|
HC CL TREAT FEMORAL FX, W/O MANIP
|
Facility
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
900501482
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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: Redlands Yucaipa Medical Group Commercial/Senior |
$964.80
|
| Rate for Payer: Riverside University Health 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 FEMORAL FX, W/O MANIP
|
Facility
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
900501482
|
|
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: 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 FEMORAL SHAFT FX,W/O
|
Facility
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
900501463
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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: Redlands Yucaipa Medical Group Commercial/Senior |
$964.80
|
| Rate for Payer: Riverside University Health 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 FEMORAL SHAFT FX,W/O
|
Facility
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
900501463
|
|
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: 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 FEM SHAFT FRAC W/MANI
|
Facility
IP
|
$6,610.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
900501085
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,322.00 |
| Max. Negotiated Rate |
$5,949.00 |
| Rate for Payer: Blue Shield of California Commercial |
$4,957.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,288.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,644.00
|
| Rate for Payer: Galaxy Health WC |
$5,618.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,966.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,949.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,408.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,322.00
|
| Rate for Payer: Multiplan Commercial |
$4,957.50
|
| Rate for Payer: Networks By Design Commercial |
$4,296.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,618.50
|
|
|
HC CL TREAT FEM SHAFT FRAC W/MANI
|
Facility
OP
|
$6,610.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
900501085
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: AlphaCare 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: BCBS Transplant Transplant |
$3,966.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,288.00
|
| Rate for Payer: Cigna of CA PPO |
$4,891.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| 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 |
$5,618.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,966.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,949.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,957.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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 |
$4,408.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,322.00
|
| 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 |
$4,957.50
|
| Rate for Payer: Networks By Design Commercial |
$4,296.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,618.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,966.00
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,966.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,305.00
|
| 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 FIBULA FX W/MANIPULAT
|
Facility
OP
|
$6,316.00
|
|
|
Service Code
|
CPT 27781
|
| Hospital Charge Code |
900501487
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,684.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: AlphaCare 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: BCBS Transplant Transplant |
$3,789.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,842.20
|
| Rate for Payer: Cash Price |
$2,842.20
|
| Rate for Payer: Cash Price |
$2,842.20
|
| Rate for Payer: Cash Price |
$2,842.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,052.80
|
| Rate for Payer: Cigna of CA PPO |
$4,673.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| 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 |
$5,368.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,789.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,684.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,737.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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 |
$4,212.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,263.20
|
| 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 |
$4,737.00
|
| Rate for Payer: Networks By Design Commercial |
$4,105.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,368.60
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,789.60
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,789.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,158.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,158.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,158.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,158.00
|
| 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 FIBULA FX W/MANIPULAT
|
Facility
IP
|
$6,316.00
|
|
|
Service Code
|
CPT 27781
|
| Hospital Charge Code |
900501487
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,263.20 |
| Max. Negotiated Rate |
$5,684.40 |
| Rate for Payer: Blue Shield of California Commercial |
$4,737.00
|
| Rate for Payer: Cash Price |
$2,842.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,052.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,526.40
|
| Rate for Payer: Galaxy Health WC |
$5,368.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,789.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,684.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,212.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,263.20
|
| Rate for Payer: Multiplan Commercial |
$4,737.00
|
| Rate for Payer: Networks By Design Commercial |
$4,105.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,368.60
|
|
|
HC CL TREAT FIBULA/SHAFT FX W/O M
|
Facility
IP
|
$575.00
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
900501759
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.00 |
| Max. Negotiated Rate |
$517.50 |
| Rate for Payer: Blue Shield of California Commercial |
$431.25
|
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Central Health Plan Commercial |
$460.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.00
|
| Rate for Payer: Galaxy Health WC |
$488.75
|
| Rate for Payer: Global Benefits Group Commercial |
$345.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$517.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$383.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.00
|
| Rate for Payer: Multiplan Commercial |
$431.25
|
| Rate for Payer: Networks By Design Commercial |
$373.75
|
| Rate for Payer: Prime Health Services Commercial |
$488.75
|
|
|
HC CL TREAT FIBULA/SHAFT FX W/O M
|
Facility
OP
|
$575.00
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
900501759
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.00 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare 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: BCBS Transplant Transplant |
$345.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Cash Price |
$258.75
|
| Rate for Payer: Central Health Plan Commercial |
$460.00
|
| Rate for Payer: Cigna of CA PPO |
$425.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| 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 |
$488.75
|
| Rate for Payer: Global Benefits Group Commercial |
$345.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$517.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$431.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$383.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.00
