|
HC ELASTIC WITH STAYS
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT L3700
|
| Hospital Charge Code |
903203700
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$67.90 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$164.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$106.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$106.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.62
|
| Rate for Payer: Blue Distinction Transplant |
$116.40
|
| Rate for Payer: Blue Shield of California Commercial |
$145.50
|
| Rate for Payer: Blue Shield of California EPN |
$105.54
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Central Health Plan Commercial |
$155.20
|
| Rate for Payer: Cigna of CA HMO |
$135.80
|
| Rate for Payer: Cigna of CA PPO |
$135.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$164.90
|
| Rate for Payer: Dignity Health Media |
$164.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$164.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$174.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$145.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$67.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.54
|
| Rate for Payer: Multiplan Commercial |
$145.50
|
| Rate for Payer: Networks By Design Commercial |
$97.00
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
| Rate for Payer: Riverside University Health System MISP |
$77.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$116.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$116.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$97.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97.00
|
| Rate for Payer: United Healthcare HMO Rider |
$97.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$97.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$164.90
|
| Rate for Payer: Vantage Medical Group Senior |
$164.90
|
|
|
HC ELASTOPLAST
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
909001032
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.09
|
| Rate for Payer: Blue Distinction Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7.55
|
| Rate for Payer: Blue Shield of California EPN |
$5.87
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$7.68
|
| Rate for Payer: Cigna of CA PPO |
$8.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Media |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Riverside University Health System MISP |
$4.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
|
|
HC ELASTOPLAST
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
909001032
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.80
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Central Health Plan Commercial |
$336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.00
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$378.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$280.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$315.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$357.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$231.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$231.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$252.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Central Health Plan Commercial |
$336.00
|
| Rate for Payer: Cigna of CA PPO |
$310.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$357.00
|
| Rate for Payer: Dignity Health Media |
$357.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$357.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$168.00
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$378.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$315.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$147.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$280.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$388.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$315.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
| Rate for Payer: Riverside University Health System MISP |
$168.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$252.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$357.00
|
| Rate for Payer: Vantage Medical Group Senior |
$357.00
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.00 |
| 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 |
$357.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$231.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$231.00
|
| 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 |
$252.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Central Health Plan Commercial |
$336.00
|
| Rate for Payer: Cigna of CA PPO |
$310.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$357.00
|
| Rate for Payer: Dignity Health Media |
$357.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$357.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$168.00
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$378.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$315.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$280.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$388.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$315.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
| Rate for Payer: Riverside University Health System MISP |
$168.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$252.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$210.00
|
| Rate for Payer: United Healthcare All Other HMO |
