|
HC CL TREAT SHLDR DISLOC W/ANES
|
Facility
|
IP
|
$7,488.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,497.60 |
| Max. Negotiated Rate |
$6,739.20 |
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,990.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,995.20
|
| Rate for Payer: Galaxy Health WC |
$6,364.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,492.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,739.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,994.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,852.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,497.60
|
| Rate for Payer: Multiplan Commercial |
$5,616.00
|
| Rate for Payer: Networks By Design Commercial |
$4,867.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,364.80
|
|
|
HC CL TREAT SHLDR DISLOC W/ANES
|
Facility
|
IP
|
$7,488.00
|
|
|
Service Code
|
CPT 23655
|
| Hospital Charge Code |
900501061
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,497.60 |
| Max. Negotiated Rate |
$6,739.20 |
| Rate for Payer: Cash Price |
$3,369.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,990.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,995.20
|
| Rate for Payer: Galaxy Health WC |
$6,364.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,492.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,739.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,994.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,852.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,497.60
|
| Rate for Payer: Multiplan Commercial |
$5,616.00
|
| Rate for Payer: Networks By Design Commercial |
$4,867.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,364.80
|
|
|
HC CL TREAT SHLDR DISLO/FX W/MANI
|
Facility
|
IP
|
$3,800.00
|
|
|
Service Code
|
CPT 23665
|
| Hospital Charge Code |
900501501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$760.00 |
| Max. Negotiated Rate |
$3,420.00 |
| Rate for Payer: Cash Price |
$1,710.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,040.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,520.00
|
| Rate for Payer: Galaxy Health WC |
$3,230.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,420.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,534.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,447.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.00
|
| Rate for Payer: Multiplan Commercial |
$2,850.00
|
| Rate for Payer: Networks By Design Commercial |
$2,470.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.00
|
|
|
HC CL TREAT SHLDR DISLO/FX W/MANI
|
Facility
|
OP
|
$3,800.00
|
|
|
Service Code
|
CPT 23665
|
| Hospital Charge Code |
900501501
|
|
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: 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 |
$2,280.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,710.00
|
| Rate for Payer: Cash Price |
$1,710.00
|
| Rate for Payer: Cash Price |
$1,710.00
|
| Rate for Payer: Cash Price |
$1,710.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,040.00
|
| Rate for Payer: Cigna of CA PPO |
$2,812.00
|
| 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 |
$3,230.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,420.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,850.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,534.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.00
|
| 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 |
$2,850.00
|
| Rate for Payer: Networks By Design Commercial |
$2,470.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.00
|
| 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 |
$2,280.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,900.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,900.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,900.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,900.00
|
| 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 SHOULDER DISLOC W/MAN
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,157.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
|
|
HC CL TREAT SHOULDER DISLOC W/MAN
|
Facility
|
IP
|
$3,039.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$607.80 |
| Max. Negotiated Rate |
$2,735.10 |
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,215.60
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,157.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
|
|
HC CL TREAT SHOULDER DISLOC W/MAN
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$607.80 |
| 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: 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,823.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,911.53
|
| Rate for Payer: Blue Shield of California EPN |
$1,486.07
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA HMO |
$1,944.96
|
| Rate for Payer: Cigna of CA PPO |
$2,248.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,279.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,313.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,519.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,519.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,519.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,519.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT SHOULDER DISLOC W/MAN
|
Facility
|
OP
|
$3,039.00
|
|
|
Service Code
|
CPT 23675
|
| Hospital Charge Code |
900501477
|
|
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: 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,823.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Cash Price |
$1,367.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,431.20
|
| Rate for Payer: Cigna of CA PPO |
$2,248.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$2,583.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,823.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,735.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,279.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,027.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$2,279.25
|
| Rate for Payer: Networks By Design Commercial |
$1,975.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,583.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,823.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,519.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,519.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,519.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,519.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT TA ANKLE FX W/O MANIP
|
Facility
|
OP
|
$2,009.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
900501560
|
|
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 |
$1,205.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,607.20
|
| Rate for Payer: Cigna of CA PPO |
$1,486.66
|
| 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 |
$1,707.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,205.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,808.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,506.75
|
| 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 |
$1,340.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.80
|
| 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 |
$1,506.75
|
| Rate for Payer: Networks By Design Commercial |
