|
HC CL TREAT TIBIA SHAFT FX W/MAN
|
Facility
|
IP
|
$6,610.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
900501090
|
|
Hospital Revenue Code
|
516
|
| 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
|
|
|
HC CL TREAT TIBIA SHAFT FX W/MAN
|
Facility
|
OP
|
$6,610.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
900501090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,949.00 |
| 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 |
$3,966.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,288.00
|
| Rate for Payer: Cigna of CA PPO |
$4,891.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: 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 |
$5,618.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,966.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,949.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,957.50
|
| 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 |
$4,408.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,322.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$4,957.50
|
| Rate for Payer: Networks By Design Commercial |
$4,296.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,618.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,966.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,305.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT TIBIA SHAFT FX W/MAN
|
Facility
|
OP
|
$6,610.00
|
|
|
Service Code
|
CPT 27752
|
| Hospital Charge Code |
900501090
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,322.00 |
| Max. Negotiated Rate |
$5,949.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,966.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,157.69
|
| Rate for Payer: Blue Shield of California EPN |
$3,232.29
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Cash Price |
$2,974.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,288.00
|
| Rate for Payer: Cigna of CA HMO |
$4,230.40
|
| Rate for Payer: Cigna of CA PPO |
$4,891.40
|
| 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 |
$5,618.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,966.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,949.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,957.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,293.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,313.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: InnovAge PACE Commercial |
$3,012.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,408.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,322.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,690.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$4,957.50
|
| Rate for Payer: Networks By Design Commercial |
$4,296.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,618.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,128.58
|
| Rate for Payer: Riverside University Health System MISP |
$2,208.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,966.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,966.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,305.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT TOE DSLOCATN W/O ANES
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
900501409
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$116.72 |
| 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 |
$964.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,011.43
|
| Rate for Payer: Blue Shield of California EPN |
$786.31
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: Cigna of CA HMO |
$1,029.12
|
| Rate for Payer: Cigna of CA PPO |
$1,189.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$486.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$964.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$804.00
|
| Rate for Payer: United Healthcare All Other HMO |
$804.00
|
| Rate for Payer: United Healthcare HMO Rider |
$804.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$804.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT TOE DSLOCATN W/O ANES
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
900501409
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$1,447.20 |
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.20
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
|
|
HC CL TREAT TOE DSLOCATN W/O ANES
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
900501409
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.72 |
| 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 |
$964.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: Cigna of CA PPO |
$1,189.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$116.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$804.00
|
| Rate for Payer: United Healthcare All Other HMO |
$804.00
|
| Rate for Payer: United Healthcare HMO Rider |
$804.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$804.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT TOE DSLOCATN W/O ANES
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 28630
|
| Hospital Charge Code |
900501409
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$1,447.20 |
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.20
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
|
|
HC CL TREAT TOE FX WO MAN EA
|
Facility
|
OP
|
$1,666.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
900501489
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$99.69 |
| 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 |
$999.60
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,332.80
|
| Rate for Payer: Cigna of CA PPO |
$1,232.84
|
| 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 |
$1,416.10
|
| Rate for Payer: Global Benefits Group Commercial |
$999.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,499.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,249.50
|
| 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 |
$1,111.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$333.20
|
| 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 |
$1,249.50
|
| Rate for Payer: Networks By Design Commercial |
$1,082.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.10
|
| 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 |
$999.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$833.00
|
| Rate for Payer: United Healthcare All Other HMO |
$833.00
|
| Rate for Payer: United Healthcare HMO Rider |
$833.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$833.00
|
| 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 TOE FX WO MAN EA
|
Facility
|
OP
|
$1,666.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
900501489
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$99.69 |
| 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 |
$999.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,047.91
|
| Rate for Payer: Blue Shield of California EPN |
$814.67
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,332.80
|
| Rate for Payer: Cigna of CA HMO |
$1,066.24
|
| Rate for Payer: Cigna of CA PPO |
$1,232.84
|
| 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 |
$1,416.10
|
| Rate for Payer: Global Benefits Group Commercial |
$999.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,499.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,249.50
|
| 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 |
$1,111.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$333.20
|
| 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 |
$1,249.50
|
| Rate for Payer: Networks By Design Commercial |
$1,082.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.10
|
| 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 |
$999.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$999.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$833.00
|
| Rate for Payer: United Healthcare All Other HMO |
$833.00
|
| Rate for Payer: United Healthcare HMO Rider |
$833.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$833.00
|
| 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 TOE FX WO MAN EA
|
Facility
|
IP
|
$1,666.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
900501489
