|
HC CL TREAT CARPO DIS THMB W/MANI
|
Facility
|
OP
|
$1,676.00
|
|
|
Service Code
|
CPT 26641
|
| Hospital Charge Code |
900501077
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,672.78
|
| 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: Blue Shield of California Commercial |
$1,054.20
|
| Rate for Payer: Blue Shield of California EPN |
$819.56
|
| 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: Central Health Plan Commercial |
$1,340.80
|
| Rate for Payer: Cigna of CA HMO |
$1,072.64
|
| 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 |
$486.16
|
| 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: TriValley Medical Group Commercial/Senior |
$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 DIST FIB FRAC W/O MAN
|
Facility
|
OP
|
$1,969.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
900501092
|
|
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 |
$1,181.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,575.20
|
| Rate for Payer: Cigna of CA PPO |
$1,457.06
|
| 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 |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,772.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,476.75
|
| 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 |
$1,313.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.80
|
| 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 |
$1,476.75
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
| 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 |
$1,181.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$984.50
|
| Rate for Payer: United Healthcare All Other HMO |
$984.50
|
| Rate for Payer: United Healthcare HMO Rider |
$984.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$984.50
|
| 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 DIST FIB FRAC W/O MAN
|
Facility
|
IP
|
$1,969.00
|
|
|
Service Code
|
CPT 27786
|
| Hospital Charge Code |
900501092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.80 |
| Max. Negotiated Rate |
$1,772.10 |
| Rate for Payer: Blue Shield of California Commercial |
$1,476.75
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,575.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.60
|
| Rate for Payer: Galaxy Health WC |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,772.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,313.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$750.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.80
|
| Rate for Payer: Multiplan Commercial |
$1,476.75
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
|
|
HC CL TREAT DIST FIB FX W/MANIP
|
Facility
|
IP
|
$2,600.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$520.00 |
| Max. Negotiated Rate |
$2,340.00 |
| Rate for Payer: Blue Shield of California Commercial |
$1,950.00
|
| 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 DIST FIB FX W/MANIP
|
Facility
|
OP
|
$2,600.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| 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 |
$1,560.00
|
| 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 |
$294.64
|
| 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 |
$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 |
$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 |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$486.16
|
| 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 |
$1,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$419.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.00
|
| 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 |
$1,950.00
|
| 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 |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| 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 |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT DIST FIB FX W/MANIP
|
Facility
|
IP
|
$2,600.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$520.00 |
| Max. Negotiated Rate |
$2,340.00 |
| Rate for Payer: Blue Shield of California Commercial |
$1,950.00
|
| 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 DIST FIB FX W/MANIP
|
Facility
|
OP
|
$2,600.00
|
|
|
Service Code
|
CPT 27788
|
| Hospital Charge Code |
900501234
|
|
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 |
$1,560.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| 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 |
$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 |
$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 |
$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 |
$1,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$419.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$520.00
|
| 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 |
$1,950.00
|
| 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 |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| 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 |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
OP
|
$2,514.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$243.33 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,379.73
|
| 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 |
$1,508.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,581.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,229.35
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,011.20
|
| Rate for Payer: Cigna of CA HMO |
$1,608.96
|
| Rate for Payer: Cigna of CA PPO |
$1,860.36
|
| 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 |
$2,136.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,508.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,262.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,885.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$486.16
|
| 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 |
$1,676.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$243.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$502.80
|
| 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 |
$1,885.50
|
| Rate for Payer: Networks By Design Commercial |
$1,634.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,136.90
|
| 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 |
$1,508.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,508.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,257.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,257.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,257.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,257.00
|
| 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 DIST PHAL FX W/MANIPU
|
Facility
|
IP
|
$2,514.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$502.80 |
| Max. Negotiated Rate |
$2,262.60 |
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,011.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,005.60
|
| Rate for Payer: Galaxy Health WC |
$2,136.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,508.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,262.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,676.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$957.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$502.80
|
| Rate for Payer: Multiplan Commercial |
$1,885.50
|
| Rate for Payer: Networks By Design Commercial |
$1,634.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,136.90
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
IP
|
$2,514.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$502.80 |
| Max. Negotiated Rate |
$2,262.60 |
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,011.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,005.60
|
| Rate for Payer: Galaxy Health WC |
$2,136.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,508.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,262.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,676.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$957.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$502.80
|
| Rate for Payer: Multiplan Commercial |
$1,885.50
|
| Rate for Payer: Networks By Design Commercial |
$1,634.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,136.90
|
|
|
HC CL TREAT DIST PHAL FX W/MANIPU
|
Facility
|
OP
|
$2,514.00
|
|
|
Service Code
|
CPT 26755
|
| Hospital Charge Code |
900501324
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$243.33 |
| 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 |
$1,508.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,011.20
|
| Rate for Payer: Cigna of CA PPO |
$1,860.36
|
| 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 |
$2,136.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,508.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,262.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,885.50
|
| 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 |
$1,676.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$243.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$502.80
|
| 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 |
$1,885.50
|
| Rate for Payer: Networks By Design Commercial |
$1,634.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,136.90
|
| 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 |
$1,508.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,257.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,257.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,257.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,257.00
|
| 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 DIST PHAL FX W/O MANI
|
Facility
|
OP
|
$2,029.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
900501362
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$155.52 |
| 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 |
$1,217.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,623.20
|
| Rate for Payer: Cigna of CA PPO |
$1,501.46
|
| 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 |
$1,724.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,217.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,826.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,521.75
