|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
IP
|
$1,515.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$274.21 |
| Max. Negotiated Rate |
$1,136.25 |
| Rate for Payer: Adventist Health Commercial |
$303.00
|
| Rate for Payer: Cash Price |
$833.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,025.65
|
| Rate for Payer: Heritage Provider Network Senior |
$1,025.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$274.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$378.75
|
| Rate for Payer: Multiplan Commercial |
$1,136.25
|
|
|
HC CL TREAT FEM FX,INTER EXT W/MA
|
Facility
|
OP
|
$1,515.00
|
|
|
Service Code
|
CPT 27503
|
| Hospital Charge Code |
900501522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$303.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,040.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$833.25
|
| Rate for Payer: Cash Price |
$833.25
|
| Rate for Payer: Cash Price |
$833.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$984.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Senior |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,033.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,025.65
|
| Rate for Payer: Heritage Provider Network Senior |
$1,025.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$722.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$274.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,338.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$378.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,562.18
|
| Rate for Payer: Multiplan Commercial |
$1,136.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$545.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$501.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT FEMORAL FX W/ MANIPUL
|
Facility
|
OP
|
$10,416.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
900501442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,155.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,853.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,728.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,812.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$5,728.80
|
| Rate for Payer: Cash Price |
$5,728.80
|
| Rate for Payer: Cash Price |
$5,728.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,770.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,853.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,853.60
|
| Rate for Payer: Dignity Health Senior |
$8,853.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,447.50
|
| Rate for Payer: Heritage Provider Network Senior |
$6,447.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$129.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,968.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,885.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,604.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,291.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,291.20
|
| Rate for Payer: Multiplan Commercial |
$7,812.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,853.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,853.60
|
| Rate for Payer: Vantage Medical Group Senior |
$8,853.60
|
|
|
HC CL TREAT FEMORAL FX W/ MANIPUL
|
Facility
|
IP
|
$10,416.00
|
|
|
Service Code
|
CPT 27232
|
| Hospital Charge Code |
900501442
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,885.30 |
| Max. Negotiated Rate |
$7,812.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.20
|
| Rate for Payer: Cash Price |
$5,728.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,051.63
|
| Rate for Payer: Heritage Provider Network Senior |
$7,051.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,885.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,604.00
|
| Rate for Payer: Multiplan Commercial |
$7,812.00
|
|
|
HC CL TREAT FEMORAL FX, W MANIPUL
|
Facility
|
OP
|
$2,444.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$488.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,679.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$1,344.20
|
| Rate for Payer: Cash Price |
$1,344.20
|
| Rate for Payer: Cash Price |
$1,344.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,588.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Senior |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,033.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,654.59
|
| Rate for Payer: Heritage Provider Network Senior |
$1,654.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,165.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$442.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,338.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$611.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,562.18
|
| Rate for Payer: Multiplan Commercial |
$1,833.00
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$879.35
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$809.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT FEMORAL FX, W MANIPUL
|
Facility
|
IP
|
$2,444.00
|
|
|
Service Code
|
CPT 27510
|
| Hospital Charge Code |
900501427
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$442.36 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$488.80
|
| Rate for Payer: Cash Price |
$1,344.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,654.59
|
| Rate for Payer: Heritage Provider Network Senior |
$1,654.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$442.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$611.00
|
| Rate for Payer: Multiplan Commercial |
$1,833.00
|
|
|
HC CL TREAT FEMORAL FX, W/O MANIP
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
900501482
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$741.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$593.45
|
| Rate for Payer: Cash Price |
$593.45
|
| Rate for Payer: Cash Price |
$593.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$701.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Senior |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$514.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.04
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$388.22
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$357.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT FEMORAL FX, W/O MANIP
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 27508
|
| Hospital Charge Code |
900501482
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$809.25 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Cash Price |
$593.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
|
|
HC CL TREAT FEMORAL SHAFT FX,W/O
|
Facility
|
OP
|
$1,274.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
900501463
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$254.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$875.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$700.70
|
| Rate for Payer: Cash Price |
$700.70
|
| Rate for Payer: Cash Price |
$700.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$828.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Senior |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$862.50