|
| 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 |
$431.25
|
| Rate for Payer: Networks By Design Commercial |
$373.75
|
| Rate for Payer: Prime Health Services Commercial |
$488.75
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$345.00
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$345.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$287.50
|
| Rate for Payer: United Healthcare All Other HMO |
$287.50
|
| Rate for Payer: United Healthcare HMO Rider |
$287.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$287.50
|
| 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 FINGER/THUMB FX W/O M
|
Facility
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
900501393
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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: Redlands Yucaipa Medical Group Commercial/Senior |
$964.80
|
| Rate for Payer: Riverside University Health 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 FINGER/THUMB FX W/O M
|
Facility
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
900501393
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$1,447.20 |
| 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: 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 FINGER/THUMB FX W/O M
|
Facility
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
900501393
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$1,447.20 |
| 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: 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 FINGER/THUMB FX W/O M
|
Facility
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
900501393
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare 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: BCBS Transplant Transplant |
$964.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,011.43
|
| Rate for Payer: Blue Shield of California EPN |
$786.31
|
| 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: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: Cigna of CA HMO |
$1,029.12
|
| Rate for Payer: Cigna of CA PPO |
$1,189.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| 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 Transplant Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$486.16
|
| Rate for Payer: 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: Redlands Yucaipa Medical Group Commercial/Senior |
$964.80
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$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 FOOT DISLOCAT W/O ANE
|
Facility
IP
|
$803.00
|
|
|
Service Code
|
CPT 28600
|
| Hospital Charge Code |
900501655
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$722.70 |
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Central Health Plan Commercial |
$642.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$321.20
|
| Rate for Payer: Galaxy Health WC |
$682.55
|
| Rate for Payer: Global Benefits Group Commercial |
$481.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$722.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$535.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.60
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
| Rate for Payer: Networks By Design Commercial |
$521.95
|
| Rate for Payer: Prime Health Services Commercial |
$682.55
|
|
|
HC CL TREAT FOOT DISLOCAT W/O ANE
|
Facility
OP
|
$803.00
|
|
|
Service Code
|
CPT 28600
|
| Hospital Charge Code |
900501655
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.60 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare 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: BCBS Transplant Transplant |
$481.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Central Health Plan Commercial |
$642.40
|
| Rate for Payer: Cigna of CA PPO |
$594.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| 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 |
$682.55
|
| Rate for Payer: Global Benefits Group Commercial |
$481.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$722.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$602.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$535.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.60
|
| 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 |
$602.25
|
| Rate for Payer: Networks By Design Commercial |
$521.95
|
| Rate for Payer: Prime Health Services Commercial |
$682.55
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$481.80
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$481.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$401.50
|
| Rate for Payer: United Healthcare All Other HMO |
$401.50
|
| Rate for Payer: United Healthcare HMO Rider |
$401.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$401.50
|
| 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 FRAC OF WT BEAR W/SKE
|
Facility
IP
|
$5,507.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
900501095
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,101.40 |
| Max. Negotiated Rate |
$4,956.30 |
| Rate for Payer: Cash Price |
$2,478.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,405.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,202.80
|
| Rate for Payer: Galaxy Health WC |
$4,680.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,304.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,956.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,673.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,101.40
|
| Rate for Payer: Multiplan Commercial |
$4,130.25
|
| Rate for Payer: Networks By Design Commercial |
$3,579.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,680.95
|
|
|
HC CL TREAT FRAC OF WT BEAR W/SKE
|
Facility
OP
|
$5,507.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
900501095
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| 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: BCBS Transplant Transplant |
$3,304.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,478.15
|
| Rate for Payer: Cash Price |
$2,478.15
|
| Rate for Payer: Cash Price |
$2,478.15
|
| Rate for Payer: Cash Price |
$2,478.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,405.60
|
| Rate for Payer: Cigna of CA PPO |
$4,075.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| 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 |
$4,680.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,304.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,956.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,130.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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 |
$3,673.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,101.40
|
| 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 |
$4,130.25
|
| Rate for Payer: Networks By Design Commercial |
$3,579.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,680.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,304.20
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,304.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,753.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,753.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,753.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,753.50
|
| 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 FX OF WT BRNG LWR LEG
|
Facility
IP
|
$987.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
900501502
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$197.40 |
| Max. Negotiated Rate |
$888.30 |
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Central Health Plan Commercial |
$789.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$394.80
|
| Rate for Payer: Galaxy Health WC |
$838.95
|
