|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
OP
|
$1,196.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$216.48 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$239.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$821.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$538.20
|
| Rate for Payer: Cash Price |
$538.20
|
| Rate for Payer: Cash Price |
$538.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$777.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: Dignity Health Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$294.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$809.69
|
| Rate for Payer: Heritage Provider Network Senior |
$809.69
|
| Rate for Payer: Humana Medicare |
$294.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$576.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$347.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.25
|
| Rate for Payer: Multiplan Commercial |
$897.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$434.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$399.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT ELBOW DISLOC W O ANES
|
Facility
|
IP
|
$1,196.00
|
|
|
Service Code
|
CPT 24600
|
| Hospital Charge Code |
900501063
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$216.48 |
| Max. Negotiated Rate |
$897.00 |
| Rate for Payer: Adventist Health Commercial |
$239.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$821.65
|
| Rate for Payer: Cash Price |
$538.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$809.69
|
| Rate for Payer: Heritage Provider Network Senior |
$809.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.00
|
| Rate for Payer: Multiplan Commercial |
$897.00
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
OP
|
$1,145.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.24 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$229.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$786.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$515.25
|
| Rate for Payer: Cash Price |
$515.25
|
| Rate for Payer: Cash Price |
$515.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$744.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: Dignity Health Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,008.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$775.16
|
| Rate for Payer: Heritage Provider Network Senior |
$775.16
|
| Rate for Payer: Humana Medicare |
$2,008.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$551.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,369.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$286.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,530.19
|
| Rate for Payer: Multiplan Commercial |
$858.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$415.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$382.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
IP
|
$1,145.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.24 |
| Max. Negotiated Rate |
$858.75 |
| Rate for Payer: Adventist Health Commercial |
$229.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$786.62
|
| Rate for Payer: Blue Shield of California Commercial |
$483.19
|
| Rate for Payer: Blue Shield of California EPN |
$460.29
|
| Rate for Payer: Cash Price |
$515.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$775.16
|
| Rate for Payer: Heritage Provider Network Senior |
$775.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$286.25
|
| Rate for Payer: Multiplan Commercial |
$858.75
|
|
|
HC CL TREAT FEMORAL FX W/ MANIPUL
|
Facility
|
OP
|
$9,612.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
900501442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$124.86 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,922.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,603.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,170.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,209.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$4,325.40
|
| Rate for Payer: Cash Price |
$4,325.40
|
| Rate for Payer: Cash Price |
$4,325.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,247.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,170.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,170.20
|
| Rate for Payer: Dignity Health Senior |
$8,170.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,949.83
|
| Rate for Payer: Heritage Provider Network Senior |
$5,949.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$124.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,739.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,403.00
|
| Rate for Payer: Multiplan Commercial |
$7,209.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,170.20
|
| Rate for Payer: Vantage Medical Group Senior |
$8,170.20
|
|
|
HC CL TREAT FEMORAL FX W/ MANIPUL
|
Facility
|
IP
|
$9,612.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
900501442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,739.77 |
| Max. Negotiated Rate |
$7,209.00 |
| Rate for Payer: Adventist Health Commercial |
$1,922.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,603.44
|
| Rate for Payer: Cash Price |
$4,325.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,507.32
|
| Rate for Payer: Heritage Provider Network Senior |
$6,507.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,739.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,403.00
|
| Rate for Payer: Multiplan Commercial |
$7,209.00
|
|
|
HC CL TREAT FEMORAL FX, W MANIPUL
|
Facility
|
OP
|
$1,848.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$334.49 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$369.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,269.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$831.60
|
| Rate for Payer: Cash Price |
$831.60
|
| Rate for Payer: Cash Price |
$831.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,201.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: Dignity Health Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,008.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,251.10
|
| Rate for Payer: Heritage Provider Network Senior |
$1,251.10
|
| Rate for Payer: Humana Medicare |
$2,008.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$890.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,369.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$462.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,386.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$671.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$617.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT FEMORAL FX, W MANIPUL
|
Facility
|
IP
|
$1,848.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$334.49 |
| Max. Negotiated Rate |
$1,386.00 |
| Rate for Payer: Adventist Health Commercial |
$369.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,269.58
|
| Rate for Payer: Blue Shield of California Commercial |
$779.86
|
| Rate for Payer: Blue Shield of California EPN |
$742.90
|
| Rate for Payer: Cash Price |
$831.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,251.10
|
| Rate for Payer: Heritage Provider Network Senior |
$1,251.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$462.00
|
| Rate for Payer: Multiplan Commercial |
$1,386.00
|
|
|
HC CL TREAT FEMORAL FX, W/O MANIP
|
Facility
|
OP
|
$987.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
900501482
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.65 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$197.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$678.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$641.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: Dignity Health Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$294.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$668.20
