|
HC HIGH ROLL CUFF ADD. KAFO
|
Facility
|
IP
|
$683.00
|
|
|
Service Code
|
CPT L2550
|
| Hospital Charge Code |
905352550
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$136.60 |
| Max. Negotiated Rate |
$614.70 |
| Rate for Payer: Adventist Health Commercial |
$136.60
|
| Rate for Payer: Blue Shield of California Commercial |
$547.77
|
| Rate for Payer: Blue Shield of California EPN |
$344.23
|
| Rate for Payer: Cash Price |
$307.35
|
| Rate for Payer: Central Health Plan Commercial |
$546.40
|
| Rate for Payer: Cigna of CA HMO |
$478.10
|
| Rate for Payer: Cigna of CA PPO |
$478.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$478.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.20
|
| Rate for Payer: EPIC Health Plan Senior |
$273.20
|
| Rate for Payer: Galaxy Health WC |
$580.55
|
| Rate for Payer: Global Benefits Group Commercial |
$409.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$614.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$433.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$402.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.60
|
| Rate for Payer: Multiplan Commercial |
$512.25
|
| Rate for Payer: Networks By Design Commercial |
$443.95
|
| Rate for Payer: Prime Health Services Commercial |
$580.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$256.33
|
| Rate for Payer: United Healthcare All Other HMO |
$249.50
|
| Rate for Payer: United Healthcare HMO Rider |
$244.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.68
|
|
|
HC HIGH ROLL CUFF ADD. KAFO
|
Facility
|
OP
|
$683.00
|
|
|
Service Code
|
CPT L2550
|
| Hospital Charge Code |
905352550
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$223.68 |
| Max. Negotiated Rate |
$614.70 |
| Rate for Payer: Adventist Health Commercial |
$280.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$580.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$375.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$512.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$397.30
|
| Rate for Payer: Blue Shield of California Commercial |
$547.77
|
| Rate for Payer: Blue Shield of California EPN |
$344.23
|
| Rate for Payer: Cash Price |
$307.35
|
| Rate for Payer: Cash Price |
$307.35
|
| Rate for Payer: Central Health Plan Commercial |
$546.40
|
| Rate for Payer: Cigna of CA HMO |
$478.10
|
| Rate for Payer: Cigna of CA PPO |
$478.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$580.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$580.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$580.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$478.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.20
|
| Rate for Payer: EPIC Health Plan Senior |
$273.20
|
| Rate for Payer: Galaxy Health WC |
$580.55
|
| Rate for Payer: Global Benefits Group Commercial |
$409.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$614.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$295.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$433.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$326.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$402.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$478.10
|
| Rate for Payer: Multiplan Commercial |
$512.25
|
| Rate for Payer: Networks By Design Commercial |
$341.50
|
| Rate for Payer: Prime Health Services Commercial |
$580.55
|
| Rate for Payer: Riverside University Health System MISP |
$273.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$409.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$409.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$256.33
|
| Rate for Payer: United Healthcare All Other HMO |
$249.50
|
| Rate for Payer: United Healthcare HMO Rider |
$244.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$580.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$580.55
|
| Rate for Payer: Vantage Medical Group Senior |
$580.55
|
|
|
HC HIP ARTHROGRAPHY INJECTION
|
Facility
|
IP
|
$651.00
|
|
|
Service Code
|
CPT 27093
|
| Hospital Charge Code |
909000116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$585.90 |
| Rate for Payer: Adventist Health Commercial |
$130.20
|
| Rate for Payer: Cash Price |
$292.95
|
| Rate for Payer: Central Health Plan Commercial |
$520.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$455.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.40
|
| Rate for Payer: EPIC Health Plan Senior |
$260.40
|
| Rate for Payer: Galaxy Health WC |
$553.35
|
| Rate for Payer: Global Benefits Group Commercial |
$390.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$413.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$384.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.20
|
| Rate for Payer: Multiplan Commercial |
$488.25
|
| Rate for Payer: Networks By Design Commercial |
$423.15
|
| Rate for Payer: Prime Health Services Commercial |
$553.35
|
|
|
HC HIP ARTHROGRAPHY INJECTION
|
Facility
|
OP
|
$651.00
|
|
|
Service Code
|
CPT 27093
|
| Hospital Charge Code |
909000116
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$130.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$553.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$358.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$488.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$292.95
|
| Rate for Payer: Cash Price |
$292.95
|
| Rate for Payer: Cash Price |
$292.95
|
| Rate for Payer: Central Health Plan Commercial |
$520.80
|
| Rate for Payer: Cigna of CA HMO |
$416.64
|
| Rate for Payer: Cigna of CA PPO |
$481.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$553.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$553.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$553.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$455.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.40
|
