|
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: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$4,737.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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 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: Redlands Yucaipa Medical Group Commercial/Senior |
$3,789.60
|
| Rate for Payer: Riverside University Health 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
|
|
|
HC CL TREAT MOUTH ROOF FX
|
Facility
OP
|
$7,072.00
|
|
|
Service Code
|
CPT 21421
|
| Hospital Charge Code |
900501741
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,034.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,022.69
|
| 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: BCBS Transplant Transplant |
$4,243.20
|
| Rate for Payer: Caremore Medicare Advantage |
$4,022.69
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,657.60
|
| Rate for Payer: Cigna of CA PPO |
$5,233.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,034.04
|
| 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 |
$6,011.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,243.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,364.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,304.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,597.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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 |
$4,717.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,022.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,414.40
|
| 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 |
$5,304.00
|
| Rate for Payer: Networks By Design Commercial |
$4,596.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,011.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,264.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,243.20
|
| Rate for Payer: Riverside University Health MISP |
$4,424.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,243.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,536.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,536.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,536.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,536.00
|
| 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 MOUTH ROOF FX
|
Facility
IP
|
$7,072.00
|
|
|
Service Code
|
CPT 21421
|
| Hospital Charge Code |
900501741
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,414.40 |
| Max. Negotiated Rate |
$6,364.80 |
| Rate for Payer: Cash Price |
$3,182.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,657.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,828.80
|
| Rate for Payer: Galaxy Health WC |
$6,011.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,243.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,364.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,717.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,414.40
|
| Rate for Payer: Multiplan Commercial |
$5,304.00
|
| Rate for Payer: Networks By Design Commercial |
$4,596.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,011.20
|
|
|
HC CL TREAT NASAL SEPTAL FX
|
Facility
IP
|
$6,699.00
|
|
|
Service Code
|
CPT 21337
|
| Hospital Charge Code |
900501499
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,339.80 |
| Max. Negotiated Rate |
$6,029.10 |
| Rate for Payer: Cash Price |
$3,014.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,359.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,679.60
|
| Rate for Payer: Galaxy Health WC |
$5,694.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,019.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,029.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,468.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,339.80
|
| Rate for Payer: Multiplan Commercial |
$5,024.25
|
| Rate for Payer: Networks By Design Commercial |
$4,354.35
|
| Rate for Payer: Prime Health Services Commercial |
$5,694.15
|
|
|
HC CL TREAT NASAL SEPTAL FX
|
Facility
OP
|
$6,699.00
|
|
|
Service Code
|
CPT 21337
|
| Hospital Charge Code |
900501499
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,597.21 |
| 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 |
$6,034.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,022.69
|
| 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 |
$4,019.40
|
| Rate for Payer: Caremore Medicare Advantage |
$4,022.69
|
| Rate for Payer: Cash Price |
$3,014.55
|
| Rate for Payer: Cash Price |
$3,014.55
|
| Rate for Payer: Cash Price |
$3,014.55
|
| Rate for Payer: Cash Price |
$3,014.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,359.20
|
| Rate for Payer: Cigna of CA PPO |
$4,957.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,034.04
|
| 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 |
$5,694.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,019.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,029.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,024.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,597.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: 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 |
$4,468.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,022.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,339.80
|
| 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 |
$5,024.25
|
| Rate for Payer: Networks By Design Commercial |
$4,354.35
|
| Rate for Payer: Prime Health Services Commercial |
$5,694.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,264.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,019.40
|
| Rate for Payer: Riverside University Health MISP |
$4,424.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,019.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,349.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,349.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,349.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,349.50
|
| 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 OF ACROMICLAV W/MANIP
|
Facility
IP
|
$4,885.00
|
|
|
Service Code
|
CPT 23545
|
| Hospital Charge Code |
900501358
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$977.00 |
| Max. Negotiated Rate |
$4,396.50 |
| Rate for Payer: Cash Price |
$2,198.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.00
|
| Rate for Payer: Galaxy Health WC |
$4,152.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,396.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.00
|
| Rate for Payer: Multiplan Commercial |
$3,663.75
|
| Rate for Payer: Networks By Design Commercial |
$3,175.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,152.25
|
|
|
HC CL TREAT OF ACROMICLAV W/MANIP
|
Facility
OP
|
$4,885.00
|
|
|
Service Code
|
CPT 23545
|
| Hospital Charge Code |
900501358
