|
HC CL TREAT ANK DISLOC W/O ANESTH
|
Facility
|
IP
|
$1,872.00
|
|
|
Service Code
|
CPT 27840
|
| Hospital Charge Code |
900501096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$374.40 |
| Max. Negotiated Rate |
$1,684.80 |
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,497.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$748.80
|
| Rate for Payer: Galaxy Health WC |
$1,591.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,123.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,684.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,248.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$713.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$374.40
|
| Rate for Payer: Multiplan Commercial |
$1,404.00
|
| Rate for Payer: Networks By Design Commercial |
$1,216.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,591.20
|
|
|
HC CL TREAT ANK DISLOC W/O ANESTH
|
Facility
|
OP
|
$1,872.00
|
|
|
Service Code
|
CPT 27840
|
| Hospital Charge Code |
900501096
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,123.20
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Cash Price |
$842.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,497.60
|
| Rate for Payer: Cigna of CA PPO |
$1,385.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,591.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,123.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,684.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,404.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,248.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$374.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,404.00
|
| Rate for Payer: Networks By Design Commercial |
$1,216.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,591.20
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,123.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$936.00
|
| Rate for Payer: United Healthcare All Other HMO |
$936.00
|
| Rate for Payer: United Healthcare HMO Rider |
$936.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$936.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT ANKLE DISCLOC W/ANES
|
Facility
|
OP
|
$5,430.00
|
|
|
Service Code
|
CPT 27842
|
| Hospital Charge Code |
900501589
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$363.58 |
| Max. Negotiated Rate |
$4,887.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,258.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,443.50
|
| Rate for Payer: Cash Price |
$2,443.50
|
| Rate for Payer: Cash Price |
$2,443.50
|
| Rate for Payer: Cash Price |
$2,443.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,344.00
|
| Rate for Payer: Cigna of CA PPO |
$4,018.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$4,615.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,887.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,072.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,621.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$363.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,086.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$4,072.50
|
| Rate for Payer: Networks By Design Commercial |
$3,529.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,615.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,258.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,715.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,715.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,715.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT ANKLE DISCLOC W/ANES
|
Facility
|
IP
|
$5,430.00
|
|
|
Service Code
|
CPT 27842
|
| Hospital Charge Code |
900501589
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,086.00 |
| Max. Negotiated Rate |
$4,887.00 |
| Rate for Payer: Cash Price |
$2,443.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,344.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,172.00
|
| Rate for Payer: Galaxy Health WC |
$4,615.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,887.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,621.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,068.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,086.00
|
| Rate for Payer: Multiplan Commercial |
$4,072.50
|
| Rate for Payer: Networks By Design Commercial |
$3,529.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,615.50
|
|
|
HC CL TREAT ANKLE MM FX W/O MANIP
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
900501371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$964.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: Cigna of CA PPO |
$1,189.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$804.00
|
| Rate for Payer: United Healthcare All Other HMO |
$804.00
|
| Rate for Payer: United Healthcare HMO Rider |
$804.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$804.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT ANKLE MM FX W/O MANIP
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 27760
|
| Hospital Charge Code |
900501371
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$1,447.20 |
| Rate for Payer: Blue Shield of California Commercial |
$1,206.00
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.20
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
|
|
HC CL TREAT ARTICULAR FX,EA W/MAN
|
Facility
|
IP
|
$4,886.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
900501595
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$977.20 |
| Max. Negotiated Rate |
$4,397.40 |
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.40
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,861.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
|
|
HC CL TREAT ARTICULAR FX,EA W/MAN
|
Facility
|
OP
|
$4,886.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
900501595
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$408.86 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,931.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,073.29
|
| Rate for Payer: Blue Shield of California EPN |
$2,389.25
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: Cigna of CA HMO |
$3,127.04
|
| Rate for Payer: Cigna of CA PPO |
$3,615.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,664.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,313.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$408.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,931.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,931.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,443.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,443.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,443.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,443.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT ARTICULAR FX,EA W/MAN
|
Facility
|
OP
|
$4,886.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
900501595
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| 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 |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,931.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: Cigna of CA PPO |
$3,615.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,664.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$408.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,931.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,443.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,443.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,443.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,443.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT ARTICULAR FX,EA W/MAN