|
| Rate for Payer: Heritage Provider Network Senior |
$862.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$607.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.04
|
| Rate for Payer: Multiplan Commercial |
$955.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$458.39
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$421.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT FEMORAL SHAFT FX,W/O
|
Facility
|
IP
|
$1,274.00
|
|
|
Service Code
|
CPT 27500
|
| Hospital Charge Code |
900501463
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$230.59 |
| Max. Negotiated Rate |
$955.50 |
| Rate for Payer: Adventist Health Commercial |
$254.80
|
| Rate for Payer: Cash Price |
$700.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$862.50
|
| Rate for Payer: Heritage Provider Network Senior |
$862.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$230.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.50
|
| Rate for Payer: Multiplan Commercial |
$955.50
|
|
|
HC CL TREAT FEM SHAFT FRAC W/MANI
|
Facility
|
IP
|
$7,659.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
900501085
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,386.28 |
| Max. Negotiated Rate |
$5,744.25 |
| Rate for Payer: Adventist Health Commercial |
$1,531.80
|
| Rate for Payer: Cash Price |
$4,212.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,185.14
|
| Rate for Payer: Heritage Provider Network Senior |
$5,185.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,386.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,914.75
|
| Rate for Payer: Multiplan Commercial |
$5,744.25
|
|
|
HC CL TREAT FEM SHAFT FRAC W/MANI
|
Facility
|
OP
|
$7,659.00
|
|
|
Service Code
|
CPT 27502
|
| Hospital Charge Code |
900501085
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,531.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,261.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$4,212.45
|
| Rate for Payer: Cash Price |
$4,212.45
|
| Rate for Payer: Cash Price |
$4,212.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,978.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Senior |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,033.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,185.14
|
| Rate for Payer: Heritage Provider Network Senior |
$5,185.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3,653.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,386.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,338.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,914.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,562.18
|
| Rate for Payer: Multiplan Commercial |
$5,744.25
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,755.71
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,535.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT FIBULA FX W/MANIPULAT
|
Facility
|
IP
|
$4,233.00
|
|
|
Service Code
|
CPT 27781
|
| Hospital Charge Code |
900501487
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$766.17 |
| Max. Negotiated Rate |
$3,174.75 |
| Rate for Payer: Adventist Health Commercial |
$846.60
|
| Rate for Payer: Cash Price |
$2,328.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,865.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,865.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$766.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.25
|
| Rate for Payer: Multiplan Commercial |
$3,174.75
|
|
|
HC CL TREAT FIBULA FX W/MANIPULAT
|
Facility
|
OP
|
$4,233.00
|
|
|
Service Code
|
CPT 27781
|
| Hospital Charge Code |
900501487
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$846.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,908.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$2,328.15
|
| Rate for Payer: Cash Price |
$2,328.15
|
| Rate for Payer: Cash Price |
$2,328.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,751.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Senior |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,033.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,865.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,865.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,019.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$766.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,338.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,562.18
|
| Rate for Payer: Multiplan Commercial |
$3,174.75
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,523.03
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,401.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT FIBULA/SHAFT FX W/O M
|
Facility
|
OP
|
$428.00
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
900501759
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$85.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$294.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$235.40
|
| Rate for Payer: Cash Price |
$235.40
|
| Rate for Payer: Cash Price |
$235.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$278.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Senior |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$289.76
|
| Rate for Payer: Heritage Provider Network Senior |
$289.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$204.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.04
|
| Rate for Payer: Multiplan Commercial |
$321.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$153.99
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$141.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT FIBULA/SHAFT FX W/O M
|
Facility
|
IP
|
$428.00
|
|
|
Service Code
|
CPT 27780
|
| Hospital Charge Code |
900501759
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$77.47 |
| Max. Negotiated Rate |
$321.00 |
| Rate for Payer: Adventist Health Commercial |
$85.60
|
| Rate for Payer: Cash Price |
$235.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$289.76
|
| Rate for Payer: Heritage Provider Network Senior |
$289.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.00
|
| Rate for Payer: Multiplan Commercial |
$321.00
|
|
|
HC CL TREAT FINGER/THUMB FX W/O M
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
900501393
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$809.25 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Cash Price |
$593.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
|
|
HC CL TREAT FINGER/THUMB FX W/O M
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 26720
|
| Hospital Charge Code |
900501393
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$741.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$593.45
|
| Rate for Payer: Cash Price |
$593.45
|
| Rate for Payer: Cash Price |
$593.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$701.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Senior |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$730.48
|
| Rate for Payer: Heritage Provider Network Senior |