$210.00
|
| Rate for Payer: United Healthcare HMO Rider |
$210.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$210.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$357.00
|
| Rate for Payer: Vantage Medical Group Senior |
$357.00
|
|
|
HC ELBOW ARTHROGRAPHY INJECT
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
CPT 24220
|
| Hospital Charge Code |
909000114
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Central Health Plan Commercial |
$336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.00
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$378.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$280.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$315.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
|
|
HC ELBOW COMPLETE
|
Facility
|
OP
|
$1,115.00
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
909001512
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$49.36 |
| Max. Negotiated Rate |
$1,003.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$113.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$144.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$118.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.81
|
| Rate for Payer: Blue Distinction Transplant |
$669.00
|
| Rate for Payer: Blue Shield of California Commercial |
$689.07
|
| Rate for Payer: Blue Shield of California EPN |
$541.89
|
| Rate for Payer: Caremore Medicare Advantage |
$113.54
|
| Rate for Payer: Cash Price |
$501.75
|
| Rate for Payer: Cash Price |
$501.75
|
| Rate for Payer: Central Health Plan Commercial |
$892.00
|
| Rate for Payer: Cigna of CA HMO |
$713.60
|
| Rate for Payer: Cigna of CA PPO |
$825.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$947.75
|
| Rate for Payer: Global Benefits Group Commercial |
$669.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,003.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$836.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$186.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: InnovAge PACE Commercial |
$170.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$743.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$223.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$836.25
|
| Rate for Payer: Networks By Design Commercial |
$724.75
|
| Rate for Payer: Prime Health Services Commercial |
$947.75
|
| Rate for Payer: Prime Health Services Medicare |
$120.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$669.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$669.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC ELBOW COMPLETE
|
Facility
|
IP
|
$1,115.00
|
|
|
Service Code
|
CPT 73080
|
| Hospital Charge Code |
909001512
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$223.00 |
| Max. Negotiated Rate |
$1,003.50 |
| Rate for Payer: Cash Price |
$501.75
|
| Rate for Payer: Central Health Plan Commercial |
$892.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$446.00
|
| Rate for Payer: Galaxy Health WC |
$947.75
|
| Rate for Payer: Global Benefits Group Commercial |
$669.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,003.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$743.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$424.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$223.00
|
| Rate for Payer: Multiplan Commercial |
$836.25
|
| Rate for Payer: Networks By Design Commercial |
$724.75
|
| Rate for Payer: Prime Health Services Commercial |
$947.75
|
|
|
HC ELBOW LIMITED 2 VIEW
|
Facility
|
IP
|
$788.00
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
909001511
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$157.60 |
| Max. Negotiated Rate |
$709.20 |
| Rate for Payer: Cash Price |
$354.60
|
| Rate for Payer: Central Health Plan Commercial |
$630.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$315.20
|
| Rate for Payer: Galaxy Health WC |
$669.80
|
| Rate for Payer: Global Benefits Group Commercial |
$472.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$709.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$525.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$300.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.60
|
| Rate for Payer: Multiplan Commercial |
$591.00
|
| Rate for Payer: Networks By Design Commercial |
$512.20
|
| Rate for Payer: Prime Health Services Commercial |
$669.80
|
|
|
HC ELBOW LIMITED 2 VIEW
|
Facility
|
OP
|
$788.00
|
|
|
Service Code
|
CPT 73070
|
| Hospital Charge Code |
909001511
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$39.48 |
| Max. Negotiated Rate |
$709.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$113.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.50
|
| Rate for Payer: Blue Distinction Transplant |
$472.80
|
| Rate for Payer: Blue Shield of California Commercial |
$486.98
|
| Rate for Payer: Blue Shield of California EPN |
$382.97
|
| Rate for Payer: Caremore Medicare Advantage |
$113.54
|
| Rate for Payer: Cash Price |
$354.60
|
| Rate for Payer: Cash Price |
$354.60
|
| Rate for Payer: Central Health Plan Commercial |
$630.40
|
| Rate for Payer: Cigna of CA HMO |
$504.32
|
| Rate for Payer: Cigna of CA PPO |
$583.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$669.80
|
| Rate for Payer: Global Benefits Group Commercial |
$472.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$709.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$591.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$186.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: InnovAge PACE Commercial |
