|
HC CL TREAT LUNATE DISLOCA W/MANI
|
Facility
|
OP
|
$5,492.00
|
|
|
Service Code
|
CPT 25690
|
| Hospital Charge Code |
900501383
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$4,942.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,295.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,471.40
|
| Rate for Payer: Cash Price |
$2,471.40
|
| Rate for Payer: Cash Price |
$2,471.40
|
| Rate for Payer: Cash Price |
$2,471.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,393.60
|
| Rate for Payer: Cigna of CA PPO |
$4,064.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$4,668.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,295.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,942.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,119.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,663.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$440.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,098.40
|
| 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 |
$4,119.00
|
| Rate for Payer: Networks By Design Commercial |
$3,569.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,668.20
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,295.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,746.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,746.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,746.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,746.00
|
| 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 LUNATE DISLOCA W/MANI
|
Facility
|
IP
|
$5,492.00
|
|
|
Service Code
|
CPT 25690
|
| Hospital Charge Code |
900501383
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,098.40 |
| Max. Negotiated Rate |
$4,942.80 |
| Rate for Payer: Cash Price |
$2,471.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,393.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,196.80
|
| Rate for Payer: Galaxy Health WC |
$4,668.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,295.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,942.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,663.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,092.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,098.40
|
| Rate for Payer: Multiplan Commercial |
$4,119.00
|
| Rate for Payer: Networks By Design Commercial |
$3,569.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,668.20
|
|
|
HC CL TREAT MANDIBULAR FX
|
Facility
|
OP
|
$15,733.00
|
|
|
Service Code
|
CPT 21453
|
| Hospital Charge Code |
900501369
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$14,159.70 |
| 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 |
$10,975.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,316.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,003.24
|
| Rate for Payer: Blue Distinction Transplant |
$9,439.80
|
| Rate for Payer: Caremore Medicare Advantage |
$7,316.90
|
| Rate for Payer: Cash Price |
$7,079.85
|
| Rate for Payer: Cash Price |
$7,079.85
|
| Rate for Payer: Cash Price |
$7,079.85
|
| Rate for Payer: Cash Price |
$7,079.85
|
| Rate for Payer: Central Health Plan Commercial |
$12,586.40
|
| Rate for Payer: Cigna of CA PPO |
$11,642.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Dignity Health Media |
$7,316.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,048.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,877.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,316.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,316.90
|
| Rate for Payer: Galaxy Health WC |
$13,373.05
|
| Rate for Payer: Global Benefits Group Commercial |
$9,439.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,159.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,799.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,999.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,316.90
|
| Rate for Payer: InnovAge PACE Commercial |
$10,975.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,493.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$640.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,316.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,146.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,804.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,804.65
|
| Rate for Payer: Multiplan Commercial |
$11,799.75
|
| Rate for Payer: Multiplan WC |
$10,003.24
|
| Rate for Payer: Networks By Design Commercial |
$10,226.45
|
| Rate for Payer: Preferred Health Network WC |
$10,207.39
|
| Rate for Payer: Prime Health Services Commercial |
$13,373.05
|
| Rate for Payer: Prime Health Services Medicare |
$7,755.91
|
| Rate for Payer: Prime Health Services WC |
$9,901.17
|
| Rate for Payer: Riverside University Health System MISP |
$8,048.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,439.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,866.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,866.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,866.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,866.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,975.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,048.59
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.90
|
|
|
HC CL TREAT MANDIBULAR FX
|
Facility
|
IP
|
$15,733.00
|
|
|
Service Code
|
CPT 21453
|
| Hospital Charge Code |
900501369
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,146.60 |
| Max. Negotiated Rate |
$14,159.70 |
| Rate for Payer: Cash Price |
$7,079.85
|
| Rate for Payer: Central Health Plan Commercial |
$12,586.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,293.20
|
| Rate for Payer: Galaxy Health WC |
$13,373.05
|
| Rate for Payer: Global Benefits Group Commercial |
$9,439.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,159.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,493.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,994.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,146.60
|
| Rate for Payer: Multiplan Commercial |
$11,799.75
|
| Rate for Payer: Networks By Design Commercial |
$10,226.45
|
| Rate for Payer: Prime Health Services Commercial |
$13,373.05
|
|
|
HC CL TREAT MANDIBULAR FX W/MANIP
|
Facility
|
OP
|
$13,615.00
|
|
|
Service Code
|
CPT 21451
|
| Hospital Charge Code |
900501420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$12,253.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,169.00
|
| Rate for Payer: Caremore Medicare Advantage |
$1,905.44
|
| Rate for Payer: Cash Price |
$6,126.75
|
| Rate for Payer: Cash Price |
$6,126.75
|
| Rate for Payer: Cash Price |
$6,126.75
|
| Rate for Payer: Cash Price |
$6,126.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,892.00
|
| Rate for Payer: Cigna of CA PPO |
$10,075.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Dignity Health Media |
$1,905.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,095.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,572.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,905.44
|
| Rate for Payer: Galaxy Health WC |
$11,572.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,169.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,253.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,211.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,124.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,905.44