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$4,396.50 |
| 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 |
$2,931.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$2,198.25
|
| Rate for Payer: Cash Price |
$2,198.25
|
| Rate for Payer: Cash Price |
$2,198.25
|
| Rate for Payer: Cash Price |
$2,198.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.00
|
| Rate for Payer: Cigna of CA PPO |
$3,614.90
|
| 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 |
$4,152.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,396.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,663.75
|
| 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 |
$3,258.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.00
|
| 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 |
$3,663.75
|
| Rate for Payer: Networks By Design Commercial |
$3,175.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,152.25
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,931.00
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,931.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,442.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,442.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,442.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,442.50
|
| 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 OF CARPOMETACARPAL
|
Facility
OP
|
$2,643.00
|
|
|
Service Code
|
CPT 26645
|
| Hospital Charge Code |
900501286
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$3,293.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: 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 |
$1,585.80
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,189.35
|
| Rate for Payer: Cash Price |
$1,189.35
|
| Rate for Payer: Cash Price |
$1,189.35
|
| Rate for Payer: Cash Price |
$1,189.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,114.40
|
| Rate for Payer: Cigna of CA PPO |
$1,955.82
|
| 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 |
$2,246.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,585.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,378.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,982.25
|
| 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 |
$1,762.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$528.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$1,982.25
|
| Rate for Payer: Networks By Design Commercial |
$1,717.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,246.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,585.80
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,585.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,321.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,321.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,321.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,321.50
|
| 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 OF CARPOMETACARPAL
|
Facility
IP
|
$2,643.00
|
|
|
Service Code
|
CPT 26645
|
| Hospital Charge Code |
900501286
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$528.60 |
| Max. Negotiated Rate |
$2,378.70 |
| Rate for Payer: Cash Price |
$1,189.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,114.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,057.20
|
| Rate for Payer: Galaxy Health WC |
$2,246.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,585.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,762.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$528.60
|
| Rate for Payer: Multiplan Commercial |
$1,982.25
|
| Rate for Payer: Networks By Design Commercial |
$1,717.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,246.55
|
|
|
HC CL TREAT OF CLAV FRAC W/MANIPU
|
Facility
IP
|
$6,647.00
|
|
|
Service Code
|
CPT 23505
|
| Hospital Charge Code |
900501357
|
|
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 OF CLAV FRAC W/MANIPU
|
Facility
OP
|
$6,647.00
|
|
|
Service Code
|
CPT 23505
|
| Hospital Charge Code |
900501357
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,982.30 |
| 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 |
$3,988.20
|
| 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 OF CLAV FRAC W/O MANI
|
Facility
IP
|
$1,780.00
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
900501058
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$356.00 |
| Max. Negotiated Rate |
$1,602.00 |
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,424.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$712.00
|
| Rate for Payer: Galaxy Health WC |
$1,513.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,068.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,602.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,187.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.00
|
| Rate for Payer: Multiplan Commercial |
$1,335.00
|
| Rate for Payer: Networks By Design Commercial |
$1,157.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,513.00
|
|
|
HC CL TREAT OF CLAV FRAC W/O MANI
|
Facility
OP
|
$1,780.00
|
|
|
Service Code
|
CPT 23500
|
| Hospital Charge Code |
900501058
|
|
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 |
$1,068.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Cash Price |
$801.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,424.00
|
| Rate for Payer: Cigna of CA PPO |
$1,317.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,513.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,068.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,602.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,335.00
|
| 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 |
$1,187.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,335.00
|
| Rate for Payer: Networks By Design Commercial |
$1,157.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,513.00
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,068.00
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,068.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$890.00
|
| Rate for Payer: United Healthcare All Other HMO |
$890.00
|
| Rate for Payer: United Healthcare HMO Rider |
$890.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$890.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT OF DIS RAD FRAC W/MAN
|
Facility
OP
|
$4,317.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
900501071
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| 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: 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 |
$2,590.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,942.65
|
| Rate for Payer: Cash Price |
$1,942.65
|
| Rate for Payer: Cash Price |
$1,942.65
|
| Rate for Payer: Cash Price |
$1,942.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,453.60
|
| Rate for Payer: Cigna of CA PPO |
$3,194.58
|