$170.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$525.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$157.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$591.00
|
| Rate for Payer: Networks By Design Commercial |
$512.20
|
| Rate for Payer: Prime Health Services Commercial |
$669.80
|
| Rate for Payer: Prime Health Services Medicare |
$120.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$472.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$472.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC ELBOW SOCKET INS USE W/LOCK
|
Facility
|
IP
|
$1,683.00
|
|
|
Service Code
|
CPT L6694
|
| Hospital Charge Code |
905356694
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$336.60 |
| Max. Negotiated Rate |
$1,514.70 |
| Rate for Payer: Blue Shield of California EPN |
$898.72
|
| Rate for Payer: Cash Price |
$757.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,346.40
|
| Rate for Payer: Cigna of CA HMO |
$1,178.10
|
| Rate for Payer: Cigna of CA PPO |
$1,178.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$673.20
|
| Rate for Payer: Galaxy Health WC |
$1,430.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,009.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,514.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,122.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$641.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$336.60
|
| Rate for Payer: Multiplan Commercial |
$1,262.25
|
| Rate for Payer: Networks By Design Commercial |
$841.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,430.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$635.50
|
| Rate for Payer: United Healthcare All Other HMO |
$620.69
|
| Rate for Payer: United Healthcare HMO Rider |
$607.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$555.39
|
|
|
HC ELBOW SOCKET INS USE W/LOCK
|
Facility
|
OP
|
$1,683.00
|
|
|
Service Code
|
CPT L6694
|
| Hospital Charge Code |
905356694
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$589.05 |
| Max. Negotiated Rate |
$1,514.70 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,430.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$925.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$925.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$814.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$994.32
|
| Rate for Payer: Blue Distinction Transplant |
$1,009.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,262.25
|
| Rate for Payer: Blue Shield of California EPN |
$915.55
|
| Rate for Payer: Cash Price |
$757.35
|
| Rate for Payer: Cash Price |
$757.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,346.40
|
| Rate for Payer: Cigna of CA HMO |
$1,178.10
|
| Rate for Payer: Cigna of CA PPO |
$1,178.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,430.55
|
| Rate for Payer: Dignity Health Media |
$1,430.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,430.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$673.20
|
| Rate for Payer: Galaxy Health WC |
$1,430.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,009.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,514.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,262.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$589.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,122.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$955.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$690.03
|
| Rate for Payer: Multiplan Commercial |
$1,262.25
|
| Rate for Payer: Networks By Design Commercial |
$841.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,430.55
|
| Rate for Payer: Riverside University Health System MISP |
$673.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,009.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,009.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$841.50
|
| Rate for Payer: United Healthcare All Other HMO |
$841.50
|
| Rate for Payer: United Healthcare HMO Rider |
$841.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$841.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,430.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,430.55
|
|
|
HC ELBOW SOCKET INS USE W/O LCK
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
CPT L6695
|
| Hospital Charge Code |
905356695
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$224.40 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Blue Shield of California EPN |
$599.15
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Central Health Plan Commercial |
$897.60
|
| Rate for Payer: Cigna of CA HMO |
$785.40
|
| Rate for Payer: Cigna of CA PPO |
$785.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$448.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$448.80
|
| Rate for Payer: Galaxy Health WC |
$953.70
|
| Rate for Payer: Global Benefits Group Commercial |
$673.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,009.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$748.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.40
|
| Rate for Payer: Multiplan Commercial |
$841.50
|
| Rate for Payer: Networks By Design Commercial |
$561.00
|
| Rate for Payer: Prime Health Services Commercial |
$953.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$423.67
|
| Rate for Payer: United Healthcare All Other HMO |