|
| Rate for Payer: InnovAge PACE Commercial |
$2,858.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,081.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$720.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,905.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,723.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,553.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,553.29
|
| Rate for Payer: Multiplan Commercial |
$10,211.25
|
| Rate for Payer: Networks By Design Commercial |
$8,849.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,572.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,019.77
|
| Rate for Payer: Riverside University Health System MISP |
$2,095.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,169.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,807.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,807.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,807.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,807.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
HC CL TREAT MANDIBULAR FX W/MANIP
|
Facility
|
IP
|
$13,615.00
|
|
|
Service Code
|
CPT 21451
|
| Hospital Charge Code |
900501420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,723.00 |
| Max. Negotiated Rate |
$12,253.50 |
| Rate for Payer: Cash Price |
$6,126.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,892.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,446.00
|
| Rate for Payer: Galaxy Health WC |
$11,572.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,169.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,253.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,081.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,187.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,723.00
|
| Rate for Payer: Multiplan Commercial |
$10,211.25
|
| Rate for Payer: Networks By Design Commercial |
$8,849.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,572.75
|
|
|
HC CL TREAT MANDIBULAR RIDGE FRAC
|
Facility
|
OP
|
$8,899.00
|
|
|
Service Code
|
CPT 21440
|
| Hospital Charge Code |
900501330
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$252.53 |
| 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 |
$6,034.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,022.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,339.40
|
| Rate for Payer: Caremore Medicare Advantage |
$4,022.69
|
| Rate for Payer: Cash Price |
$4,004.55
|
| Rate for Payer: Cash Price |
$4,004.55
|
| Rate for Payer: Cash Price |
$4,004.55
|
| Rate for Payer: Cash Price |
$4,004.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,119.20
|
| Rate for Payer: Cigna of CA PPO |
$6,585.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,034.04
|
| Rate for Payer: Dignity Health Media |
$4,022.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,424.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,430.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,022.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,022.69
|
| Rate for Payer: Galaxy Health WC |
$7,564.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,339.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,009.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,674.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,597.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,022.69
|
| Rate for Payer: InnovAge PACE Commercial |
$6,034.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,935.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$252.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,022.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,779.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,390.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,390.40
|
| Rate for Payer: Multiplan Commercial |
$6,674.25
|
| Rate for Payer: Networks By Design Commercial |
$5,784.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,564.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,264.05
|
| Rate for Payer: Riverside University Health System MISP |
$4,424.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,339.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,449.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,449.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,449.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,449.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,034.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: Vantage Medical Group Senior |
$4,022.69
|
|
|
HC CL TREAT MANDIBULAR RIDGE FRAC
|
Facility
|
IP
|
$8,899.00
|
|
|
Service Code
|
CPT 21440
|
| Hospital Charge Code |
900501330
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,779.80 |
| Max. Negotiated Rate |
$8,009.10 |
| Rate for Payer: Cash Price |
$4,004.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,119.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,559.60
|
| Rate for Payer: Galaxy Health WC |
$7,564.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,339.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,009.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,935.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,390.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,779.80
|
| Rate for Payer: Multiplan Commercial |
$6,674.25
|
| Rate for Payer: Networks By Design Commercial |
$5,784.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,564.15
|
|
|
HC CL TREAT MED MALL FX W/MANIPUL
|
Facility
|
OP
|
$6,087.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$478.90 |
| Max. Negotiated Rate |
$5,478.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,652.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,828.72
|
| Rate for Payer: Blue Shield of California EPN |
$2,976.54
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,869.60
|
| Rate for Payer: Cigna of CA HMO |
$3,895.68
|
| Rate for Payer: Cigna of CA PPO |
$4,504.38
|
| 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 |
$5,173.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,652.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,478.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,565.25
|
| 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 |
$4,060.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$478.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,217.40
|
| 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 |
$4,565.25
|
| Rate for Payer: Networks By Design Commercial |
$3,956.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,173.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,652.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,652.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,043.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,043.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,043.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,043.50
|
| 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 MED MALL FX W/MANIPUL
|
Facility
|
IP
|
$6,087.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,217.40 |