$1,305.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,707.65
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,205.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,004.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,004.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,004.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,004.50
|
| 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 TA ANKLE FX W/O MANIP
|
Facility
|
IP
|
$2,009.00
|
|
|
Service Code
|
CPT 27816
|
| Hospital Charge Code |
900501560
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$401.80 |
| Max. Negotiated Rate |
$1,808.10 |
| Rate for Payer: Cash Price |
$904.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$803.60
|
| Rate for Payer: Galaxy Health WC |
$1,707.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,205.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,808.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,340.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$765.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.80
|
| Rate for Payer: Multiplan Commercial |
$1,506.75
|
| Rate for Payer: Networks By Design Commercial |
$1,305.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,707.65
|
|
|
HC CL TREAT TALUS FRAC,W/MANIP
|
Facility
|
OP
|
$6,140.00
|
|
|
Service Code
|
CPT 28435
|
| Hospital Charge Code |
900501235
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$343.79 |
| 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 |
$3,684.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,763.00
|
| Rate for Payer: Cash Price |
$2,763.00
|
| Rate for Payer: Cash Price |
$2,763.00
|
| Rate for Payer: Cash Price |
$2,763.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,912.00
|
| Rate for Payer: Cigna of CA PPO |
$4,543.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$5,219.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,684.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,526.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,605.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,095.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$343.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,228.00
|
| 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 |
$4,605.00
|
| Rate for Payer: Networks By Design Commercial |
$3,991.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,219.00
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,684.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,070.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,070.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,070.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,070.00
|
| 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 TALUS FRAC,W/MANIP
|
Facility
|
IP
|
$6,140.00
|
|
|
Service Code
|
CPT 28435
|
| Hospital Charge Code |
900501235
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,228.00 |
| Max. Negotiated Rate |
$5,526.00 |
| Rate for Payer: Cash Price |
$2,763.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,912.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,456.00
|
| Rate for Payer: Galaxy Health WC |
$5,219.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,684.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,526.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,095.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,339.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,228.00
|
| Rate for Payer: Multiplan Commercial |
$4,605.00
|
| Rate for Payer: Networks By Design Commercial |
$3,991.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,219.00
|
|
|
HC CL TREAT TALUS FX, W/O MANIPUL
|
Facility
|
IP
|
$1,780.00
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
900501475
|
|
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: Kaiser Permanente of CA Medi-Cal |
$678.18
|
| 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 TALUS FX, W/O MANIPUL
|
Facility
|
OP
|
$1,780.00
|
|
|
Service Code
|
CPT 28430
|
| Hospital Charge Code |
900501475
|
|
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 |
$1,068.00
|
| 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: 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 |
$1,513.00
|
| 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) Other |
$1,335.00
|
| 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 |
$1,187.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$544.67
|
| 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: Riverside University Health System 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 THIGH FX
|
Facility
|
OP
|
$4,886.00
|
|
|
Service Code
|
CPT 27238
|
| Hospital Charge Code |
900501436
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$4,397.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,931.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: Cigna of CA PPO |
$3,615.64
|
| 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 |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,664.50
|
| 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 |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$465.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
| 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 |
$2,931.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,443.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,443.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,443.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,443.00
|
| 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 THIGH FX
|
Facility
|
IP
|
$4,886.00
|
|
|
Service Code
|
CPT 27238
|
| Hospital Charge Code |
900501436
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$977.20 |
| Max. Negotiated Rate |
$4,397.40 |
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.40
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,861.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
|
|
HC CL TREAT THIGH FX W/MANIP
|
Facility
|
OP
|
$4,560.00
|
|
|
Service Code
|
CPT 27517
|
| Hospital Charge Code |
900501685
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$4,104.00 |
| 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 |
$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 |
$2,736.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,648.00
|
| Rate for Payer: Cigna of CA PPO |
$3,374.40
|
| 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 |
$3,876.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,736.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,104.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,420.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,041.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.00
|
| 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 |
$3,420.00
|
| Rate for Payer: Networks By Design Commercial |
$2,964.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,876.00
|
| 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 |
$2,736.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,280.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,280.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,280.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,280.00
|
| 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 THIGH FX W/MANIP
|
Facility
|
IP
|