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$333.20 |
| Max. Negotiated Rate |
$1,499.40 |
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,332.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.40
|
| Rate for Payer: Galaxy Health WC |
$1,416.10
|
| Rate for Payer: Global Benefits Group Commercial |
$999.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,499.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,111.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$634.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$333.20
|
| Rate for Payer: Multiplan Commercial |
$1,249.50
|
| Rate for Payer: Networks By Design Commercial |
$1,082.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.10
|
|
|
HC CL TREAT TOE FX WO MAN EA
|
Facility
|
IP
|
$1,666.00
|
|
|
Service Code
|
CPT 28510
|
| Hospital Charge Code |
900501489
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$333.20 |
| Max. Negotiated Rate |
$1,499.40 |
| Rate for Payer: Cash Price |
$749.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,332.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$666.40
|
| Rate for Payer: Galaxy Health WC |
$1,416.10
|
| Rate for Payer: Global Benefits Group Commercial |
$999.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,499.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,111.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$634.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$333.20
|
| Rate for Payer: Multiplan Commercial |
$1,249.50
|
| Rate for Payer: Networks By Design Commercial |
$1,082.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,416.10
|
|
|
HC CL TREAT TRIMALLOR FX W/MANIPU
|
Facility
|
OP
|
$4,378.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
900501094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$3,940.20 |
| 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 |
$2,626.80
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,502.40
|
| Rate for Payer: Cigna of CA PPO |
$3,239.72
|
| 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 |
$3,721.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,626.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,940.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,283.50
|
| 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 |
$2,920.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$875.60
|
| 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 |
$3,283.50
|
| Rate for Payer: Networks By Design Commercial |
$2,845.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,721.30
|
| 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 |
$2,626.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,189.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,189.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,189.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,189.00
|
| 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 TRIMALLOR FX W/MANIPU
|
Facility
|
IP
|
$4,378.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
900501094
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$875.60 |
| Max. Negotiated Rate |
$3,940.20 |
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,502.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,751.20
|
| Rate for Payer: Galaxy Health WC |
$3,721.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,626.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,940.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,920.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,668.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$875.60
|
| Rate for Payer: Multiplan Commercial |
$3,283.50
|
| Rate for Payer: Networks By Design Commercial |
$2,845.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,721.30
|
|
|
HC CL TREAT TRIMALLOR FX W/MANIPU
|
Facility
|
OP
|
$4,378.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
900501094
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$875.60 |
| Max. Negotiated Rate |
$3,940.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,626.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,753.76
|
| Rate for Payer: Blue Shield of California EPN |
$2,140.84
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,502.40
|
| Rate for Payer: Cigna of CA HMO |
$2,801.92
|
| Rate for Payer: Cigna of CA PPO |
$3,239.72
|
| 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 |
$3,721.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,626.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,940.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,283.50
|
| 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 |
$2,920.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$875.60
|
| 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 |
$3,283.50
|
| Rate for Payer: Networks By Design Commercial |
$2,845.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,721.30
|
| 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 |
$2,626.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,626.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,189.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,189.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,189.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,189.00
|
| 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 TRIMALLOR FX W/MANIPU
|
Facility
|
IP
|
$4,378.00
|
|
|
Service Code
|
CPT 27818
|
| Hospital Charge Code |
900501094
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$875.60 |
| Max. Negotiated Rate |
$3,940.20 |
| Rate for Payer: Cash Price |
$1,970.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,502.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,751.20
|
| Rate for Payer: Galaxy Health WC |
$3,721.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,626.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,940.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,920.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,668.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$875.60
|
| Rate for Payer: Multiplan Commercial |
$3,283.50
|
| Rate for Payer: Networks By Design Commercial |
$2,845.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,721.30
|
|
|
HC CL TREAT TROCHANTERIC FX WO MAN
|
Facility
|
IP
|
$994.00
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
900527246
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$894.60 |
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Central Health Plan Commercial |
$795.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.60
|
| Rate for Payer: Galaxy Health WC |
$844.90
|
| Rate for Payer: Global Benefits Group Commercial |
$596.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$894.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$663.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$378.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.80
|
| Rate for Payer: Multiplan Commercial |
$745.50
|
| Rate for Payer: Networks By Design Commercial |
$646.10
|
| Rate for Payer: Prime Health Services Commercial |
$844.90
|
|
|
HC CL TREAT TROCHANTERIC FX WO MAN
|
Facility
|
OP
|
$994.00
|
|
|
Service Code
|
CPT 27246
|
| Hospital Charge Code |
900527246
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.80 |
| 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 |
$596.40
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Cash Price |
$447.30
|
| Rate for Payer: Central Health Plan Commercial |
$795.20
|
| Rate for Payer: Cigna of CA PPO |
$735.56
|
| 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 |
$844.90
|
| Rate for Payer: Global Benefits Group Commercial |
$596.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$894.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$745.50
|
| 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 |
$663.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.80
|
| 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 |
$745.50
|
| Rate for Payer: Networks By Design Commercial |
$646.10
|
| Rate for Payer: Prime Health Services Commercial |
$844.90
|
| 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 |