| Max. Negotiated Rate |
$5,478.30 |
| Rate for Payer: Blue Shield of California Commercial |
$4,565.25
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,869.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,434.80
|
| Rate for Payer: Galaxy Health WC |
$5,173.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,652.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,478.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,060.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,319.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,217.40
|
| Rate for Payer: Multiplan Commercial |
$4,565.25
|
| Rate for Payer: Networks By Design Commercial |
$3,956.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,173.95
|
|
|
HC CL TREAT MED MALL FX W/MANIPUL
|
Facility
|
IP
|
$6,087.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,217.40 |
| Max. Negotiated Rate |
$5,478.30 |
| Rate for Payer: Blue Shield of California Commercial |
$4,565.25
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,869.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,434.80
|
| Rate for Payer: Galaxy Health WC |
$5,173.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,652.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,478.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,060.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,319.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,217.40
|
| Rate for Payer: Multiplan Commercial |
$4,565.25
|
| Rate for Payer: Networks By Design Commercial |
$3,956.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,173.95
|
|
|
HC CL TREAT MED MALL FX W/MANIPUL
|
Facility
|
OP
|
$6,087.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,478.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,652.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Cash Price |
$2,739.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,869.60
|
| Rate for Payer: Cigna of CA PPO |
$4,504.38
|
| 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 |
$5,173.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,652.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,478.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,565.25
|
| 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 |
$4,060.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$478.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,217.40
|
| 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 |
$4,565.25
|
| Rate for Payer: Networks By Design Commercial |
$3,956.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,173.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,652.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,043.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,043.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,043.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,043.50
|
| 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 METACARPAL FX, SNGL
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
900501386
|
|
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: Kaiser Permanente of CA Medi-Cal |
$612.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
|
|
HC CL TREAT METACARPAL FX, SNGL
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
900501386
|
|
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: Kaiser Permanente of CA Medi-Cal |
$612.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
|
|
HC CL TREAT METACARPAL FX, SNGL
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
900501386
|
|
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 |
$1,366.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$964.80
|
| Rate for Payer: 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: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$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 |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.80
|
| Rate for Payer: 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 METACARPAL FX, SNGL
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
900501386
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$964.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: Cigna of CA PPO |
$1,189.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$804.00
|
| Rate for Payer: United Healthcare All Other HMO |
$804.00
|
| Rate for Payer: United Healthcare HMO Rider |
$804.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$804.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT METACARPAL W/MANIPULA
|
Facility
|
OP
|
$1,694.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
900501340
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$264.56 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,489.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,016.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,065.53
|
| Rate for Payer: Blue Shield of California EPN |
$828.37
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,355.20
|
| Rate for Payer: Cigna of CA HMO |
$1,084.16
|
| Rate for Payer: Cigna of CA PPO |
$1,253.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,439.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,016.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,524.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,270.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$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 |
$1,129.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,270.50
|
| Rate for Payer: Networks By Design Commercial |
$1,101.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,439.90
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,016.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,016.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$847.00
|
| Rate for Payer: United Healthcare All Other HMO |
$847.00
|
| Rate for Payer: United Healthcare HMO Rider |
$847.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$847.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT METACARPAL W/MANIPULA
|
Facility
|
IP
|
$1,694.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
900501340
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$338.80 |
| Max. Negotiated Rate |
$1,524.60 |
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$677.60
|
| Rate for Payer: Galaxy Health WC |
$1,439.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,016.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,524.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,129.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$645.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.80
|
| Rate for Payer: Multiplan Commercial |
$1,270.50
|
| Rate for Payer: Networks By Design Commercial |
$1,101.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,439.90
|
|
|
HC CL TREAT METACARPAL W/MANIPULA
|
Facility
|
IP
|
$1,694.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
900501340
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$338.80 |
| Max. Negotiated Rate |
$1,524.60 |
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,355.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$677.60
|
| Rate for Payer: Galaxy Health WC |