| Rate for Payer: EPIC Health Plan Senior |
$260.40
|
| Rate for Payer: Galaxy Health WC |
$553.35
|
| Rate for Payer: Global Benefits Group Commercial |
$390.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$346.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$413.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$382.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$384.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$455.70
|
| Rate for Payer: Multiplan Commercial |
$488.25
|
| Rate for Payer: Networks By Design Commercial |
$423.15
|
| Rate for Payer: Prime Health Services Commercial |
$553.35
|
| Rate for Payer: Riverside University Health System MISP |
$260.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$390.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$325.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$553.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$553.35
|
| Rate for Payer: Vantage Medical Group Senior |
$553.35
|
|
|
HC HIP JT ADJ FLEX EXT ABD
|
Facility
|
OP
|
$1,103.00
|
|
|
Service Code
|
CPT L2624
|
| Hospital Charge Code |
905352624
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$361.23 |
| Max. Negotiated Rate |
$992.70 |
| Rate for Payer: Adventist Health Commercial |
$452.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$937.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$606.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$827.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$641.62
|
| Rate for Payer: Blue Shield of California Commercial |
$884.61
|
| Rate for Payer: Blue Shield of California EPN |
$555.91
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Cigna of CA HMO |
$772.10
|
| Rate for Payer: Cigna of CA PPO |
$772.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$937.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$937.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$937.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$772.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$441.20
|
| Rate for Payer: EPIC Health Plan Senior |
$441.20
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$457.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$700.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$650.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$772.10
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Networks By Design Commercial |
$551.50
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
| Rate for Payer: Riverside University Health System MISP |
$441.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$661.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$413.96
|
| Rate for Payer: United Healthcare All Other HMO |
$402.93
|
| Rate for Payer: United Healthcare HMO Rider |
$394.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$361.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$937.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$937.55
|
| Rate for Payer: Vantage Medical Group Senior |
$937.55
|
|
|
HC HIP JT ADJ FLEX EXT ABD
|
Facility
|
OP
|
$1,103.00
|
|
|
Service Code
|
CPT L2624
|
| Hospital Charge Code |
915352624
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$361.23 |
| Max. Negotiated Rate |
$992.70 |
| Rate for Payer: Adventist Health Commercial |
$452.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$937.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$606.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$827.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$641.62
|
| Rate for Payer: Blue Shield of California Commercial |
$884.61
|
| Rate for Payer: Blue Shield of California EPN |
$555.91
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Cigna of CA HMO |
$772.10
|
| Rate for Payer: Cigna of CA PPO |
$772.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$937.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$937.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$937.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$772.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$441.20
|
| Rate for Payer: EPIC Health Plan Senior |
$441.20
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$457.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$700.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$650.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$772.10
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Networks By Design Commercial |
$551.50
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
| Rate for Payer: Riverside University Health System MISP |
$441.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$661.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$413.96
|
| Rate for Payer: United Healthcare All Other HMO |
$402.93
|
| Rate for Payer: United Healthcare HMO Rider |
$394.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$361.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$937.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$937.55
|
| Rate for Payer: Vantage Medical Group Senior |
$937.55
|
|
|
HC HIP JT ADJ FLEX EXT ABD
|
Facility
|
IP
|
$1,103.00
|
|
|
Service Code
|
CPT L2624
|
| Hospital Charge Code |
905352624
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$220.60 |
| Max. Negotiated Rate |
$992.70 |
| Rate for Payer: Adventist Health Commercial |
$220.60
|
| Rate for Payer: Blue Shield of California Commercial |
$884.61
|
| Rate for Payer: Blue Shield of California EPN |
$555.91
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Cigna of CA HMO |
$772.10
|
| Rate for Payer: Cigna of CA PPO |
$772.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$772.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$441.20
|
| Rate for Payer: EPIC Health Plan Senior |
$441.20