| 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 |
$3,669.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,590.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,885.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,237.75
|
| 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 |
$2,879.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$863.40
|
| 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 |
$3,237.75
|
| Rate for Payer: Networks By Design Commercial |
$2,806.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,669.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,590.20
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,590.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,158.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,158.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,158.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,158.50
|
| 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 OF DIS RAD FRAC W/MAN
|
Facility
IP
|
$4,317.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
900501071
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$863.40 |
| Max. Negotiated Rate |
$3,885.30 |
| Rate for Payer: Cash Price |
$1,942.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,453.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,726.80
|
| Rate for Payer: Galaxy Health WC |
$3,669.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,590.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,885.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,879.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$863.40
|
| Rate for Payer: Multiplan Commercial |
$3,237.75
|
| Rate for Payer: Networks By Design Commercial |
$2,806.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,669.45
|
|
|
HC CL TREAT OF DIS RAD FRAC W/MAN
|
Facility
OP
|
$4,317.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
900501071
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$863.40 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: 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 |
$2,590.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,715.39
|
| Rate for Payer: Blue Shield of California EPN |
$2,111.01
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,942.65
|
| Rate for Payer: Cash Price |
$1,942.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,453.60
|
| Rate for Payer: Cigna of CA HMO |
$2,762.88
|
| Rate for Payer: Cigna of CA PPO |
$3,194.58
|
| 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 |
$3,669.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,590.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,885.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,237.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: IEHP medi-cal |
$3,313.35
|
| 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 |
$2,879.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$863.40
|
| 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 |
$3,237.75
|
| Rate for Payer: Networks By Design Commercial |
$2,806.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,669.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,590.20
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,590.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,590.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,158.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,158.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,158.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,158.50
|
| 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 OF DIS RAD FRAC W/MAN
|
Facility
IP
|
$4,317.00
|
|
|
Service Code
|
CPT 25605
|
| Hospital Charge Code |
900501071
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$863.40 |
| Max. Negotiated Rate |
$3,885.30 |
| Rate for Payer: Cash Price |
$1,942.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,453.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,726.80
|
| Rate for Payer: Galaxy Health WC |
$3,669.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,590.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,885.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,879.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$863.40
|
| Rate for Payer: Multiplan Commercial |
$3,237.75
|
| Rate for Payer: Networks By Design Commercial |
$2,806.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,669.45
|
|
|
HC CL TREAT OF DIS RAD FX W/O MAN
|
Facility
IP
|
$2,225.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$445.00 |
| Max. Negotiated Rate |
$2,002.50 |
| Rate for Payer: Cash Price |
$1,001.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,780.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$890.00
|
| Rate for Payer: Galaxy Health WC |
$1,891.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,335.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,002.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,484.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$445.00
|
| Rate for Payer: Multiplan Commercial |
$1,668.75
|
| Rate for Payer: Networks By Design Commercial |
$1,446.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,891.25
|
|
|
HC CL TREAT OF DIS RAD FX W/O MAN
|
Facility
OP
|
$2,225.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$5,779.00 |
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,335.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,399.52
|
| Rate for Payer: Blue Shield of California EPN |
$1,088.02
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,001.25
|
| Rate for Payer: Cash Price |
$1,001.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,780.00
|
| Rate for Payer: Cigna of CA HMO |
$1,424.00
|
| Rate for Payer: Cigna of CA PPO |
$1,646.50
|
| 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 |
$1,891.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,335.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,002.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,668.75
|
| 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 |
$1,484.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$445.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,668.75
|
| Rate for Payer: Networks By Design Commercial |
$1,446.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,891.25
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,335.00
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,335.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,335.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,112.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,112.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,112.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,112.50
|
| 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 OF DIS RAD FX W/O MAN