$1,439.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,016.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,524.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,129.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$645.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.80
|
| Rate for Payer: Multiplan Commercial |
$1,270.50
|
| Rate for Payer: Networks By Design Commercial |
$1,101.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,439.90
|
|
|
HC CL TREAT METACARPAL W/MANIPULA
|
Facility
|
OP
|
$1,694.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
900501340
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$264.56 |
| 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 |
$1,016.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,355.20
|
| Rate for Payer: Cigna of CA PPO |
$1,253.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,439.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,016.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,524.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,270.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,129.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$338.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,270.50
|
| Rate for Payer: Networks By Design Commercial |
$1,101.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,439.90
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,016.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$847.00
|
| Rate for Payer: United Healthcare All Other HMO |
$847.00
|
| Rate for Payer: United Healthcare HMO Rider |
$847.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$847.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT META FX SNGL W/MAN
|
Facility
|
IP
|
$2,493.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
900501076
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$498.60 |
| Max. Negotiated Rate |
$2,243.70 |
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,994.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$997.20
|
| Rate for Payer: Galaxy Health WC |
$2,119.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,495.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,243.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,662.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$949.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.60
|
| Rate for Payer: Multiplan Commercial |
$1,869.75
|
| Rate for Payer: Networks By Design Commercial |
$1,620.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,119.05
|
|
|
HC CL TREAT META FX SNGL W/MAN
|
Facility
|
OP
|
$2,493.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
900501076
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$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 |
$1,495.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,994.40
|
| Rate for Payer: Cigna of CA PPO |
$1,844.82
|
| 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 |
$2,119.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,495.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,243.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,869.75
|
| 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 |
$1,662.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.60
|
| 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 |
$1,869.75
|
| Rate for Payer: Networks By Design Commercial |
$1,620.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,119.05
|
| 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 |
$1,495.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,246.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,246.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,246.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,246.50
|
| 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 META FX SNGL W/MAN
|
Facility
|
IP
|
$2,493.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
900501076
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$498.60 |
| Max. Negotiated Rate |
$2,243.70 |
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,994.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$997.20
|
| Rate for Payer: Galaxy Health WC |
$2,119.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,495.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,243.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,662.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$949.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.60
|
| Rate for Payer: Multiplan Commercial |
$1,869.75
|
| Rate for Payer: Networks By Design Commercial |
$1,620.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,119.05
|
|
|
HC CL TREAT META FX SNGL W/MAN
|
Facility
|
OP
|
$2,493.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
900501076
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| 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 |
$1,495.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,568.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,219.08
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Cash Price |
$1,121.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,994.40
|
| Rate for Payer: Cigna of CA HMO |
$1,595.52
|
| Rate for Payer: Cigna of CA PPO |
$1,844.82
|
| 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 |
$2,119.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,495.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,243.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,869.75
|
| 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 |
$1,662.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.60
|
| 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 |
$1,869.75
|
| Rate for Payer: Networks By Design Commercial |
$1,620.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,119.05
|
| 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 |
$1,495.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,495.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,246.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,246.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,246.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,246.50
|
| 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 META FX W/EXT FIX EA
|
Facility
|
OP
|
$6,316.00
|
|
|
Service Code
|
CPT 26607
|
| Hospital Charge Code |
900501717
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,632.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,789.60
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| 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 |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$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) Other |
$4,737.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,212.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$772.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,263.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$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 |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| 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 |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