$4,560.00
|
|
|
Service Code
|
CPT 27517
|
| Hospital Charge Code |
900501685
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$912.00 |
| Max. Negotiated Rate |
$4,104.00 |
| Rate for Payer: Blue Shield of California Commercial |
$3,420.00
|
| Rate for Payer: Cash Price |
$2,052.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,648.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,824.00
|
| Rate for Payer: Galaxy Health WC |
$3,876.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,736.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,104.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,041.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,737.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.00
|
| Rate for Payer: Multiplan Commercial |
$3,420.00
|
| Rate for Payer: Networks By Design Commercial |
$2,964.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,876.00
|
|
|
HC CL TREAT THIGH FX W/O MANIPULA
|
Facility
|
OP
|
$937.00
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
900501448
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.52 |
| 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 |
$562.20
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Central Health Plan Commercial |
$749.60
|
| Rate for Payer: Cigna of CA PPO |
$693.38
|
| 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 |
$796.45
|
| Rate for Payer: Global Benefits Group Commercial |
$562.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$843.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$702.75
|
| 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 |
$624.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.40
|
| 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 |
$702.75
|
| Rate for Payer: Networks By Design Commercial |
$609.05
|
| Rate for Payer: Prime Health Services Commercial |
$796.45
|
| 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 |
$562.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$468.50
|
| Rate for Payer: United Healthcare All Other HMO |
$468.50
|
| Rate for Payer: United Healthcare HMO Rider |
$468.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$468.50
|
| 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 THIGH FX W/O MANIPULA
|
Facility
|
IP
|
$937.00
|
|
|
Service Code
|
CPT 27501
|
| Hospital Charge Code |
900501448
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$187.40 |
| Max. Negotiated Rate |
$843.30 |
| Rate for Payer: Blue Shield of California Commercial |
$702.75
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Central Health Plan Commercial |
$749.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$374.80
|
| Rate for Payer: Galaxy Health WC |
$796.45
|
| Rate for Payer: Global Benefits Group Commercial |
$562.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$843.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$624.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.40
|
| Rate for Payer: Multiplan Commercial |
$702.75
|
| Rate for Payer: Networks By Design Commercial |
$609.05
|
| Rate for Payer: Prime Health Services Commercial |
$796.45
|
|
|
HC CL TREAT TIBIAL FX W/O MANIPUL
|
Facility
|
OP
|
$1,969.00
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
900501367
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,181.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,575.20
|
| Rate for Payer: Cigna of CA PPO |
$1,457.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,772.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,476.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,313.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,476.75
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,181.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$984.50
|
| Rate for Payer: United Healthcare All Other HMO |
$984.50
|
| Rate for Payer: United Healthcare HMO Rider |
$984.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$984.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT TIBIAL FX W/O MANIPUL
|
Facility
|
IP
|
$1,969.00
|
|
|
Service Code
|
CPT 27530
|
| Hospital Charge Code |
900501367
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.80 |
| Max. Negotiated Rate |
$1,772.10 |
| Rate for Payer: Blue Shield of California Commercial |
$1,476.75
|
| Rate for Payer: Cash Price |
$886.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,575.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$787.60
|
| Rate for Payer: Galaxy Health WC |
$1,673.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,181.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,772.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,313.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$750.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.80
|
| Rate for Payer: Multiplan Commercial |
$1,476.75
|
| Rate for Payer: Networks By Design Commercial |
$1,279.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,673.65
|
|
|
HC CL TREAT TIBIAL FX W/SKELETAL
|
Facility
|
OP
|
$6,647.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
900501554
|
|
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 |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,988.20
|
| Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
| 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 |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$5,649.95
|
| 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) Other |
$4,985.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,433.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$475.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,329.40
|
| 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 |
$4,985.25
|
| 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 |
$4,286.86
|
| Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
| 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 |
$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 TIBIAL FX W/SKELETAL
|
Facility
|
IP
|
$6,647.00
|
|
|
Service Code
|
CPT 27532
|
| Hospital Charge Code |
900501554
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,329.40 |
| Max. Negotiated Rate |
$5,982.30 |
| Rate for Payer: Blue Shield of California Commercial |
$4,985.25
|
| 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: Kaiser Permanente of CA Medi-Cal |
$2,532.51
|
| 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 TIBIA SHAFT FX W/MAN
|
Facility
|
IP
|
$6,610.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
900501090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,322.00 |
| Max. Negotiated Rate |
$5,949.00 |
| Rate for Payer: Blue Shield of California Commercial |
$4,957.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,288.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,644.00
|
| Rate for Payer: Galaxy Health WC |
$5,618.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,966.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,949.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,408.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,518.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,322.00
|
| Rate for Payer: Multiplan Commercial |
$4,957.50
|
| Rate for Payer: Networks By Design Commercial |
$4,296.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,618.50
|
|