$730.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$514.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.04
|
| Rate for Payer: Multiplan Commercial |
$809.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$388.22
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$357.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT FOOT DISLOCAT W/O ANE
|
Facility
|
OP
|
$511.00
|
|
|
Service Code
|
CPT 28600
|
| Hospital Charge Code |
900501655
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$102.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$351.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$281.05
|
| Rate for Payer: Cash Price |
$281.05
|
| Rate for Payer: Cash Price |
$281.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$332.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Senior |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$345.95
|
| Rate for Payer: Heritage Provider Network Senior |
$345.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$243.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.04
|
| Rate for Payer: Multiplan Commercial |
$383.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$183.86
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$169.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT FOOT DISLOCAT W/O ANE
|
Facility
|
IP
|
$511.00
|
|
|
Service Code
|
CPT 28600
|
| Hospital Charge Code |
900501655
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$92.49 |
| Max. Negotiated Rate |
$383.25 |
| Rate for Payer: Adventist Health Commercial |
$102.20
|
| Rate for Payer: Cash Price |
$281.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$345.95
|
| Rate for Payer: Heritage Provider Network Senior |
$345.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.75
|
| Rate for Payer: Multiplan Commercial |
$383.25
|
|
|
HC CL TREAT FRAC OF WT BEAR W/SKE
|
Facility
|
OP
|
$4,598.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
900501095
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$919.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,158.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,033.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,528.90
|
| Rate for Payer: Cash Price |
$2,528.90
|
| Rate for Payer: Cash Price |
$2,528.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,988.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,236.83
|
| Rate for Payer: Dignity Health Senior |
$2,033.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,033.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,112.85
|
| Rate for Payer: Heritage Provider Network Senior |
$3,112.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,033.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,193.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$832.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,338.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,149.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,562.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,562.18
|
| Rate for Payer: Multiplan Commercial |
$3,448.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,654.36
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,522.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,050.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,236.83
|
| Rate for Payer: Vantage Medical Group Senior |
$2,033.48
|
|
|
HC CL TREAT FRAC OF WT BEAR W/SKE
|
Facility
|
IP
|
$4,598.00
|
|
|
Service Code
|
CPT 27825
|
| Hospital Charge Code |
900501095
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$832.24 |
| Max. Negotiated Rate |
$3,448.50 |
| Rate for Payer: Adventist Health Commercial |
$919.60
|
| Rate for Payer: Cash Price |
$2,528.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,112.85
|
| Rate for Payer: Heritage Provider Network Senior |
$3,112.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$832.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,149.50
|
| Rate for Payer: Multiplan Commercial |
$3,448.50
|
|
|
HC CL TREAT FX OF WT BRNG LWR LEG
|
Facility
|
IP
|
$908.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
900501502
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$681.00 |
| Rate for Payer: Adventist Health Commercial |
$181.60
|
| Rate for Payer: Cash Price |
$499.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$614.72
|
| Rate for Payer: Heritage Provider Network Senior |
$614.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.00
|
| Rate for Payer: Multiplan Commercial |
$681.00
|
|
|
HC CL TREAT FX OF WT BRNG LWR LEG
|
Facility
|
OP
|
$908.00
|
|
|
Service Code
|
CPT 27824
|
| Hospital Charge Code |
900501502
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$181.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$623.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$499.40
|
| Rate for Payer: Cash Price |
$499.40
|
| Rate for Payer: Cash Price |
$499.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$590.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Senior |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$614.72
|
| Rate for Payer: Heritage Provider Network Senior |
$614.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$433.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.04
|
| Rate for Payer: Multiplan Commercial |
$681.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$326.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$300.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC CL TREAT FX ORBIT, W/O MANIPUL
|
Facility
|
OP
|
$2,002.00
|
|
|
Service Code
|
CPT 21400
|
| Hospital Charge Code |
900501526
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$400.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,375.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$647.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,531.00
|
| Rate for Payer: Cash Price |
$1,101.10
|
| Rate for Payer: Cash Price |
$1,101.10
|
| Rate for Payer: Cash Price |
$1,101.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,301.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$970.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.75
|
| Rate for Payer: Dignity Health Senior |
$647.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$647.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,355.35
|
| Rate for Payer: Heritage Provider Network Senior |
$1,355.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$647.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$954.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$744.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$500.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$815.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$815.28
|
| Rate for Payer: Multiplan Commercial |
$1,501.50
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$720.32
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$662.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$970.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.75
|
| Rate for Payer: Vantage Medical Group Senior |
$647.05
|
|