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$700.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$650.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.60
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Networks By Design Commercial |
$716.95
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$413.96
|
| Rate for Payer: United Healthcare All Other HMO |
$402.93
|
| Rate for Payer: United Healthcare HMO Rider |
$394.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$361.23
|
|
|
HC HIP JT ADJ FLEX EXT ABD
|
Facility
|
IP
|
$1,103.00
|
|
|
Service Code
|
CPT L2624
|
| Hospital Charge Code |
915352624
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$220.60 |
| Max. Negotiated Rate |
$992.70 |
| Rate for Payer: Adventist Health Commercial |
$220.60
|
| Rate for Payer: Blue Shield of California Commercial |
$884.61
|
| Rate for Payer: Blue Shield of California EPN |
$555.91
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Cigna of CA HMO |
$772.10
|
| Rate for Payer: Cigna of CA PPO |
$772.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$772.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$441.20
|
| Rate for Payer: EPIC Health Plan Senior |
$441.20
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$700.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$650.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.60
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Networks By Design Commercial |
$716.95
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$413.96
|
| Rate for Payer: United Healthcare All Other HMO |
$402.93
|
| Rate for Payer: United Healthcare HMO Rider |
$394.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$361.23
|
|
|
HC HIP JT ADJ FLEXION EA
|
Facility
|
IP
|
$778.00
|
|
|
Service Code
|
CPT L2622
|
| Hospital Charge Code |
905352622
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$155.60 |
| Max. Negotiated Rate |
$700.20 |
| Rate for Payer: Adventist Health Commercial |
$155.60
|
| Rate for Payer: Blue Shield of California Commercial |
$623.96
|
| Rate for Payer: Blue Shield of California EPN |
$392.11
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Central Health Plan Commercial |
$622.40
|
| Rate for Payer: Cigna of CA HMO |
$544.60
|
| Rate for Payer: Cigna of CA PPO |
$544.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$544.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$311.20
|
| Rate for Payer: EPIC Health Plan Senior |
$311.20
|
| Rate for Payer: Galaxy Health WC |
$661.30
|
| Rate for Payer: Global Benefits Group Commercial |
$466.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$700.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$494.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$459.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.60
|
| Rate for Payer: Multiplan Commercial |
$583.50
|
| Rate for Payer: Networks By Design Commercial |
$505.70
|
| Rate for Payer: Prime Health Services Commercial |
$661.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$291.98
|
| Rate for Payer: United Healthcare All Other HMO |
$284.20
|
| Rate for Payer: United Healthcare HMO Rider |
$278.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.79
|
|
|
HC HIP JT ADJ FLEXION EA
|
Facility
|
OP
|
$778.00
|
|
|
Service Code
|
CPT L2622
|
| Hospital Charge Code |
905352622
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$254.79 |
| Max. Negotiated Rate |
$700.20 |
| Rate for Payer: Adventist Health Commercial |
$318.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$661.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$427.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$583.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$452.56
|
| Rate for Payer: Blue Shield of California Commercial |
$623.96
|
| Rate for Payer: Blue Shield of California EPN |
$392.11
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Central Health Plan Commercial |
$622.40
|
| Rate for Payer: Cigna of CA HMO |
$544.60
|
| Rate for Payer: Cigna of CA PPO |
$544.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$661.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$661.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$661.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$544.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$311.20
|
| Rate for Payer: EPIC Health Plan Senior |
$311.20
|
| Rate for Payer: Galaxy Health WC |
$661.30
|
| Rate for Payer: Global Benefits Group Commercial |
$466.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$700.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$409.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$494.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$452.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$459.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$544.60
|
| Rate for Payer: Multiplan Commercial |
$583.50
|
| Rate for Payer: Networks By Design Commercial |
$389.00
|
| Rate for Payer: Prime Health Services Commercial |
$661.30
|
| Rate for Payer: Riverside University Health System MISP |
$311.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$466.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$466.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$291.98
|
| Rate for Payer: United Healthcare All Other HMO |
$284.20
|
| Rate for Payer: United Healthcare HMO Rider |
$278.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$661.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$661.30
|
| Rate for Payer: Vantage Medical Group Senior |
$661.30
|
|
|
HC HIP JT ADJ FLEXION EA
|
Facility
|
IP
|
$778.00
|
|
|
Service Code
|
CPT L2622
|
| Hospital Charge Code |
915352622
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$155.60 |
| Max. Negotiated Rate |
$700.20 |
| Rate for Payer: Adventist Health Commercial |
$155.60
|
| Rate for Payer: Blue Shield of California Commercial |
$623.96