$413.79
|
| Rate for Payer: United Healthcare HMO Rider |
$404.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$370.26
|
|
|
HC ELBOW SOCKET INS USE W/O LCK
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
CPT L6695
|
| Hospital Charge Code |
905356695
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$392.70 |
| Max. Negotiated Rate |
$1,009.80 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$953.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$617.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$617.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$543.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$662.88
|
| Rate for Payer: Blue Distinction Transplant |
$673.20
|
| Rate for Payer: Blue Shield of California Commercial |
$841.50
|
| Rate for Payer: Blue Shield of California EPN |
$610.37
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Cash Price |
$504.90
|
| Rate for Payer: Central Health Plan Commercial |
$897.60
|
| Rate for Payer: Cigna of CA HMO |
$785.40
|
| Rate for Payer: Cigna of CA PPO |
$785.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$953.70
|
| Rate for Payer: Dignity Health Media |
$953.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$953.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$448.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$448.80
|
| Rate for Payer: Galaxy Health WC |
$953.70
|
| Rate for Payer: Global Benefits Group Commercial |
$673.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,009.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$841.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$392.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$748.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$795.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$460.02
|
| Rate for Payer: Multiplan Commercial |
$841.50
|
| Rate for Payer: Networks By Design Commercial |
$561.00
|
| Rate for Payer: Prime Health Services Commercial |
$953.70
|
| Rate for Payer: Riverside University Health System MISP |
$448.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$673.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$673.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$561.00
|
| Rate for Payer: United Healthcare All Other HMO |
$561.00
|
| Rate for Payer: United Healthcare HMO Rider |
$561.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$561.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$953.70
|
| Rate for Payer: Vantage Medical Group Senior |
$953.70
|
|
|
HC ELEC HAND IND ART DIGITS
|
Facility
|
IP
|
$66,573.55
|
|
|
Service Code
|
CPT L6880
|
| Hospital Charge Code |
905356880
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$13,314.71 |
| Max. Negotiated Rate |
$59,916.20 |
| Rate for Payer: Blue Shield of California EPN |
$35,550.28
|
| Rate for Payer: Cash Price |
$29,958.10
|
| Rate for Payer: Central Health Plan Commercial |
$53,258.84
|
| Rate for Payer: Cigna of CA HMO |
$46,601.48
|
| Rate for Payer: Cigna of CA PPO |
$46,601.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,629.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$26,629.42
|
| Rate for Payer: Galaxy Health WC |
$56,587.52
|
| Rate for Payer: Global Benefits Group Commercial |
$39,944.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,916.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44,404.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,364.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,314.71
|
| Rate for Payer: Multiplan Commercial |
$49,930.16
|
| Rate for Payer: Networks By Design Commercial |
$33,286.78
|
| Rate for Payer: Prime Health Services Commercial |
$56,587.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$25,138.17
|
| Rate for Payer: United Healthcare All Other HMO |
$24,552.33
|
| Rate for Payer: United Healthcare HMO Rider |
$24,019.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,969.27
|
|
|
HC ELEC HAND IND ART DIGITS
|
Facility
|
OP
|
$66,573.55
|
|
|
Service Code
|
CPT L6880
|
| Hospital Charge Code |
905356880
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$23,300.74 |
| Max. Negotiated Rate |
$59,916.20 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56,587.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,615.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36,615.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,234.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,331.65
|
| Rate for Payer: Blue Distinction Transplant |
$39,944.13
|
| Rate for Payer: Blue Shield of California Commercial |
$49,930.16
|
| Rate for Payer: Blue Shield of California EPN |
$36,216.01
|
| Rate for Payer: Cash Price |
$29,958.10
|
| Rate for Payer: Central Health Plan Commercial |
$53,258.84
|
| Rate for Payer: Cigna of CA HMO |
$46,601.48
|
| Rate for Payer: Cigna of CA PPO |
$46,601.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56,587.52
|
| Rate for Payer: Dignity Health Media |
$56,587.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$56,587.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,629.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$26,629.42
|
| Rate for Payer: Galaxy Health WC |
$56,587.52
|
| Rate for Payer: Global Benefits Group Commercial |
$39,944.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,916.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$49,930.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23,300.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44,404.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27,295.16