|
Facility
|
IP
|
$4,886.00
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
900501595
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$977.20 |
| Max. Negotiated Rate |
$4,397.40 |
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.40
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,861.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
|
|
HC CL TREAT ARTICULAR FX,EA W/O M
|
Facility
|
OP
|
$1,694.00
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
900501557
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$168.36 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,016.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,355.20
|
| Rate for Payer: Cigna of CA PPO |
$1,253.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,439.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,016.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,524.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,270.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,129.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,270.50
|
| Rate for Payer: Networks By Design Commercial |
$1,101.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,439.90
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,016.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$847.00
|
| Rate for Payer: United Healthcare All Other HMO |
$847.00
|
| Rate for Payer: United Healthcare HMO Rider |
$847.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$847.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT ARTICULAR FX,EA W/O M
|
Facility
|
IP
|
$1,694.00
|
|
|
Service Code
|
CPT 26740
|
| Hospital Charge Code |
900501557
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$338.80 |
| Max. Negotiated Rate |
$1,524.60 |
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$677.60
|
| Rate for Payer: Galaxy Health WC |
$1,439.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,016.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,524.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,129.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$645.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.80
|
| Rate for Payer: Multiplan Commercial |
$1,270.50
|
| Rate for Payer: Networks By Design Commercial |
$1,101.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,439.90
|
|
|
HC CL TREAT BIMALL ANKLE FX W/MAN
|
Facility
|
IP
|
$2,600.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
900501093
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$520.00 |
| Max. Negotiated Rate |
$2,340.00 |
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,080.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,040.00
|
| Rate for Payer: Galaxy Health WC |
$2,210.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,560.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$990.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.00
|
| Rate for Payer: Multiplan Commercial |
$1,950.00
|
| Rate for Payer: Networks By Design Commercial |
$1,690.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,210.00
|
|
|
HC CL TREAT BIMALL ANKLE FX W/MAN
|
Facility
|
OP
|
$2,600.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
900501093
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$476.06 |
| Max. Negotiated Rate |
$3,313.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,560.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,635.40
|
| Rate for Payer: Blue Shield of California EPN |
$1,271.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,080.00
|
| Rate for Payer: Cigna of CA HMO |
$1,664.00
|
| Rate for Payer: Cigna of CA PPO |
$1,924.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$2,210.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,560.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,340.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,950.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,313.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$476.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$1,950.00
|
| Rate for Payer: Networks By Design Commercial |
$1,690.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,210.00
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,560.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,560.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,300.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,300.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,300.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,300.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT BIMALL ANKLE FX W/MAN
|
Facility
|
IP
|
$2,600.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
900501093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$520.00 |
| Max. Negotiated Rate |
$2,340.00 |
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,080.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,040.00
|
| Rate for Payer: Galaxy Health WC |
$2,210.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,560.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$990.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.00
|
| Rate for Payer: Multiplan Commercial |
$1,950.00
|
| Rate for Payer: Networks By Design Commercial |
$1,690.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,210.00
|
|
|
HC CL TREAT BIMALL ANKLE FX W/MAN
|
Facility
|
OP
|
$2,600.00
|
|
|
Service Code
|
CPT 27810
|
| Hospital Charge Code |
900501093
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$3,293.27 |
| 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 |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,560.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Cash Price |
$1,170.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,080.00
|
| Rate for Payer: Cigna of CA PPO |
$1,924.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$2,210.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,560.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,340.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,950.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$476.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$1,950.00
|
| Rate for Payer: Networks By Design Commercial |
$1,690.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,210.00
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,560.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,300.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,300.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,300.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,300.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT BIMALL ANKLE FX W/O M
|
Facility
|
OP
|
$1,780.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
900501519
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,068.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,424.00
|
| Rate for Payer: Cigna of CA PPO |
$1,317.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,513.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,068.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,602.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,335.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,187.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,335.00