|
| Rate for Payer: Blue Shield of California EPN |
$392.11
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Central Health Plan Commercial |
$622.40
|
| Rate for Payer: Cigna of CA HMO |
$544.60
|
| Rate for Payer: Cigna of CA PPO |
$544.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$544.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$311.20
|
| Rate for Payer: EPIC Health Plan Senior |
$311.20
|
| Rate for Payer: Galaxy Health WC |
$661.30
|
| Rate for Payer: Global Benefits Group Commercial |
$466.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$700.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$494.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$459.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.60
|
| Rate for Payer: Multiplan Commercial |
$583.50
|
| Rate for Payer: Networks By Design Commercial |
$505.70
|
| Rate for Payer: Prime Health Services Commercial |
$661.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$291.98
|
| Rate for Payer: United Healthcare All Other HMO |
$284.20
|
| Rate for Payer: United Healthcare HMO Rider |
$278.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.79
|
|
|
HC HIP JT ADJ FLEXION EA
|
Facility
|
OP
|
$778.00
|
|
|
Service Code
|
CPT L2622
|
| Hospital Charge Code |
915352622
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$254.79 |
| Max. Negotiated Rate |
$700.20 |
| Rate for Payer: Adventist Health Commercial |
$318.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$661.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$427.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$583.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$452.56
|
| Rate for Payer: Blue Shield of California Commercial |
$623.96
|
| Rate for Payer: Blue Shield of California EPN |
$392.11
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Central Health Plan Commercial |
$622.40
|
| Rate for Payer: Cigna of CA HMO |
$544.60
|
| Rate for Payer: Cigna of CA PPO |
$544.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$661.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$661.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$661.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$544.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$311.20
|
| Rate for Payer: EPIC Health Plan Senior |
$311.20
|
| Rate for Payer: Galaxy Health WC |
$661.30
|
| Rate for Payer: Global Benefits Group Commercial |
$466.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$700.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$409.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$494.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$452.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$459.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$544.60
|
| Rate for Payer: Multiplan Commercial |
$583.50
|
| Rate for Payer: Networks By Design Commercial |
$389.00
|
| Rate for Payer: Prime Health Services Commercial |
$661.30
|
| Rate for Payer: Riverside University Health System MISP |
$311.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$466.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$466.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$291.98
|
| Rate for Payer: United Healthcare All Other HMO |
$284.20
|
| Rate for Payer: United Healthcare HMO Rider |
$278.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$254.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$661.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$661.30
|
| Rate for Payer: Vantage Medical Group Senior |
$661.30
|
|
|
HC HIP JT CLEVIS OR THRUST BEARIN
|
Facility
|
OP
|
$957.00
|
|
|
Service Code
|
CPT L2600
|
| Hospital Charge Code |
915352600
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$210.56 |
| Max. Negotiated Rate |
$861.30 |
| Rate for Payer: Adventist Health Commercial |
$392.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$526.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$717.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$556.69
|
| Rate for Payer: Blue Shield of California Commercial |
$767.51
|
| Rate for Payer: Blue Shield of California EPN |
$482.33
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Central Health Plan Commercial |
$765.60
|
| Rate for Payer: Cigna of CA HMO |
$669.90
|
| Rate for Payer: Cigna of CA PPO |
$669.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$813.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$813.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$669.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.80
|
| Rate for Payer: EPIC Health Plan Senior |
$382.80
|
| Rate for Payer: Galaxy Health WC |
$813.45
|
| Rate for Payer: Global Benefits Group Commercial |
$574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$861.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$607.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$232.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$564.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$392.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$669.90
|
| Rate for Payer: Multiplan Commercial |
$717.75
|
| Rate for Payer: Networks By Design Commercial |
$478.50
|
| Rate for Payer: Prime Health Services Commercial |
$813.45
|
| Rate for Payer: Riverside University Health System MISP |
$382.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$574.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$574.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$359.16
|
| Rate for Payer: United Healthcare All Other HMO |
$349.59
|
| Rate for Payer: United Healthcare HMO Rider |
$342.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$313.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$813.45
|
| Rate for Payer: Vantage Medical Group Senior |
$813.45
|
|
|
HC HIP JT CLEVIS OR THRUST BEARIN