|
| Rate for Payer: Heritage Provider Network Senior |
$668.20
|
| Rate for Payer: Humana Medicare |
$294.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$475.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$347.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.25
|
| Rate for Payer: Multiplan Commercial |
$740.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$358.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$329.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT FEMORAL FX, W/O MANIP
|
Facility
|
IP
|
$987.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
900501482
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.65 |
| Max. Negotiated Rate |
$740.25 |
| Rate for Payer: Adventist Health Commercial |
$197.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$678.07
|
| Rate for Payer: Blue Shield of California Commercial |
$416.51
|
| Rate for Payer: Blue Shield of California EPN |
$396.77
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$668.20
|
| Rate for Payer: Heritage Provider Network Senior |
$668.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.75
|
| Rate for Payer: Multiplan Commercial |
$740.25
|
|
|
HC CL TREAT FEMORAL SHAFT FX,W/O
|
Facility
|
OP
|
$1,166.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
900501463
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$211.05 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$233.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$801.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$524.70
|
| Rate for Payer: Cash Price |
$524.70
|
| Rate for Payer: Cash Price |
$524.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$757.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: Dignity Health Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$294.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$789.38
|
| Rate for Payer: Heritage Provider Network Senior |
$789.38
|
| Rate for Payer: Humana Medicare |
$294.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$562.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$211.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$347.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.25
|
| Rate for Payer: Multiplan Commercial |
$874.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$423.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$389.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT FEMORAL SHAFT FX,W/O
|
Facility
|
IP
|
$1,166.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
900501463
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$211.05 |
| Max. Negotiated Rate |
$874.50 |
| Rate for Payer: Adventist Health Commercial |
$233.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$801.04
|
| Rate for Payer: Blue Shield of California Commercial |
$492.05
|
| Rate for Payer: Blue Shield of California EPN |
$468.73
|
| Rate for Payer: Cash Price |
$524.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$789.38
|
| Rate for Payer: Heritage Provider Network Senior |
$789.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$211.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.50
|
| Rate for Payer: Multiplan Commercial |
$874.50
|
|
|
HC CL TREAT FEM SHAFT FRAC W/MANI
|
Facility
|
IP
|
$5,791.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
900501085
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,048.17 |
| Max. Negotiated Rate |
$4,343.25 |
| Rate for Payer: Adventist Health Commercial |
$1,158.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,978.42
|
| Rate for Payer: Blue Shield of California Commercial |
$2,443.80
|
| Rate for Payer: Blue Shield of California EPN |
$2,327.98
|
| Rate for Payer: Cash Price |
$2,605.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,920.51
|
| Rate for Payer: Heritage Provider Network Senior |
$3,920.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,048.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,447.75
|
| Rate for Payer: Multiplan Commercial |
$4,343.25
|
|
|
HC CL TREAT FEM SHAFT FRAC W/MANI
|
Facility
|
OP
|
$5,791.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
900501085
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,158.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,978.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$2,605.95
|
| Rate for Payer: Cash Price |
$2,605.95
|
| Rate for Payer: Cash Price |
$2,605.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,764.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: Dignity Health Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,008.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,920.51
|
| Rate for Payer: Heritage Provider Network Senior |
$3,920.51
|
| Rate for Payer: Humana Medicare |
$2,008.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,791.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,048.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,369.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,447.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,530.19
|
| Rate for Payer: Multiplan Commercial |
$4,343.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,102.71
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,934.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT FIBULA FX W/MANIPULAT
|
Facility
|
IP
|
$3,875.00
|
|
|
Service Code
|
CPT 27781
|
| Hospital Charge Code |
900501487
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$701.38 |
| Max. Negotiated Rate |
$2,906.25 |
| Rate for Payer: Adventist Health Commercial |
$775.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,662.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,635.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,557.75
|
| Rate for Payer: Cash Price |
$1,743.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,623.38
|
| Rate for Payer: Heritage Provider Network Senior |
$2,623.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$701.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$968.75
|
| Rate for Payer: Multiplan Commercial |
$2,906.25
|
|
|
HC CL TREAT FIBULA FX W/MANIPULAT
|
Facility
|
OP
|
$3,875.00
|
|
|
Service Code
|
CPT 27781
|
| Hospital Charge Code |
900501487
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$701.38 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$775.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,662.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$1,743.75
|
| Rate for Payer: Cash Price |
$1,743.75
|
| Rate for Payer: Cash Price |
$1,743.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,518.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: Dignity Health Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,008.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,623.38
|
| Rate for Payer: Heritage Provider Network Senior |
$2,623.38
|
| Rate for Payer: Humana Medicare |
$2,008.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,867.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$701.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,369.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$968.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,906.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,407.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,294.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT FIBULA/SHAFT FX W/O M
|
Facility
|
OP
|
$392.00
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
