|
HC CL TREAT OF SHLD DISLOC W/MANI
|
Facility
|
IP
|
$2,547.00
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
900501060
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$509.40 |
| Max. Negotiated Rate |
$2,292.30 |
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,037.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,018.80
|
| Rate for Payer: Galaxy Health WC |
$2,164.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,528.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,292.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,698.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$970.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$509.40
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
| Rate for Payer: Networks By Design Commercial |
$1,655.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,164.95
|
|
|
HC CL TREAT OF SHLD DISLOC W/MANI
|
Facility
|
OP
|
$2,547.00
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
900501060
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$266.51 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,528.20
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,037.60
|
| Rate for Payer: Cigna of CA PPO |
$1,884.78
|
| 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 |
$2,164.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,528.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,292.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,910.25
|
| 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 |
$1,698.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$266.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$509.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
| Rate for Payer: Networks By Design Commercial |
$1,655.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,164.95
|
| 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 |
$1,528.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,273.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,273.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,273.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,273.50
|
| 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 SHLD DISLOC W/MANI
|
Facility
|
IP
|
$2,547.00
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
900501060
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$509.40 |
| Max. Negotiated Rate |
$2,292.30 |
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,037.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,018.80
|
| Rate for Payer: Galaxy Health WC |
$2,164.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,528.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,292.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,698.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$970.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$509.40
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
| Rate for Payer: Networks By Design Commercial |
$1,655.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,164.95
|
|
|
HC CL TREAT OF SHLD DISLOC W/MANI
|
Facility
|
OP
|
$2,547.00
|
|
|
Service Code
|
CPT 23650
|
| Hospital Charge Code |
900501060
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$266.51 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,528.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,602.06
|
| Rate for Payer: Blue Shield of California EPN |
$1,245.48
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Cash Price |
$1,146.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,037.60
|
| Rate for Payer: Cigna of CA HMO |
$1,630.08
|
| Rate for Payer: Cigna of CA PPO |
$1,884.78
|
| 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 |
$2,164.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,528.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,292.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,910.25
|
| 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 |
$1,698.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$266.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$509.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,910.25
|
| Rate for Payer: Networks By Design Commercial |
$1,655.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,164.95
|
| 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 |
$1,528.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,528.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,273.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,273.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,273.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,273.50
|
| 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 TIB SHFT FRAC W/WO
|
Facility
|
IP
|
$1,565.00
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
900501233
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.00 |
| Max. Negotiated Rate |
$1,408.50 |
| Rate for Payer: Blue Shield of California Commercial |
$1,173.75
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$626.00
|
| Rate for Payer: Galaxy Health WC |
$1,330.25
|
| Rate for Payer: Global Benefits Group Commercial |
$939.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,408.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,043.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$596.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.00
|
| Rate for Payer: Multiplan Commercial |
$1,173.75
|
| Rate for Payer: Networks By Design Commercial |
$1,017.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,330.25
|
|
|
HC CL TREAT OF TIB SHFT FRAC W/WO
|
Facility
|
OP
|
$1,565.00
|
|
|
Service Code
|
CPT 27750
|
| Hospital Charge Code |
900501233
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$939.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.00
|
| Rate for Payer: Cigna of CA PPO |
$1,158.10
|
| 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 |
$1,330.25
|
| Rate for Payer: Global Benefits Group Commercial |
$939.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,408.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,173.75
|
| 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 |
$1,043.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.00
|
| 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 |
$1,173.75
|
| Rate for Payer: Networks By Design Commercial |
$1,017.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,330.25
|
| 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 |
$939.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$782.50
|
| Rate for Payer: United Healthcare All Other HMO |
$782.50
|
| Rate for Payer: United Healthcare HMO Rider |
$782.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$782.50
|
| 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 TM DIS INT OR SUBQ
|
Facility
|
IP
|
$1,496.00
|
|
|
Service Code
|
CPT 21480
|
| Hospital Charge Code |
900501057
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$299.20 |
| Max. Negotiated Rate |
$1,346.40 |
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.40
|
| Rate for Payer: Galaxy Health WC |
$1,271.60
|
| Rate for Payer: Global Benefits Group Commercial |
$897.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,346.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.20
|
| Rate for Payer: Multiplan Commercial |
$1,122.00
|
| Rate for Payer: Networks By Design Commercial |
$972.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,271.60
|
|
|
HC CL TREAT OF TM DIS INT OR SUBQ
|
Facility
|
OP
|
$1,496.00
|
|
|
Service Code
|
CPT 21480
|
| Hospital Charge Code |
900501057
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$134.41 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$897.60
|
| Rate for Payer: Blue Shield of California Commercial |
$940.98
|
| Rate for Payer: Blue Shield of California EPN |
$731.54
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.80
|
| Rate for Payer: Cigna of CA HMO |
$957.44
|
| Rate for Payer: Cigna of CA PPO |
$1,107.04
|
| 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 |
$1,271.60
|
| Rate for Payer: Global Benefits Group Commercial |
$897.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,346.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,122.00
|
| 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 |
$997.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,122.00
|
| Rate for Payer: Networks By Design Commercial |
$972.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,271.60
