|
HC CL TREAT KNEE FRACTURES
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
900501533
|
|
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 KNEE FRACTURES
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
900501533
|
|
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 LUNATE DISLOCA W/MANI
|
Facility
|
IP
|
$3,994.00
|
|
|
Service Code
|
CPT 25690
|
| Hospital Charge Code |
900501383
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$722.91 |
| Max. Negotiated Rate |
$2,995.50 |
| Rate for Payer: Adventist Health Commercial |
$798.80
|
| Rate for Payer: Cash Price |
$2,196.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,703.94
|
| Rate for Payer: Heritage Provider Network Senior |
$2,703.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$722.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$998.50
|
| Rate for Payer: Multiplan Commercial |
$2,995.50
|
|
|
HC CL TREAT LUNATE DISLOCA W/MANI
|
Facility
|
OP
|
$3,994.00
|
|
|
Service Code
|
CPT 25690
|
| Hospital Charge Code |
900501383
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$798.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,743.88
|
| 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 |
$2,196.70
|
| Rate for Payer: Cash Price |
$2,196.70
|
| Rate for Payer: Cash Price |
$2,196.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,596.10
|
| 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 |
$2,703.94
|
| Rate for Payer: Heritage Provider Network Senior |
$2,703.94
|
| 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 |
$1,905.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$722.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,338.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$998.50
|
| 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 |
$2,995.50
|
| Rate for Payer: Multiplan WC |
$3,240.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,437.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,322.41
|
| 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 MANDIBULAR FX
|
Facility
|
OP
|
$10,460.00
|
|
|
Service Code
|
CPT 21453
|
| Hospital Charge Code |
900501369
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$11,976.10 |
| Rate for Payer: Adventist Health Commercial |
$2,092.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,186.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,268.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,516.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$5,753.00
|
| Rate for Payer: Cash Price |
$5,753.00
|
| Rate for Payer: Cash Price |
$5,753.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,799.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,268.08
|
| Rate for Payer: Dignity Health Senior |
$7,516.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,516.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,081.42
|
| Rate for Payer: Heritage Provider Network Senior |
$7,081.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,516.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,989.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,893.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,643.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,615.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,470.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,470.71
|
| Rate for Payer: Multiplan Commercial |
$7,845.00
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,763.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,463.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,274.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,268.08
|
| Rate for Payer: Vantage Medical Group Senior |
$7,516.44
|
|
|
HC CL TREAT MANDIBULAR FX
|
Facility
|
IP
|
$10,460.00
|
|
|
Service Code
|
CPT 21453
|
| Hospital Charge Code |
900501369
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,893.26 |
| Max. Negotiated Rate |
$7,845.00 |
| Rate for Payer: Adventist Health Commercial |
$2,092.00
|
| Rate for Payer: Cash Price |
$5,753.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,081.42
|
| Rate for Payer: Heritage Provider Network Senior |
$7,081.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,893.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,615.00
|
| Rate for Payer: Multiplan Commercial |
$7,845.00
|
|
|
HC CL TREAT MANDIBULAR FX W/MANIP
|
Facility
|
OP
|
$3,872.00
|
|
|
Service Code
|
CPT 21451
|
| Hospital Charge Code |
900501420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$774.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,660.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,882.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,516.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,070.32
|
| Rate for Payer: Dignity Health Senior |
$1,882.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,882.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,621.34
|
| Rate for Payer: Heritage Provider Network Senior |
$2,621.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,882.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,846.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$700.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,164.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$968.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,371.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,371.46
|
| Rate for Payer: Multiplan Commercial |
$2,904.00
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,393.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,282.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,882.11
|
|
|
HC CL TREAT MANDIBULAR FX W/MANIP
|
Facility
|
IP
|
$3,872.00
|
|
|
Service Code
|
CPT 21451
|
| Hospital Charge Code |
900501420
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$700.83 |
| Max. Negotiated Rate |
$2,904.00 |
| Rate for Payer: Adventist Health Commercial |
$774.40
|
| Rate for Payer: Cash Price |
$2,129.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,621.34
|
| Rate for Payer: Heritage Provider Network Senior |
$2,621.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$700.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$968.00
|
| Rate for Payer: Multiplan Commercial |
$2,904.00
|
|
|
HC CL TREAT MANDIBULAR RIDGE FRAC
|
Facility
|
OP
|
$11,011.00
|
|
|
Service Code
|
CPT 21440
|
| Hospital Charge Code |
900501330
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$2,202.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,564.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,004.00
|
| Rate for Payer: Cash Price |
$6,056.05
|
| Rate for Payer: Cash Price |
$6,056.05
|
| Rate for Payer: Cash Price |
$6,056.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,157.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Senior |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,120.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,454.45
|
| Rate for Payer: Heritage Provider Network Senior |
$7,454.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,252.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,992.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,738.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,752.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,192.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,192.01
|
| Rate for Payer: Multiplan Commercial |
$8,258.25
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,961.76
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,645.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC CL TREAT MANDIBULAR RIDGE FRAC
|
Facility
|
IP
|
$11,011.00
|
|
|
Service Code
|
CPT 21440
|
| Hospital Charge Code |
900501330
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,992.99 |
| Max. Negotiated Rate |
$8,258.25 |
| Rate for Payer: Adventist Health Commercial |
$2,202.20
|
| Rate for Payer: Cash Price |
$6,056.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,454.45
|
| Rate for Payer: Heritage Provider Network Senior |
$7,454.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,992.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,752.75
|
| Rate for Payer: Multiplan Commercial |
$8,258.25
|
|
|
HC CL TREAT MED MALL FX W/MANIPUL
|
Facility
|
OP
|
$4,598.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
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 |