|
| Rate for Payer: Multiplan Commercial |
$49,930.16
|
| Rate for Payer: Networks By Design Commercial |
$33,286.78
|
| Rate for Payer: Prime Health Services Commercial |
$56,587.52
|
| Rate for Payer: Riverside University Health System MISP |
$26,629.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39,944.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39,944.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$33,286.78
|
| Rate for Payer: United Healthcare All Other HMO |
$33,286.78
|
| Rate for Payer: United Healthcare HMO Rider |
$33,286.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33,286.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56,587.52
|
| Rate for Payer: Vantage Medical Group Senior |
$56,587.52
|
|
|
HC ELEC KNEE-SHIN SWING ONLY
|
Facility
|
OP
|
$16,766.00
|
|
|
Service Code
|
CPT L5857
|
| Hospital Charge Code |
905355857
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5,868.10 |
| Max. Negotiated Rate |
$15,089.40 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,251.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,221.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,221.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,118.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,905.35
|
| Rate for Payer: Blue Distinction Transplant |
$10,059.60
|
| Rate for Payer: Blue Shield of California Commercial |
$12,574.50
|
| Rate for Payer: Blue Shield of California EPN |
$9,120.70
|
| Rate for Payer: Cash Price |
$7,544.70
|
| Rate for Payer: Cash Price |
$7,544.70
|
| Rate for Payer: Central Health Plan Commercial |
$13,412.80
|
| Rate for Payer: Cigna of CA HMO |
$11,736.20
|
| Rate for Payer: Cigna of CA PPO |
$11,736.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,251.10
|
| Rate for Payer: Dignity Health Media |
$14,251.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,251.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,706.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,706.40
|
| Rate for Payer: Galaxy Health WC |
$14,251.10
|
| Rate for Payer: Global Benefits Group Commercial |
$10,059.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,089.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,574.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,868.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,182.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,193.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,874.06
|
| Rate for Payer: Multiplan Commercial |
$12,574.50
|
| Rate for Payer: Networks By Design Commercial |
$8,383.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,251.10
|
| Rate for Payer: Riverside University Health System MISP |
$6,706.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,059.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,059.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,383.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,383.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,383.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,383.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,251.10
|
| Rate for Payer: Vantage Medical Group Senior |
$14,251.10
|
|
|
HC ELEC KNEE-SHIN SWING ONLY
|
Facility
|
IP
|
$16,766.00
|
|
|
Service Code
|
CPT L5857
|
| Hospital Charge Code |
905355857
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,353.20 |
| Max. Negotiated Rate |
$15,089.40 |
| Rate for Payer: Blue Shield of California EPN |
$8,953.04
|
| Rate for Payer: Cash Price |
$7,544.70
|
| Rate for Payer: Central Health Plan Commercial |
$13,412.80
|
| Rate for Payer: Cigna of CA HMO |
$11,736.20
|
| Rate for Payer: Cigna of CA PPO |
$11,736.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,706.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,706.40
|
| Rate for Payer: Galaxy Health WC |
$14,251.10
|
| Rate for Payer: Global Benefits Group Commercial |
$10,059.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,089.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,182.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,387.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,353.20
|
| Rate for Payer: Multiplan Commercial |
$12,574.50
|
| Rate for Payer: Networks By Design Commercial |
$8,383.00
|
| Rate for Payer: Prime Health Services Commercial |
$14,251.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,330.84
|
| Rate for Payer: United Healthcare All Other HMO |
$6,183.30
|
| Rate for Payer: United Healthcare HMO Rider |
$6,049.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,532.78
|
|
|
HC ELEC KNEE-SHIN SWING/STANCE
|
Facility
|
IP
|
$47,249.00
|
|
|
Service Code
|
CPT L5856
|
| Hospital Charge Code |
905355856
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$9,449.80 |
| Max. Negotiated Rate |
$42,524.10 |
| Rate for Payer: Blue Shield of California EPN |
$25,230.97
|
| Rate for Payer: Cash Price |
$21,262.05
|
| Rate for Payer: Central Health Plan Commercial |
$37,799.20
|
| Rate for Payer: Cigna of CA HMO |
$33,074.30
|
| Rate for Payer: Cigna of CA PPO |
$33,074.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,899.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$18,899.60
|
| Rate for Payer: Galaxy Health WC |
$40,161.65
|
| Rate for Payer: Global Benefits Group Commercial |