|
| Rate for Payer: Networks By Design Commercial |
$1,157.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,513.00
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,068.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$890.00
|
| Rate for Payer: United Healthcare All Other HMO |
$890.00
|
| Rate for Payer: United Healthcare HMO Rider |
$890.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$890.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT BIMALL ANKLE FX W/O M
|
Facility
|
IP
|
$1,780.00
|
|
|
Service Code
|
CPT 27808
|
| Hospital Charge Code |
900501519
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$356.00 |
| Max. Negotiated Rate |
$1,602.00 |
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,424.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$712.00
|
| Rate for Payer: Galaxy Health WC |
$1,513.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,068.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,602.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,187.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$678.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.00
|
| Rate for Payer: Multiplan Commercial |
$1,335.00
|
| Rate for Payer: Networks By Design Commercial |
$1,157.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,513.00
|
|
|
HC CL TREAT CARPAL BONE FX W/MANI
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 25635
|
| Hospital Charge Code |
900501382
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,157.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
|
|
HC CL TREAT CARPAL BONE FX W/MANI
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 25635
|
| Hospital Charge Code |
900501382
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$3,293.27 |
| 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 |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,823.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA PPO |
$2,248.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,279.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$437.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,519.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,519.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,519.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,519.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT CARPAL SCAPHOID FX W/
|
Facility
|
IP
|
$4,115.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
900501381
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$823.00 |
| Max. Negotiated Rate |
$3,703.50 |
| Rate for Payer: Cash Price |
$1,851.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,292.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,646.00
|
| Rate for Payer: Galaxy Health WC |
$3,497.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,469.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,703.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,744.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,567.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$823.00
|
| Rate for Payer: Multiplan Commercial |
$3,086.25
|
| Rate for Payer: Networks By Design Commercial |
$2,674.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,497.75
|
|
|
HC CL TREAT CARPAL SCAPHOID FX W/
|
Facility
|
OP
|
$4,115.00
|
|
|
Service Code
|
CPT 25624
|
| Hospital Charge Code |
900501381
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| 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 |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,469.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,851.75
|
| Rate for Payer: Cash Price |
$1,851.75
|
| Rate for Payer: Cash Price |
$1,851.75
|
| Rate for Payer: Cash Price |
$1,851.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,292.00
|
| Rate for Payer: Cigna of CA PPO |
$3,045.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$3,497.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,469.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,703.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,086.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,744.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$823.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$3,086.25
|
| Rate for Payer: Networks By Design Commercial |
$2,674.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,497.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,469.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,057.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,057.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,057.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,057.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
OP
|
$1,676.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,005.60
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,340.80
|
| Rate for Payer: Cigna of CA PPO |
$1,240.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,424.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,508.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,257.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,117.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$393.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$335.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,257.00
|
| Rate for Payer: Networks By Design Commercial |
$1,089.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,424.60
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,005.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$838.00
|
| Rate for Payer: United Healthcare All Other HMO |
$838.00
|
| Rate for Payer: United Healthcare HMO Rider |
$838.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$838.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
IP
|
$1,676.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$335.20 |
| Max. Negotiated Rate |
$1,508.40 |
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,340.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$670.40
|
| Rate for Payer: Galaxy Health WC |
$1,424.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,508.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,117.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$638.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$335.20
|
| Rate for Payer: Multiplan Commercial |
$1,257.00
|
| Rate for Payer: Networks By Design Commercial |
$1,089.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,424.60
|
|
|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
IP
|
$1,676.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$335.20 |
| Max. Negotiated Rate |
$1,508.40 |
| Rate for Payer: Cash Price |
$754.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,340.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$670.40
|
| Rate for Payer: Galaxy Health WC |
$1,424.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,508.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,117.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$638.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$335.20
|
| Rate for Payer: Multiplan Commercial |
$1,257.00
|
| Rate for Payer: Networks By Design Commercial |
$1,089.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,424.60
|
|