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$897.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$748.00
|
| Rate for Payer: United Healthcare HMO Rider |
$748.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$748.00
|
| 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 TM DIS INT OR SUBQ
|
Facility
|
IP
|
$1,496.00
|
|
|
Service Code
|
CPT 21480
|
| Hospital Charge Code |
900501057
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$299.20 |
| Max. Negotiated Rate |
$1,346.40 |
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.40
|
| Rate for Payer: Galaxy Health WC |
$1,271.60
|
| Rate for Payer: Global Benefits Group Commercial |
$897.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,346.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.20
|
| Rate for Payer: Multiplan Commercial |
$1,122.00
|
| Rate for Payer: Networks By Design Commercial |
$972.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,271.60
|
|
|
HC CL TREAT OF TM DIS INT OR SUBQ
|
Facility
|
OP
|
$1,496.00
|
|
|
Service Code
|
CPT 21480
|
| Hospital Charge Code |
900501057
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$134.41 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$897.60
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,196.80
|
| Rate for Payer: Cigna of CA PPO |
$1,107.04
|
| 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 |
$1,271.60
|
| Rate for Payer: Global Benefits Group Commercial |
$897.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,346.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,122.00
|
| 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 |
$997.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,122.00
|
| Rate for Payer: Networks By Design Commercial |
$972.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,271.60
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$748.00
|
| Rate for Payer: United Healthcare HMO Rider |
$748.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$748.00
|
| 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 ULN SHAFT FRAC W/O
|
Facility
|
OP
|
$1,694.00
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
900501068
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$270.75 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,016.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Cash Price |
$762.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,355.20
|
| Rate for Payer: Cigna of CA PPO |
$1,253.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,439.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,016.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,524.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,270.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,129.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$270.75
|
| 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 OF ULN SHAFT FRAC W/O
|
Facility
|
IP
|
$1,694.00
|
|
|
Service Code
|
CPT 25530
|
| Hospital Charge Code |
900501068
|
|
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 OF WRIST DISLOCATION
|
Facility
|
IP
|
$1,428.00
|
|
|
Service Code
|
CPT 25660
|
| Hospital Charge Code |
900501457
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$1,285.20 |
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,142.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$571.20
|
| Rate for Payer: Galaxy Health WC |
$1,213.80
|
| Rate for Payer: Global Benefits Group Commercial |
$856.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,285.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$952.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$544.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$285.60
|
| Rate for Payer: Multiplan Commercial |
$1,071.00
|
| Rate for Payer: Networks By Design Commercial |
$928.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,213.80
|
|
|
HC CL TREAT OF WRIST DISLOCATION
|
Facility
|
OP
|
$1,428.00
|
|
|
Service Code
|
CPT 25660
|
| Hospital Charge Code |
900501457
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: 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 |
$856.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,142.40
|
| Rate for Payer: Cigna of CA PPO |
$1,056.72
|
| 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 |
$1,213.80
|
| Rate for Payer: Global Benefits Group Commercial |
$856.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,285.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,071.00
|
| 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 |
$952.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$319.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$285.60
|
| 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 |
$1,071.00
|
| Rate for Payer: Networks By Design Commercial |
$928.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,213.80
|
| 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 |
$856.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$714.00
|
| Rate for Payer: United Healthcare All Other HMO |
$714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$714.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$714.00
|
| 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 PHAL SHFT FX W/MANI
|
Facility
|
OP
|
$2,514.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
900501078
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$257.49 |
| 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 |
$1,508.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,011.20
|
| Rate for Payer: Cigna of CA PPO |
$1,860.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$2,136.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,508.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,262.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,885.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,676.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$257.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$502.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,885.50
|
| Rate for Payer: Networks By Design Commercial |
$1,634.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,136.90
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,508.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,257.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,257.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,257.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT PHAL SHFT FX W/MANI
|
Facility
|
IP
|
$2,514.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
900501078
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$502.80 |
| Max. Negotiated Rate |
$2,262.60 |
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,011.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,005.60
|
| Rate for Payer: Galaxy Health WC |
$2,136.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,508.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,262.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,676.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$957.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$502.80
|
| Rate for Payer: Multiplan Commercial |
$1,885.50
|
| Rate for Payer: Networks By Design Commercial |
$1,634.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,136.90
|
|
|
HC CL TREAT PHAL SHFT FX W/MANI
|
Facility
|
IP
|
$2,514.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
900501078
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$502.80 |
| Max. Negotiated Rate |
$2,262.60 |
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,011.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,005.60
|
| Rate for Payer: Galaxy Health WC |
$2,136.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,508.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,262.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,676.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$957.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$502.80
|
| Rate for Payer: Multiplan Commercial |
$1,885.50
|
| Rate for Payer: Networks By Design Commercial |
$1,634.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,136.90
|
|
|
HC CL TREAT PHAL SHFT FX W/MANI
|
Facility
|
OP
|
$2,514.00
|
|
|
Service Code
|
CPT 26725
|
| Hospital Charge Code |
900501078
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$257.49 |
| 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 |
