Each client may specify the percentile point at which they would like
their customary and reasonable allowances set. Pinnacle
uses the 80th percentile to determine C&R amounts.

Customary and Reasonable Charges . . .
Pinnacle develops customary and reasonable (C&R) charges using historical claims data, prevailing fees, and comparisons with outside sources including McGraw Hill, Yale Wasserman, and Blue Cross of California, to determine allowable amounts on non-participating charges.

Procedures included cover the spectrum of medical, surgical, laboratory, radiology, anesthesiology, maternity and dental services. There are 11 separate geographic designations and data is broken down into different percentiles including the 50th, 75th, 80th and 90th percentile. Each client may specify the percentile point at which they would like their customary and reasonable allowances set. Pinnacle currently uses the 80th percentile to determine C&R amounts for each procedure.