$28,349.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,524.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,515.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,001.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,449.80
|
| Rate for Payer: Multiplan Commercial |
$35,436.75
|
| Rate for Payer: Networks By Design Commercial |
$23,624.50
|
| Rate for Payer: Prime Health Services Commercial |
$40,161.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,841.22
|
| Rate for Payer: United Healthcare All Other HMO |
$17,425.43
|
| Rate for Payer: United Healthcare HMO Rider |
$17,047.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,592.17
|
|
|
HC ELEC KNEE-SHIN SWING/STANCE
|
Facility
|
OP
|
$47,249.00
|
|
|
Service Code
|
CPT L5856
|
| Hospital Charge Code |
905355856
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16,537.15 |
| Max. Negotiated Rate |
$42,524.10 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40,161.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,986.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25,986.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22,877.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,914.71
|
| Rate for Payer: Blue Distinction Transplant |
$28,349.40
|
| Rate for Payer: Blue Shield of California Commercial |
$35,436.75
|
| Rate for Payer: Blue Shield of California EPN |
$25,703.46
|
| Rate for Payer: Cash Price |
$21,262.05
|
| Rate for Payer: Cash Price |
$21,262.05
|
| Rate for Payer: Central Health Plan Commercial |
$37,799.20
|
| Rate for Payer: Cigna of CA HMO |
$33,074.30
|
| Rate for Payer: Cigna of CA PPO |
$33,074.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40,161.65
|
| Rate for Payer: Dignity Health Media |
$40,161.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$40,161.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,899.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$18,899.60
|
| Rate for Payer: Galaxy Health WC |
$40,161.65
|
| Rate for Payer: Global Benefits Group Commercial |
$28,349.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,524.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$35,436.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,537.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,515.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28,727.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,372.09
|
| Rate for Payer: Multiplan Commercial |
$35,436.75
|
| Rate for Payer: Networks By Design Commercial |
$23,624.50
|
| Rate for Payer: Prime Health Services Commercial |
$40,161.65
|
| Rate for Payer: Riverside University Health System MISP |
$18,899.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,349.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28,349.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$23,624.50
|
| Rate for Payer: United Healthcare All Other HMO |
$23,624.50
|
| Rate for Payer: United Healthcare HMO Rider |
$23,624.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23,624.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40,161.65
|
| Rate for Payer: Vantage Medical Group Senior |
$40,161.65
|
|
|
HC ELECT ELBOW ADOLESC MYOELECTRC
|
Facility
|
IP
|
$23,337.00
|
|
|
Service Code
|
CPT L7190
|
| Hospital Charge Code |
905357190
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,667.40 |
| Max. Negotiated Rate |
$21,003.30 |
| Rate for Payer: Blue Shield of California EPN |
$12,461.96
|
| Rate for Payer: Cash Price |
$10,501.65
|
| Rate for Payer: Central Health Plan Commercial |
$18,669.60
|
| Rate for Payer: Cigna of CA HMO |
$16,335.90
|
| Rate for Payer: Cigna of CA PPO |
$16,335.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,334.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,334.80
|
| Rate for Payer: Galaxy Health WC |
$19,836.45
|
| Rate for Payer: Global Benefits Group Commercial |
$14,002.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,003.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,565.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,891.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,667.40
|
| Rate for Payer: Multiplan Commercial |
$17,502.75
|
| Rate for Payer: Networks By Design Commercial |
$11,668.50
|
| Rate for Payer: Prime Health Services Commercial |
$19,836.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,812.05
|
| Rate for Payer: United Healthcare All Other HMO |
$8,606.69
|
| Rate for Payer: United Healthcare HMO Rider |
$8,419.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,701.21
|
|
|
HC ELECT ELBOW ADOLESC MYOELECTRC
|
Facility
|
OP
|
$23,337.00
|
|
|
Service Code
|
CPT L7190
|
| Hospital Charge Code |
905357190
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6,733.12 |
| Max. Negotiated Rate |
$21,003.30 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,836.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,835.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,835.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,299.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,787.50
|
| Rate for Payer: Blue Distinction Transplant |
$14,002.20
|
| Rate for Payer: Blue Shield of California Commercial |
$17,502.75
|
| Rate for Payer: Blue Shield of California EPN |
$12,695.33
|
| Rate for Payer: Cash Price |
$10,501.65
|
| Rate for Payer: Cash Price |
$10,501.65
|
| Rate for Payer: Central Health Plan Commercial |