$1,508.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,581.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,229.35
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Cash Price |
$1,131.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,011.20
|
| Rate for Payer: Cigna of CA HMO |
$1,608.96
|
| Rate for Payer: Cigna of CA PPO |
$1,860.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$2,136.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,508.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,262.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,885.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$486.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,676.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$257.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$502.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,885.50
|
| Rate for Payer: Networks By Design Commercial |
$1,634.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,136.90
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,508.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,508.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,257.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,257.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,257.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT POST HIP ARTHOPLAS
|
Facility
|
IP
|
$4,978.00
|
|
|
Service Code
|
CPT 27266
|
| Hospital Charge Code |
900501084
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$995.60 |
| Max. Negotiated Rate |
$4,480.20 |
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,991.20
|
| Rate for Payer: Galaxy Health WC |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,320.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,896.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| Rate for Payer: Multiplan Commercial |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
|
|
HC CL TREAT POST HIP ARTHOPLAS
|
Facility
|
OP
|
$4,978.00
|
|
|
Service Code
|
CPT 27266
|
| Hospital Charge Code |
900501084
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$175.43 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,986.80
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Cash Price |
$2,240.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,982.40
|
| Rate for Payer: Cigna of CA PPO |
$3,683.72
|
| 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 |
$4,231.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,986.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,480.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,733.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,320.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$995.60
|
| 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 |
$3,733.50
|
| Rate for Payer: Networks By Design Commercial |
$3,235.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,231.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,986.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,489.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,489.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,489.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,489.00
|
| 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 POST HIP ARTH W/O ANE
|
Facility
|
IP
|
$1,552.00
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
900501222
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$310.40 |
| Max. Negotiated Rate |
$1,396.80 |
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,241.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$620.80
|
| Rate for Payer: Galaxy Health WC |
$1,319.20
|
| Rate for Payer: Global Benefits Group Commercial |
$931.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,396.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,035.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$591.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.40
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,008.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,319.20
|
|
|
HC CL TREAT POST HIP ARTH W/O ANE
|
Facility
|
OP
|
$1,552.00
|
|
|
Service Code
|
CPT 27265
|
| Hospital Charge Code |
900501222
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$931.20
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Cash Price |
$698.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,241.60
|
| Rate for Payer: Cigna of CA PPO |
$1,148.48
|
| 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 |
$1,319.20
|
| Rate for Payer: Global Benefits Group Commercial |
$931.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,396.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,164.00
|
| 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 |
$1,035.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$661.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,164.00
|
| Rate for Payer: Networks By Design Commercial |
$1,008.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,319.20
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$931.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$776.00
|
| Rate for Payer: United Healthcare All Other HMO |
$776.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$776.00
|
| 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 PROXIMAL HUMERAL FX
|
Facility
|
IP
|
$1,823.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
900501385
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$364.60 |
| Max. Negotiated Rate |
$1,640.70 |
| Rate for Payer: Cash Price |
$820.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,458.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$729.20
|
| Rate for Payer: Galaxy Health WC |
$1,549.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,093.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,640.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,215.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$694.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.60
|
| Rate for Payer: Multiplan Commercial |
$1,367.25
|
| Rate for Payer: Networks By Design Commercial |
$1,184.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,549.55
|
|
|
HC CL TREAT PROXIMAL HUMERAL FX
|
Facility
|
IP
|
$1,823.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
900501385
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$364.60 |
| Max. Negotiated Rate |
$1,640.70 |
| Rate for Payer: Cash Price |
$820.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,458.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$729.20
|
| Rate for Payer: Galaxy Health WC |
$1,549.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,093.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,640.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,215.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$694.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.60
|
| Rate for Payer: Multiplan Commercial |
$1,367.25
|
| Rate for Payer: Networks By Design Commercial |
$1,184.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,549.55
|
|
|
HC CL TREAT PROXIMAL HUMERAL FX
|
Facility
|
OP
|
$1,823.00
|
|
|
Service Code
|
CPT 23600
|
| Hospital Charge Code |
900501385
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,093.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$820.35
|
| Rate for Payer: Cash Price |
$820.35
|
| Rate for Payer: Cash Price |
$820.35
|
| Rate for Payer: Cash Price |
$820.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,458.40
|
| Rate for Payer: Cigna of CA PPO |
$1,349.02
|
| 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 |
$1,549.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,093.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,640.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,367.25
|
| 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 |
$1,215.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.60
|
| 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 |
$1,367.25
|
| Rate for Payer: Networks By Design Commercial |
$1,184.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,549.55
|
| 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 |
$1,093.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$911.50
|
| Rate for Payer: United Healthcare All Other HMO |
$911.50
|
| Rate for Payer: United Healthcare HMO Rider |
$911.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$911.50
|
| 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
|
|