|
Facility
|
IP
|
$957.00
|
|
|
Service Code
|
CPT L2600
|
| Hospital Charge Code |
905352600
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$191.40 |
| Max. Negotiated Rate |
$861.30 |
| Rate for Payer: Adventist Health Commercial |
$191.40
|
| Rate for Payer: Blue Shield of California Commercial |
$767.51
|
| Rate for Payer: Blue Shield of California EPN |
$482.33
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Central Health Plan Commercial |
$765.60
|
| Rate for Payer: Cigna of CA HMO |
$669.90
|
| Rate for Payer: Cigna of CA PPO |
$669.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$669.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.80
|
| Rate for Payer: EPIC Health Plan Senior |
$382.80
|
| Rate for Payer: Galaxy Health WC |
$813.45
|
| Rate for Payer: Global Benefits Group Commercial |
$574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$861.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$607.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$564.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.40
|
| Rate for Payer: Multiplan Commercial |
$717.75
|
| Rate for Payer: Networks By Design Commercial |
$622.05
|
| Rate for Payer: Prime Health Services Commercial |
$813.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$359.16
|
| Rate for Payer: United Healthcare All Other HMO |
$349.59
|
| Rate for Payer: United Healthcare HMO Rider |
$342.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$313.42
|
|
|
HC HIP JT CLEVIS OR THRUST BEARIN
|
Facility
|
OP
|
$957.00
|
|
|
Service Code
|
CPT L2600
|
| Hospital Charge Code |
905352600
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$210.56 |
| Max. Negotiated Rate |
$861.30 |
| Rate for Payer: Adventist Health Commercial |
$392.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$526.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$717.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$556.69
|
| Rate for Payer: Blue Shield of California Commercial |
$767.51
|
| Rate for Payer: Blue Shield of California EPN |
$482.33
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Central Health Plan Commercial |
$765.60
|
| Rate for Payer: Cigna of CA HMO |
$669.90
|
| Rate for Payer: Cigna of CA PPO |
$669.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$813.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$813.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$669.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.80
|
| Rate for Payer: EPIC Health Plan Senior |
$382.80
|
| Rate for Payer: Galaxy Health WC |
$813.45
|
| Rate for Payer: Global Benefits Group Commercial |
$574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$861.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$607.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$232.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$564.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$392.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$669.90
|
| Rate for Payer: Multiplan Commercial |
$717.75
|
| Rate for Payer: Networks By Design Commercial |
$478.50
|
| Rate for Payer: Prime Health Services Commercial |
$813.45
|
| Rate for Payer: Riverside University Health System MISP |
$382.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$574.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$574.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$359.16
|
| Rate for Payer: United Healthcare All Other HMO |
$349.59
|
| Rate for Payer: United Healthcare HMO Rider |
$342.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$313.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$813.45
|
| Rate for Payer: Vantage Medical Group Senior |
$813.45
|
|
|
HC HIP JT CLEVIS OR THRUST BEARIN
|
Facility
|
IP
|
$957.00
|
|
|
Service Code
|
CPT L2600
|
| Hospital Charge Code |
915352600
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$191.40 |
| Max. Negotiated Rate |
$861.30 |
| Rate for Payer: Adventist Health Commercial |
$191.40
|
| Rate for Payer: Blue Shield of California Commercial |
$767.51
|
| Rate for Payer: Blue Shield of California EPN |
$482.33
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Central Health Plan Commercial |
$765.60
|
| Rate for Payer: Cigna of CA HMO |
$669.90
|
| Rate for Payer: Cigna of CA PPO |
$669.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$669.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.80
|
| Rate for Payer: EPIC Health Plan Senior |
$382.80
|
| Rate for Payer: Galaxy Health WC |
$813.45
|
| Rate for Payer: Global Benefits Group Commercial |
$574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$861.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$607.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$564.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.40
|
| Rate for Payer: Multiplan Commercial |
$717.75
|
| Rate for Payer: Networks By Design Commercial |
$622.05
|
| Rate for Payer: Prime Health Services Commercial |
$813.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$359.16
|
| Rate for Payer: United Healthcare All Other HMO |
$349.59
|
| Rate for Payer: United Healthcare HMO Rider |
$342.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$313.42
|
|
|
HC HIP JT CLEVIS TYPE 2 POS EA
|
Facility
|
OP
|
$1,614.00
|
|
|
Service Code
|
CPT L2570
|
| Hospital Charge Code |
915352570
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$443.07 |
| Max. Negotiated Rate |
$1,452.60 |
| Rate for Payer: Adventist Health Commercial |
$661.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,371.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,210.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$938.86
|
| Rate for Payer: Blue Shield of California Commercial |
$1,294.43
|
| Rate for Payer: Blue Shield of California EPN |
$813.46
|