$596.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$497.00
|
| Rate for Payer: United Healthcare All Other HMO |
$497.00
|
| Rate for Payer: United Healthcare HMO Rider |
$497.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$497.00
|
| 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 ULNAR FX,PROXIMAL END
|
Facility
|
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
900501467
|
|
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 |
$964.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: Cigna of CA PPO |
$1,189.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$804.00
|
| Rate for Payer: United Healthcare All Other HMO |
$804.00
|
| Rate for Payer: United Healthcare HMO Rider |
$804.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$804.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT ULNAR FX,PROXIMAL END
|
Facility
|
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 24670
|
| Hospital Charge Code |
900501467
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$1,447.20 |
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.20
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
|
|
HC CL TREAT ULNAR FX, W/MANIPULAT
|
Facility
|
OP
|
$2,100.00
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
900501391
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$3,313.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,008.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,260.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,320.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,026.90
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,680.00
|
| Rate for Payer: Cigna of CA HMO |
$1,344.00
|
| Rate for Payer: Cigna of CA PPO |
$1,554.00
|
| 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 |
$1,785.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,260.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,890.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,575.00
|
| 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 |
$1,400.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$455.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$420.00
|
| 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 |
$1,575.00
|
| Rate for Payer: Networks By Design Commercial |
$1,365.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,785.00
|
| 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 |
$1,260.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,260.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,050.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,050.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,050.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,050.00
|
| 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 ULNAR FX, W/MANIPULAT
|
Facility
|
IP
|
$2,100.00
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
900501391
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$1,890.00 |
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$840.00
|
| Rate for Payer: Galaxy Health WC |
$1,785.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,260.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,890.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,400.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$800.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$420.00
|
| Rate for Payer: Multiplan Commercial |
$1,575.00
|
| Rate for Payer: Networks By Design Commercial |
$1,365.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,785.00
|
|
|
HC CL TREAT ULNAR FX, W/MANIPULAT
|
Facility
|
OP
|
$2,100.00
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
900501391
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$3,293.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: 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 |
$1,260.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,008.09
|
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,680.00
|
| Rate for Payer: Cigna of CA PPO |
$1,554.00
|
| 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 |
$1,785.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,260.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,890.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,575.00
|
| 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 |
$1,400.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$455.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$420.00
|
| 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 |
$1,575.00
|
| Rate for Payer: Networks By Design Commercial |
$1,365.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,785.00
|
| 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 |
$1,260.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,050.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,050.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,050.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,050.00
|
| 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 ULNAR FX, W/MANIPULAT
|
Facility
|
IP
|
$2,100.00
|
|
|
Service Code
|
CPT 24675
|
| Hospital Charge Code |
900501391
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$1,890.00 |
| Rate for Payer: Cash Price |
$945.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$840.00
|
| Rate for Payer: Galaxy Health WC |
$1,785.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,260.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,890.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,400.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$800.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$420.00
|
| Rate for Payer: Multiplan Commercial |
$1,575.00
|
| Rate for Payer: Networks By Design Commercial |
$1,365.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,785.00
|
|
|
HC CL TREAT ULNAR SHAFT FX W/MANI
|
Facility
|
IP
|
$1,995.00
|
|
|
Service Code
|
CPT 25535
|
| Hospital Charge Code |
900501376
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$399.00 |
| Max. Negotiated Rate |
$1,795.50 |
| Rate for Payer: Cash Price |
$897.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,596.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$798.00
|
| Rate for Payer: Galaxy Health WC |
$1,695.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,197.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,795.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,330.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$760.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.00
|
| Rate for Payer: Multiplan Commercial |
$1,496.25
|
| Rate for Payer: Networks By Design Commercial |
$1,296.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,695.75
|
|
|
HC CL TREAT ULNAR SHAFT FX W/MANI
|
Facility
|
OP
|
$1,995.00
|
|
|
Service Code
|
CPT 25535
|
| Hospital Charge Code |
900501376
|
|
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 |
$1,197.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$897.75
|
| Rate for Payer: Cash Price |
$897.75
|
| Rate for Payer: Cash Price |
$897.75
|
| Rate for Payer: Cash Price |
$897.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,596.00
|
| Rate for Payer: Cigna of CA PPO |
$1,476.30
|
| 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 |
$1,695.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,197.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,795.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,496.25
|
| 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 |
$1,330.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$469.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.00
|
| 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 |
$1,496.25
|
| Rate for Payer: Networks By Design Commercial |
$1,296.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,695.75
|
| 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 |
$1,197.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$997.50
|
| Rate for Payer: United Healthcare All Other HMO |
$997.50
|
| Rate for Payer: United Healthcare HMO Rider |
$997.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$997.50
|
| 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
|
|