$3,531.00
|
| 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 MED MALL FX W/MANIPUL
|
Facility
|
IP
|
$4,598.00
|
|
|
Service Code
|
CPT 27762
|
| Hospital Charge Code |
900501091
|
|
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 METACARPAL FX, SNGL
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
900501386
|
|
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 METACARPAL FX, SNGL
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 26600
|
| Hospital Charge Code |
900501386
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$576.73
|
| 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 METACARPAL W/MANIPULA
|
Facility
|
IP
|
$1,079.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
900501340
|
|
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 METACARPAL W/MANIPULA
|
Facility
|
OP
|
$1,079.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
900501340
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.30 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$215.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$576.73
|
| 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 META FX SNGL W/MAN
|
Facility
|
IP
|
$1,281.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
900501076
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$231.86 |
| Max. Negotiated Rate |
$960.75 |
| Rate for Payer: Adventist Health Commercial |
$256.20
|
| Rate for Payer: Cash Price |
$704.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$867.24
|
| Rate for Payer: Heritage Provider Network Senior |
$867.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.25
|
| Rate for Payer: Multiplan Commercial |
$960.75
|
|
|
HC CL TREAT META FX SNGL W/MAN
|
Facility
|
OP
|
$1,281.00
|
|
|
Service Code
|
CPT 26605
|
| Hospital Charge Code |
900501076
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$256.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$880.05
|
| 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 |
$704.55
|
| Rate for Payer: Cash Price |
$704.55
|
| Rate for Payer: Cash Price |
$704.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$832.65
|
| 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 |
$867.24
|
| Rate for Payer: Heritage Provider Network Senior |
$867.24
|
| 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 |
$611.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.25
|
| 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 |
$960.75
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$460.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$424.14
|
| 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 META FX W/EXT FIX EA
|
Facility
|
OP
|
$4,233.00
|
|
|
Service Code
|
CPT 26607
|
| Hospital Charge Code |
900501717
|
|
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 |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| 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 |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Senior |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,122.60
|
| 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 |
$4,122.60
|
| 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 |
$4,740.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,058.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,194.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,194.48
|
| Rate for Payer: Multiplan Commercial |
$3,174.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| 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 |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC CL TREAT META FX W/EXT FIX EA
|
Facility
|
IP
|
$4,233.00
|
|
|
Service Code
|
CPT 26607
|
| Hospital Charge Code |
900501717
|
|
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 MOUTH ROOF FX
|
Facility
|
OP
|
$9,353.00
|
|
|
Service Code
|
CPT 21421
|
| Hospital Charge Code |
900501741
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,870.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,425.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,111.00
|
| Rate for Payer: Cash Price |
$5,144.15
|
| Rate for Payer: Cash Price |
$5,144.15
|
| Rate for Payer: Cash Price |
$5,144.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,079.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Senior |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,120.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,331.98
|
| Rate for Payer: Heritage Provider Network Senior |
$6,331.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4,461.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,692.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,738.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,338.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,192.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,192.01
|
| Rate for Payer: Multiplan Commercial |
$7,014.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,365.21
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,096.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC CL TREAT MOUTH ROOF FX
|
Facility
|
IP
|
$9,353.00
|
|
|
Service Code
|
CPT 21421
|
| Hospital Charge Code |
900501741
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,692.89 |
| Max. Negotiated Rate |
$7,014.75 |
| Rate for Payer: Adventist Health Commercial |
$1,870.60
|
| Rate for Payer: Cash Price |
$5,144.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,331.98
|
| Rate for Payer: Heritage Provider Network Senior |
$6,331.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,692.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,338.25
|
| Rate for Payer: Multiplan Commercial |
$7,014.75
|
|
|
HC CL TREAT NASAL SEPTAL FX
|
Facility
|
IP
|
$3,885.00
|
|
|
Service Code
|
CPT 21337
|
| Hospital Charge Code |
900501499
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$703.18 |
| Max. Negotiated Rate |
$2,913.75 |
| Rate for Payer: Adventist Health Commercial |
$777.00
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,630.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,630.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.25
|
| Rate for Payer: Multiplan Commercial |
$2,913.75
|
|
|
HC CL TREAT NASAL SEPTAL FX
|
Facility
|
OP
|
$3,885.00
|
|
|
Service Code
|
CPT 21337
|
| Hospital Charge Code |
900501499
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$777.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,668.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,959.00
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cash Price |
$2,136.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,525.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Senior |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,120.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,630.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,630.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,853.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,738.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,192.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,192.01
|
| Rate for Payer: Multiplan Commercial |
$2,913.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,397.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,286.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC CL TREAT OF ACROMICLAV W/MANIP
|
Facility
|
OP
|
$1,602.00
|
|
|
Service Code
|
CPT 23545
|
| Hospital Charge Code |
900501358
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$320.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,100.57
|
| 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 |
$881.10
|
| Rate for Payer: Cash Price |
$881.10
|
| Rate for Payer: Cash Price |
$881.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,041.30
|
| 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 |
$1,084.55
|
| Rate for Payer: Heritage Provider Network Senior |
$1,084.55
|
| 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 |
$764.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$289.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$350.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$400.50
|
| 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 |
$1,201.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$576.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$530.42
|
| 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
|
|