| Rate for Payer: Cash Price |
$726.30
|
| Rate for Payer: Cash Price |
$726.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,291.20
|
| Rate for Payer: Cigna of CA HMO |
$1,129.80
|
| Rate for Payer: Cigna of CA PPO |
$1,129.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,371.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,371.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,371.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,129.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$645.60
|
| Rate for Payer: EPIC Health Plan Senior |
$645.60
|
| Rate for Payer: Galaxy Health WC |
$1,371.90
|
| Rate for Payer: Global Benefits Group Commercial |
$968.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,452.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$443.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,024.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$489.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$952.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$661.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,129.80
|
| Rate for Payer: Multiplan Commercial |
$1,210.50
|
| Rate for Payer: Networks By Design Commercial |
$807.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.90
|
| Rate for Payer: Riverside University Health System MISP |
$645.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$968.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$968.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$605.73
|
| Rate for Payer: United Healthcare All Other HMO |
$589.59
|
| Rate for Payer: United Healthcare HMO Rider |
$576.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,371.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,371.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,371.90
|
|
|
HC HIP JT CLEVIS TYPE 2 POS EA
|
Facility
|
OP
|
$1,614.00
|
|
|
Service Code
|
CPT L2570
|
| Hospital Charge Code |
905352570
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$443.07 |
| Max. Negotiated Rate |
$1,452.60 |
| Rate for Payer: Adventist Health Commercial |
$661.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,371.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,210.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$938.86
|
| Rate for Payer: Blue Shield of California Commercial |
$1,294.43
|
| Rate for Payer: Blue Shield of California EPN |
$813.46
|
| Rate for Payer: Cash Price |
$726.30
|
| Rate for Payer: Cash Price |
$726.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,291.20
|
| Rate for Payer: Cigna of CA HMO |
$1,129.80
|
| Rate for Payer: Cigna of CA PPO |
$1,129.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,371.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,371.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,371.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,129.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$645.60
|
| Rate for Payer: EPIC Health Plan Senior |
$645.60
|
| Rate for Payer: Galaxy Health WC |
$1,371.90
|
| Rate for Payer: Global Benefits Group Commercial |
$968.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,452.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$443.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,024.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$489.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$952.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$661.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,129.80
|
| Rate for Payer: Multiplan Commercial |
$1,210.50
|
| Rate for Payer: Networks By Design Commercial |
$807.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.90
|
| Rate for Payer: Riverside University Health System MISP |
$645.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$968.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$968.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$605.73
|
| Rate for Payer: United Healthcare All Other HMO |
$589.59
|
| Rate for Payer: United Healthcare HMO Rider |
$576.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,371.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,371.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,371.90
|
|
|
HC HIP JT CLEVIS TYPE 2 POS EA
|
Facility
|
IP
|
$1,614.00
|
|
|
Service Code
|
CPT L2570
|
| Hospital Charge Code |
905352570
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$322.80 |
| Max. Negotiated Rate |
$1,452.60 |
| Rate for Payer: Adventist Health Commercial |
$322.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,294.43
|
| Rate for Payer: Blue Shield of California EPN |
$813.46
|
| Rate for Payer: Cash Price |
$726.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,291.20
|
| Rate for Payer: Cigna of CA HMO |
$1,129.80
|
| Rate for Payer: Cigna of CA PPO |
$1,129.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,129.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$645.60
|
| Rate for Payer: EPIC Health Plan Senior |
$645.60
|
| Rate for Payer: Galaxy Health WC |
$1,371.90
|
| Rate for Payer: Global Benefits Group Commercial |
$968.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,452.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,024.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$952.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.80
|
| Rate for Payer: Multiplan Commercial |
$1,210.50
|
| Rate for Payer: Networks By Design Commercial |
$1,049.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$605.73
|
| Rate for Payer: United Healthcare All Other HMO |
$589.59
|
| Rate for Payer: United Healthcare HMO Rider |
$576.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.59
|
|
|
HC HIP JT CLEVIS TYPE 2 POS EA
|
Facility
|
IP
|
$1,614.00
|
|
|
Service Code
|
CPT L2570
|
| Hospital Charge Code |
915352570
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$322.80 |