900501759
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$70.95 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$78.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$269.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$254.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: Dignity Health Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$294.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$265.38
|
| Rate for Payer: Heritage Provider Network Senior |
$265.38
|
| Rate for Payer: Humana Medicare |
$294.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$188.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$347.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.25
|
| Rate for Payer: Multiplan Commercial |
$294.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$142.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$130.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT FIBULA/SHAFT FX W/O M
|
Facility
|
IP
|
$392.00
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
900501759
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$70.95 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Adventist Health Commercial |
$78.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$269.30
|
| Rate for Payer: Blue Shield of California Commercial |
$165.42
|
| Rate for Payer: Blue Shield of California EPN |
$157.58
|
| Rate for Payer: Cash Price |
$176.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$265.38
|
| Rate for Payer: Heritage Provider Network Senior |
$265.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.00
|
| Rate for Payer: Multiplan Commercial |
$294.00
|
|
|
HC CL TREAT FINGER/THUMB FX W/O M
|
Facility
|
IP
|
$987.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
900501393
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.65 |
| Max. Negotiated Rate |
$740.25 |
| Rate for Payer: Adventist Health Commercial |
$197.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$678.07
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$668.20
|
| Rate for Payer: Heritage Provider Network Senior |
$668.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.75
|
| Rate for Payer: Multiplan Commercial |
$740.25
|
|
|
HC CL TREAT FINGER/THUMB FX W/O M
|
Facility
|
OP
|
$987.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
900501393
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.65 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$197.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$678.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cash Price |
$444.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$641.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: Dignity Health Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$294.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$668.20
|
| Rate for Payer: Heritage Provider Network Senior |
$668.20
|
| Rate for Payer: Humana Medicare |
$294.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$475.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$347.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.25
|
| Rate for Payer: Multiplan Commercial |
$740.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$358.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$329.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT FOOT DISLOCAT W/O ANE
|
Facility
|
IP
|
$467.00
|
|
|
Service Code
|
CPT 28600
|
| Hospital Charge Code |
900501655
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.53 |
| Max. Negotiated Rate |
$350.25 |
| Rate for Payer: Adventist Health Commercial |
$93.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$320.83
|
| Rate for Payer: Cash Price |
$210.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$316.16
|
| Rate for Payer: Heritage Provider Network Senior |
$316.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.75
|
| Rate for Payer: Multiplan Commercial |
$350.25
|
|
|
HC CL TREAT FOOT DISLOCAT W/O ANE
|
Facility
|
OP
|
$467.00
|
|
|
Service Code
|
CPT 28600
|
| Hospital Charge Code |
900501655
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.53 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$93.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$320.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Cash Price |
$210.15
|
| Rate for Payer: Cash Price |
$210.15
|
| Rate for Payer: Cash Price |
$210.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$303.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: Dignity Health Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$294.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$316.16
|
| Rate for Payer: Heritage Provider Network Senior |
$316.16
|
| Rate for Payer: Humana Medicare |
$294.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$225.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$347.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.25
|
| Rate for Payer: Multiplan Commercial |
$350.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$169.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$156.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CL TREAT FRAC OF WT BEAR W/SKE
|
Facility
|
OP
|
$4,208.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
900501095
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$761.65 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$841.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,890.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,735.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: Dignity Health Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,008.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,848.82
|
| Rate for Payer: Heritage Provider Network Senior |
$2,848.82
|
| Rate for Payer: Humana Medicare |
$2,008.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,008.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,028.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$761.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,369.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,052.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,530.19
|
| Rate for Payer: Multiplan Commercial |
$3,156.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,527.92
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,405.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC CL TREAT FRAC OF WT BEAR W/SKE
|
Facility
|
IP
|
$4,208.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
900501095
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$761.65 |
| Max. Negotiated Rate |
$3,156.00 |
| Rate for Payer: Adventist Health Commercial |
$841.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,890.90
|
| Rate for Payer: Cash Price |
$1,893.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,848.82
|
| Rate for Payer: Heritage Provider Network Senior |
$2,848.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$761.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,052.00
|
| Rate for Payer: Multiplan Commercial |
$3,156.00
|
|
|
HC CL TREAT FX OF WT BRNG LWR LEG
|
Facility
|
IP
|
$832.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
900501502
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.59 |
| Max. Negotiated Rate |
$624.00 |
| Rate for Payer: Adventist Health Commercial |
$166.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$571.58
|
| Rate for Payer: Cash Price |
$374.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$563.26
|
| Rate for Payer: Heritage Provider Network Senior |
$563.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.00
|
| Rate for Payer: Multiplan Commercial |
$624.00
|
|