| Rate for Payer: Global Benefits Group Commercial |
$592.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$888.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$658.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.40
|
| Rate for Payer: Multiplan Commercial |
$740.25
|
| Rate for Payer: Networks By Design Commercial |
$641.55
|
| Rate for Payer: Prime Health Services Commercial |
$838.95
|
|
|
HC CL TREAT FX OF WT BRNG LWR LEG
|
Facility
OP
|
$987.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
900501502
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$197.40 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$294.64
|
| 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: BCBS Transplant Transplant |
$592.20
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Central Health Plan Commercial |
$789.60
|
| Rate for Payer: Cigna of CA PPO |
$730.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| 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 |
$838.95
|
| Rate for Payer: Global Benefits Group Commercial |
$592.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$888.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$740.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$658.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.40
|
| 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 |
$740.25
|
| Rate for Payer: Networks By Design Commercial |
$641.55
|
| Rate for Payer: Prime Health Services Commercial |
$838.95
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$592.20
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$592.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$493.50
|
| Rate for Payer: United Healthcare All Other HMO |
$493.50
|
| Rate for Payer: United Healthcare HMO Rider |
$493.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$493.50
|
| 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 FX ORBIT, W/O MANIPUL
|
Facility
IP
|
$3,460.00
|
|
|
Service Code
|
CPT 21400
|
| Hospital Charge Code |
900501526
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$692.00 |
| Max. Negotiated Rate |
$3,114.00 |
| Rate for Payer: Cash Price |
$1,557.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,768.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,384.00
|
| Rate for Payer: Galaxy Health WC |
$2,941.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,076.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,114.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,307.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$692.00
|
| Rate for Payer: Multiplan Commercial |
$2,595.00
|
| Rate for Payer: Networks By Design Commercial |
$2,249.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,941.00
|
|
|
HC CL TREAT FX ORBIT, W/O MANIPUL
|
Facility
OP
|
$3,460.00
|
|
|
Service Code
|
CPT 21400
|
| Hospital Charge Code |
900501526
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$687.44
|
| 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: BCBS Transplant Transplant |
$2,076.00
|
| Rate for Payer: Caremore Medicare Advantage |
$687.44
|
| Rate for Payer: Cash Price |
$1,557.00
|
| Rate for Payer: Cash Price |
$1,557.00
|
| Rate for Payer: Cash Price |
$1,557.00
|
| Rate for Payer: Cash Price |
$1,557.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,768.00
|
| Rate for Payer: Cigna of CA PPO |
$2,560.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$2,941.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,076.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,114.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,595.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$687.44
|
| Rate for Payer: Innovage PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,307.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$692.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$2,595.00
|
| Rate for Payer: Networks By Design Commercial |
$2,249.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,941.00
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,076.00
|
| Rate for Payer: Riverside University Health MISP |
$756.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,076.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,730.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,730.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,730.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,730.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC CL TREAT GRT HUMERUS FX W/MANI
|
Facility
IP
|
$6,647.00
|
|
|
Service Code
|
CPT 23625
|
| Hospital Charge Code |
900501414
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,329.40 |
| Max. Negotiated Rate |
$5,982.30 |
| Rate for Payer: Cash Price |
$2,991.15
|
| Rate for Payer: Central Health Plan Commercial |
$5,317.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,658.80
|
| Rate for Payer: Galaxy Health WC |
$5,649.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,988.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,982.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,433.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,329.40
|
| Rate for Payer: Multiplan Commercial |
$4,985.25
|
| Rate for Payer: Networks By Design Commercial |
$4,320.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,649.95
|
|
|
HC CL TREAT GRT HUMERUS FX W/MANI
|
Facility
OP
|
$6,647.00
|
|
|
Service Code
|
CPT 23625
|
| Hospital Charge Code |
900501414
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: AlphaCare 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: BCBS Transplant Transplant |
$3,988.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,991.15
|
| Rate for Payer: Cash Price |
$2,991.15
|
| Rate for Payer: Cash Price |
$2,991.15
|
| Rate for Payer: Cash Price |
$2,991.15
|
| Rate for Payer: Central Health Plan Commercial |
$5,317.60
|
| Rate for Payer: Cigna of CA PPO |
$4,918.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| 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 |
$5,649.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,988.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,982.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,985.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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 |
$4,433.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,329.40
|
| 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 |
$4,985.25
|
| Rate for Payer: Networks By Design Commercial |
$4,320.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,649.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,988.20
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,988.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,323.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,323.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,323.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,323.50
|
| 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 GRT HUMERUS FX W/O MA
|
Facility
IP
|
$2,009.00
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
900501476
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$401.80 |
| Max. Negotiated Rate |
$1,808.10 |
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$803.60
|
| Rate for Payer: Galaxy Health WC |
$1,707.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,205.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,808.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,340.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.80
|
| Rate for Payer: Multiplan Commercial |
$1,506.75
|
| Rate for Payer: Networks By Design Commercial |
$1,305.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,707.65
|
|