| Max. Negotiated Rate |
$1,452.60 |
| Rate for Payer: Adventist Health Commercial |
$322.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,294.43
|
| Rate for Payer: Blue Shield of California EPN |
$813.46
|
| Rate for Payer: Cash Price |
$726.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,291.20
|
| Rate for Payer: Cigna of CA HMO |
$1,129.80
|
| Rate for Payer: Cigna of CA PPO |
$1,129.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,129.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$645.60
|
| Rate for Payer: EPIC Health Plan Senior |
$645.60
|
| Rate for Payer: Galaxy Health WC |
$1,371.90
|
| Rate for Payer: Global Benefits Group Commercial |
$968.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,452.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,024.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$952.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.80
|
| Rate for Payer: Multiplan Commercial |
$1,210.50
|
| Rate for Payer: Networks By Design Commercial |
$1,049.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$605.73
|
| Rate for Payer: United Healthcare All Other HMO |
$589.59
|
| Rate for Payer: United Healthcare HMO Rider |
$576.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.59
|
|
|
HC HIP JT HEAVY DUTY EA
|
Facility
|
OP
|
$1,189.00
|
|
|
Service Code
|
CPT L2620
|
| Hospital Charge Code |
915352620
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$326.92 |
| Max. Negotiated Rate |
$1,070.10 |
| Rate for Payer: Adventist Health Commercial |
$487.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,010.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$653.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$891.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$691.64
|
| Rate for Payer: Blue Shield of California Commercial |
$953.58
|
| Rate for Payer: Blue Shield of California EPN |
$599.26
|
| Rate for Payer: Cash Price |
$535.05
|
| Rate for Payer: Cash Price |
$535.05
|
| Rate for Payer: Central Health Plan Commercial |
$951.20
|
| Rate for Payer: Cigna of CA HMO |
$832.30
|
| Rate for Payer: Cigna of CA PPO |
$832.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,010.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,010.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,010.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$832.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$475.60
|
| Rate for Payer: EPIC Health Plan Senior |
$475.60
|
| Rate for Payer: Galaxy Health WC |
$1,010.65
|
| Rate for Payer: Global Benefits Group Commercial |
$713.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,070.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$326.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$755.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$361.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$701.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$832.30
|
| Rate for Payer: Multiplan Commercial |
$891.75
|
| Rate for Payer: Networks By Design Commercial |
$594.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,010.65
|
| Rate for Payer: Riverside University Health System MISP |
$475.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$713.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$713.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$446.23
|
| Rate for Payer: United Healthcare All Other HMO |
$434.34
|
| Rate for Payer: United Healthcare HMO Rider |
$424.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$389.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,010.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,010.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,010.65
|
|
|
HC HIP JT HEAVY DUTY EA
|
Facility
|
IP
|
$1,189.00
|
|
|
Service Code
|
CPT L2620
|
| Hospital Charge Code |
915352620
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$237.80 |
| Max. Negotiated Rate |
$1,070.10 |
| Rate for Payer: Adventist Health Commercial |
$237.80
|
| Rate for Payer: Blue Shield of California Commercial |
$953.58
|
| Rate for Payer: Blue Shield of California EPN |
$599.26
|
| Rate for Payer: Cash Price |
$535.05
|
| Rate for Payer: Central Health Plan Commercial |
$951.20
|
| Rate for Payer: Cigna of CA HMO |
$832.30
|
| Rate for Payer: Cigna of CA PPO |
$832.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$832.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$475.60
|
| Rate for Payer: EPIC Health Plan Senior |
$475.60
|
| Rate for Payer: Galaxy Health WC |
$1,010.65
|
| Rate for Payer: Global Benefits Group Commercial |
$713.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,070.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$755.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$701.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.80
|
| Rate for Payer: Multiplan Commercial |
$891.75
|
| Rate for Payer: Networks By Design Commercial |
$772.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,010.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$446.23
|
| Rate for Payer: United Healthcare All Other HMO |
$434.34
|
| Rate for Payer: United Healthcare HMO Rider |
$424.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$389.40
|
|
|
HC HIP JT HEAVY DUTY EA
|
Facility
|
IP
|
$1,189.00
|
|
|
Service Code
|
CPT L2620
|
| Hospital Charge Code |
905352620
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$237.80 |
| Max. Negotiated Rate |
$1,070.10 |
| Rate for Payer: Adventist Health Commercial |
$237.80
|
| Rate for Payer: Blue Shield of California Commercial |
$953.58
|
| Rate for Payer: Blue Shield of California EPN |
$599.26
|
| Rate for Payer: Cash Price |
$535.05
|
| Rate for Payer: Central Health Plan Commercial |
$951.20
|
| Rate for Payer: Cigna of CA HMO |
$832.30
|
| Rate for Payer: Cigna of CA PPO |