$18,669.60
|
| Rate for Payer: Cigna of CA HMO |
$16,335.90
|
| Rate for Payer: Cigna of CA PPO |
$16,335.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,836.45
|
| Rate for Payer: Dignity Health Media |
$19,836.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,836.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,334.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,334.80
|
| Rate for Payer: Galaxy Health WC |
$19,836.45
|
| Rate for Payer: Global Benefits Group Commercial |
$14,002.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,003.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17,502.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,167.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,565.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,733.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,568.17
|
| Rate for Payer: Multiplan Commercial |
$17,502.75
|
| Rate for Payer: Networks By Design Commercial |
$11,668.50
|
| Rate for Payer: Prime Health Services Commercial |
$19,836.45
|
| Rate for Payer: Riverside University Health System MISP |
$9,334.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,002.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,002.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,668.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11,668.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11,668.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,668.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,836.45
|
| Rate for Payer: Vantage Medical Group Senior |
$19,836.45
|
|
|
HC ELECT ELBOW ADOLESC SWTCH CONT
|
Facility
|
OP
|
$17,413.00
|
|
|
Service Code
|
CPT L7185
|
| Hospital Charge Code |
905357185
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5,120.50 |
| Max. Negotiated Rate |
$15,671.70 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,801.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,577.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,577.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,431.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,287.60
|
| Rate for Payer: Blue Distinction Transplant |
$10,447.80
|
| Rate for Payer: Blue Shield of California Commercial |
$13,059.75
|
| Rate for Payer: Blue Shield of California EPN |
$9,472.67
|
| Rate for Payer: Cash Price |
$7,835.85
|
| Rate for Payer: Cash Price |
$7,835.85
|
| Rate for Payer: Central Health Plan Commercial |
$13,930.40
|
| Rate for Payer: Cigna of CA HMO |
$12,189.10
|
| Rate for Payer: Cigna of CA PPO |
$12,189.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,801.05
|
| Rate for Payer: Dignity Health Media |
$14,801.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,801.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,965.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,965.20
|
| Rate for Payer: Galaxy Health WC |
$14,801.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10,447.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,671.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13,059.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,094.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,614.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,120.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,139.33
|
| Rate for Payer: Multiplan Commercial |
$13,059.75
|
| Rate for Payer: Networks By Design Commercial |
$8,706.50
|
| Rate for Payer: Prime Health Services Commercial |
$14,801.05
|
| Rate for Payer: Riverside University Health System MISP |
$6,965.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,447.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,447.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,706.50
|
| Rate for Payer: United Healthcare All Other HMO |
$8,706.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,706.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,706.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,801.05
|
| Rate for Payer: Vantage Medical Group Senior |
$14,801.05
|
|
|
HC ELECT ELBOW ADOLESC SWTCH CONT
|
Facility
|
IP
|
$17,413.00
|
|
|
Service Code
|
CPT L7185
|
| Hospital Charge Code |
905357185
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,482.60 |
| Max. Negotiated Rate |
$15,671.70 |
| Rate for Payer: Blue Shield of California EPN |
$9,298.54
|
| Rate for Payer: Cash Price |
$7,835.85
|
| Rate for Payer: Central Health Plan Commercial |
$13,930.40
|
| Rate for Payer: Cigna of CA HMO |
$12,189.10
|
| Rate for Payer: Cigna of CA PPO |
$12,189.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,965.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,965.20
|
| Rate for Payer: Galaxy Health WC |
$14,801.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10,447.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,671.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,614.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,634.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,482.60
|
| Rate for Payer: Multiplan Commercial |
$13,059.75
|
| Rate for Payer: Networks By Design Commercial |
$8,706.50
|
| Rate for Payer: Prime Health Services Commercial |
$14,801.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,575.15
|
| Rate for Payer: United Healthcare All Other HMO |
$6,421.91
|
| Rate for Payer: United Healthcare HMO Rider |
$6,282.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,746.29
|
|