|
| 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 |
$1,353.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.80
|
| 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 |
$1,521.75
|
| Rate for Payer: Networks By Design Commercial |
$1,318.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,724.65
|
| 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 |
$1,217.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,014.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,014.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,014.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,014.50
|
| 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 DIST PHAL FX W/O MANI
|
Facility
|
IP
|
$2,029.00
|
|
|
Service Code
|
CPT 26750
|
| Hospital Charge Code |
900501362
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$405.80 |
| Max. Negotiated Rate |
$1,826.10 |
| Rate for Payer: Cash Price |
$913.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,623.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$811.60
|
| Rate for Payer: Galaxy Health WC |
$1,724.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,217.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,826.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,353.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$773.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$405.80
|
| Rate for Payer: Multiplan Commercial |
$1,521.75
|
| Rate for Payer: Networks By Design Commercial |
$1,318.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,724.65
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
OP
|
$2,244.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| 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 |
$1,346.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,411.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,097.32
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,795.20
|
| Rate for Payer: Cigna of CA HMO |
$1,436.16
|
| Rate for Payer: Cigna of CA PPO |
$1,660.56
|
| 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 |
$1,907.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,346.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,019.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,683.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$486.16
|
| 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 |
$1,496.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.80
|
| 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 |
$1,683.00
|
| Rate for Payer: Networks By Design Commercial |
$1,458.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,907.40
|
| 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 |
$1,346.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,346.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,122.00
|
| 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 ELBOW DISLOC W O ANES
|
Facility
|
IP
|
$2,244.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$448.80 |
| Max. Negotiated Rate |
$2,019.60 |
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,795.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$897.60
|
| Rate for Payer: Galaxy Health WC |
$1,907.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,346.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,019.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,496.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$854.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.80
|
| Rate for Payer: Multiplan Commercial |
$1,683.00
|
| Rate for Payer: Networks By Design Commercial |
$1,458.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,907.40
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
OP
|
$2,244.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
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 |
$1,346.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,795.20
|
| Rate for Payer: Cigna of CA PPO |
$1,660.56
|
| 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 |
$1,907.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,346.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,019.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,683.00
|
| 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 |
$1,496.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.80
|
| 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 |
$1,683.00
|
| Rate for Payer: Networks By Design Commercial |
$1,458.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,907.40
|
| 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 |
$1,346.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,122.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,122.00
|
| 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 ELBOW DISLOC W O ANES
|
Facility
|
IP
|
$2,244.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$448.80 |
| Max. Negotiated Rate |
$2,019.60 |
| Rate for Payer: Cash Price |
$1,009.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,795.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$897.60
|
| Rate for Payer: Galaxy Health WC |
$1,907.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,346.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,019.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,496.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$854.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.80
|
| Rate for Payer: Multiplan Commercial |
$1,683.00
|
| Rate for Payer: Networks By Design Commercial |
$1,458.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,907.40
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.85 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$176.85
|
| 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 FEM FX,INTER EXT W/MA
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Blue Shield of California Commercial |
$2,279.25
|
| 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 FEM FX,INTER EXT W/MA
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$176.85 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| 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: Blue Shield of California Commercial |
$1,911.53
|
| Rate for Payer: Blue Shield of California EPN |
$1,486.07
|
| 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: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA HMO |
$1,944.96
|
| 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 |
$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 |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$176.85
|
| 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: TriValley Medical Group Commercial/Senior |
$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 FEM FX,INTER EXT W/MA
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Blue Shield of California Commercial |
$2,279.25
|
| 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 FEMORAL FX W/ MANIPUL
|
Facility
|
OP
|
$7,876.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
900501442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$152.08 |
| Max. Negotiated Rate |
$7,088.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,694.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,331.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,331.80
|
| 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 |
$4,725.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Cash Price |
$3,544.20
|
| Rate for Payer: Cash Price |
$3,544.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,300.80
|
| Rate for Payer: Cigna of CA PPO |
$5,828.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,694.60
|
| Rate for Payer: Dignity Health Media |
$6,694.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,694.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,150.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,150.40
|
| Rate for Payer: Galaxy Health WC |
$6,694.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,725.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,088.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,907.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,756.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,253.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,575.20
|
| Rate for Payer: Multiplan Commercial |
$5,907.00
|
| Rate for Payer: Networks By Design Commercial |
$5,119.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,694.60
|
| Rate for Payer: Riverside University Health System MISP |
$3,150.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,725.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,694.60
|
| Rate for Payer: Vantage Medical Group Senior |
$6,694.60
|
|
|
HC CL TREAT FEMORAL FX W/ MANIPUL
|
Facility
|
IP
|
$7,876.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
900501442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,575.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$3,544.20
|
| Rate for Payer: Cash Price |
$3,544.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,300.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,150.40
|
| Rate for Payer: Galaxy Health WC |
$6,694.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,725.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,088.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,253.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,000.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,575.20
|
| Rate for Payer: Multiplan Commercial |
$5,907.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,694.60
|
|
|
HC CL TREAT FEMORAL FX, W MANIPUL
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Blue Shield of California Commercial |
$2,279.25
|
| 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 FEMORAL FX, W MANIPUL
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
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 |
$640.87
|
| 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
|
|