$832.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$832.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$475.60
|
| Rate for Payer: EPIC Health Plan Senior |
$475.60
|
| Rate for Payer: Galaxy Health WC |
$1,010.65
|
| Rate for Payer: Global Benefits Group Commercial |
$713.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,070.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$755.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$701.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.80
|
| Rate for Payer: Multiplan Commercial |
$891.75
|
| Rate for Payer: Networks By Design Commercial |
$772.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,010.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$446.23
|
| Rate for Payer: United Healthcare All Other HMO |
$434.34
|
| Rate for Payer: United Healthcare HMO Rider |
$424.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$389.40
|
|
|
HC HIP JT HEAVY DUTY EA
|
Facility
|
OP
|
$1,189.00
|
|
|
Service Code
|
CPT L2620
|
| Hospital Charge Code |
905352620
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$326.92 |
| Max. Negotiated Rate |
$1,070.10 |
| Rate for Payer: Adventist Health Commercial |
$487.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,010.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$653.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$891.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$691.64
|
| Rate for Payer: Blue Shield of California Commercial |
$953.58
|
| Rate for Payer: Blue Shield of California EPN |
$599.26
|
| Rate for Payer: Cash Price |
$535.05
|
| Rate for Payer: Cash Price |
$535.05
|
| Rate for Payer: Central Health Plan Commercial |
$951.20
|
| Rate for Payer: Cigna of CA HMO |
$832.30
|
| Rate for Payer: Cigna of CA PPO |
$832.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,010.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,010.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,010.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$832.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$475.60
|
| Rate for Payer: EPIC Health Plan Senior |
$475.60
|
| Rate for Payer: Galaxy Health WC |
$1,010.65
|
| Rate for Payer: Global Benefits Group Commercial |
$713.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,070.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$326.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$755.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$361.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$701.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$832.30
|
| Rate for Payer: Multiplan Commercial |
$891.75
|
| Rate for Payer: Networks By Design Commercial |
$594.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,010.65
|
| Rate for Payer: Riverside University Health System MISP |
$475.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$713.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$713.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$446.23
|
| Rate for Payer: United Healthcare All Other HMO |
$434.34
|
| Rate for Payer: United Healthcare HMO Rider |
$424.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$389.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,010.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,010.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,010.65
|
|
|
HC HIP JT LOCK EA
|
Facility
|
OP
|
$1,015.00
|
|
|
Service Code
|
CPT L2610
|
| Hospital Charge Code |
915352610
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$332.41 |
| Max. Negotiated Rate |
$913.50 |
| Rate for Payer: Adventist Health Commercial |
$416.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$862.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$761.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$590.43
|
| Rate for Payer: Blue Shield of California Commercial |
$814.03
|
| Rate for Payer: Blue Shield of California EPN |
$511.56
|
| Rate for Payer: Cash Price |
$456.75
|
| Rate for Payer: Cash Price |
$456.75
|
| Rate for Payer: Central Health Plan Commercial |
$812.00
|
| Rate for Payer: Cigna of CA HMO |
$710.50
|
| Rate for Payer: Cigna of CA PPO |
$710.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$862.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$862.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$862.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$710.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$406.00
|
| Rate for Payer: EPIC Health Plan Senior |
$406.00
|
| Rate for Payer: Galaxy Health WC |
$862.75
|
| Rate for Payer: Global Benefits Group Commercial |
$609.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$913.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$335.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$644.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$370.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$598.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$416.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$710.50
|
| Rate for Payer: Multiplan Commercial |
$761.25
|
| Rate for Payer: Networks By Design Commercial |
$507.50
|
| Rate for Payer: Prime Health Services Commercial |
$862.75
|
| Rate for Payer: Riverside University Health System MISP |
$406.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$609.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$609.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$380.93
|
| Rate for Payer: United Healthcare All Other HMO |
$370.78
|
| Rate for Payer: United Healthcare HMO Rider |
$362.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$332.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$862.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$862.75
|
| Rate for Payer: Vantage Medical Group Senior |
$862.75
|
|