|
Facility
OP
|
$2,225.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| 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 |
$1,335.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,001.25
|
| Rate for Payer: Cash Price |
$1,001.25
|
| Rate for Payer: Cash Price |
$1,001.25
|
| Rate for Payer: Cash Price |
$1,001.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,780.00
|
| Rate for Payer: Cigna of CA PPO |
$1,646.50
|
| 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 |
$1,891.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,335.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,002.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,668.75
|
| 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 |
$1,484.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$445.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,668.75
|
| Rate for Payer: Networks By Design Commercial |
$1,446.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,891.25
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,335.00
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,335.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,112.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,112.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,112.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,112.50
|
| 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 OF DIS RAD FX W/O MAN
|
Facility
IP
|
$2,225.00
|
|
|
Service Code
|
CPT 25600
|
| Hospital Charge Code |
900501070
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$445.00 |
| Max. Negotiated Rate |
$2,002.50 |
| Rate for Payer: Cash Price |
$1,001.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,780.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$890.00
|
| Rate for Payer: Galaxy Health WC |
$1,891.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,335.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,002.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,484.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$445.00
|
| Rate for Payer: Multiplan Commercial |
$1,668.75
|
| Rate for Payer: Networks By Design Commercial |
$1,446.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,891.25
|
|
|
HC CL TREAT OF ELB DISLOC W/ANEST
|
Facility
IP
|
$6,525.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,305.00 |
| Max. Negotiated Rate |
$5,872.50 |
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,220.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,610.00
|
| Rate for Payer: Galaxy Health WC |
$5,546.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,915.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,872.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,352.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,305.00
|
| Rate for Payer: Multiplan Commercial |
$4,893.75
|
| Rate for Payer: Networks By Design Commercial |
$4,241.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,546.25
|
|
|
HC CL TREAT OF ELB DISLOC W/ANEST
|
Facility
IP
|
$6,525.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,305.00 |
| Max. Negotiated Rate |
$5,872.50 |
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,220.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,610.00
|
| Rate for Payer: Galaxy Health WC |
$5,546.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,915.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,872.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,352.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,305.00
|
| Rate for Payer: Multiplan Commercial |
$4,893.75
|
| Rate for Payer: Networks By Design Commercial |
$4,241.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,546.25
|
|
|
HC CL TREAT OF ELB DISLOC W/ANEST
|
Facility
OP
|
$6,525.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
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 |
$3,915.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,220.00
|
| Rate for Payer: Cigna of CA PPO |
$4,828.50
|
| 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 |
$5,546.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,915.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,872.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,893.75
|
| 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 |
$4,352.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,305.00
|
| 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 |
$4,893.75
|
| Rate for Payer: Networks By Design Commercial |
$4,241.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,546.25
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,915.00
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,915.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,262.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,262.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,262.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,262.50
|
| 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 OF ELB DISLOC W/ANEST
|
Facility
OP
|
$6,525.00
|
|
|
Service Code
|
CPT 24605
|
| Hospital Charge Code |
900501064
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,305.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: 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 |
$3,915.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,104.22
|
| Rate for Payer: Blue Shield of California EPN |
$3,190.72
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Cash Price |
$2,936.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,220.00
|
| Rate for Payer: Cigna of CA HMO |
$4,176.00
|
| Rate for Payer: Cigna of CA PPO |
$4,828.50
|
| 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 |
$5,546.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,915.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,872.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,893.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: IEHP medi-cal |
$3,313.35
|
| 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 |
$4,352.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,305.00
|
| 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 |
$4,893.75
|
| Rate for Payer: Networks By Design Commercial |
$4,241.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,546.25
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,915.00
|
| Rate for Payer: Riverside University Health MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,915.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,915.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,262.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,262.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,262.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,262.50
|
| 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
|
|
