|
HC SO AC TYPE
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT L3670
|
| Hospital Charge Code |
915353670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$98.40 |
| Max. Negotiated Rate |
$348.50 |
| Rate for Payer: Cigna of CA HMO |
$287.00
|
| Rate for Payer: Cigna of CA PPO |
$287.00
|
| Rate for Payer: Adventist Health Commercial |
$168.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$348.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$225.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$248.17
|
| Rate for Payer: Blue Shield of California Commercial |
$315.29
|
| Rate for Payer: Blue Shield of California Commercial |
$207.87
|
| Rate for Payer: Cash Price |
$410.00
|
| Rate for Payer: Cash Price |
$410.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$348.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$348.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$287.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.00
|
| Rate for Payer: EPIC Health Plan Senior |
$164.00
|
| Rate for Payer: Galaxy Health WC |
$348.50
|
| Rate for Payer: Global Benefits Group Commercial |
$246.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$149.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$260.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$168.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$241.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$287.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$287.00
|
| Rate for Payer: Multiplan Commercial |
$328.00
|
| Rate for Payer: Networks By Design Commercial |
$205.00
|
| Rate for Payer: Prime Health Services Commercial |
$348.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$246.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$246.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$153.87
|
| Rate for Payer: United Healthcare All Other HMO |
$149.77
|
| Rate for Payer: United Healthcare HMO Rider |
$146.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$134.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$348.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.50
|
| Rate for Payer: Vantage Medical Group Senior |
$348.50
|
|
|
HC SO AC TYPE
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
CPT L3670
|
| Hospital Charge Code |
905353670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$98.40 |
| Max. Negotiated Rate |
$348.50 |
| Rate for Payer: Adventist Health Commercial |
$168.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$348.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$225.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$248.17
|
| Rate for Payer: Blue Shield of California Commercial |
$315.29
|
| Rate for Payer: Blue Shield of California Commercial |
$207.87
|
| Rate for Payer: Cash Price |
$410.00
|
| Rate for Payer: Cash Price |
$410.00
|
| Rate for Payer: Cigna of CA HMO |
$287.00
|
| Rate for Payer: Cigna of CA PPO |
$287.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$348.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$348.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$287.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.00
|
| Rate for Payer: EPIC Health Plan Senior |
$164.00
|
| Rate for Payer: Galaxy Health WC |
$348.50
|
| Rate for Payer: Global Benefits Group Commercial |
$246.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$149.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$260.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$168.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$241.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$287.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$287.00
|
| Rate for Payer: Multiplan Commercial |
$328.00
|
| Rate for Payer: Networks By Design Commercial |
$205.00
|
| Rate for Payer: Prime Health Services Commercial |
$348.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$246.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$246.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$153.87
|
| Rate for Payer: United Healthcare All Other HMO |
$149.77
|
| Rate for Payer: United Healthcare HMO Rider |
$146.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$134.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$348.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.50
|
| Rate for Payer: Vantage Medical Group Senior |
$348.50
|
|
|
HC SO AC TYPE
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
CPT L3670
|
| Hospital Charge Code |
905353670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$82.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$82.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$410.00
|
| Rate for Payer: Cash Price |
$410.00
|
| Rate for Payer: Cigna of CA HMO |
$287.00
|
| Rate for Payer: Cigna of CA PPO |
$287.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$287.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.00
|
| Rate for Payer: EPIC Health Plan Senior |
$164.00
|
| Rate for Payer: Galaxy Health WC |
$348.50
|
| Rate for Payer: Global Benefits Group Commercial |
$246.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$260.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$241.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.40
|
| Rate for Payer: Multiplan Commercial |
$328.00
|
| Rate for Payer: Networks By Design Commercial |
$266.50
|
| Rate for Payer: Prime Health Services Commercial |
$348.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$153.87
|
| Rate for Payer: United Healthcare All Other HMO |
$149.77
|
| Rate for Payer: United Healthcare HMO Rider |
$146.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$134.28
|
|
|
HC SO AIRPLANE 2/2O JOINT CF
|
Facility
|
OP
|
$1,960.00
|
|
|
Service Code
|
CPT L3674
|
| Hospital Charge Code |
915353674
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$470.40 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Adventist Health Commercial |
$803.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,666.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,078.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,470.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,186.39
|
| Rate for Payer: Blue Shield of California Commercial |
$993.72
|
| Rate for Payer: Blue Shield of California Commercial |
$1,507.24
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cigna of CA HMO |
$1,372.00
|
| Rate for Payer: Cigna of CA PPO |
$1,372.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,666.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,666.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,666.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,372.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$784.00
|
| Rate for Payer: EPIC Health Plan Senior |
$784.00
|
| Rate for Payer: Galaxy Health WC |
$1,666.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,176.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,276.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,244.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,443.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,156.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,372.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,372.00
|
| Rate for Payer: Multiplan Commercial |
$1,568.00
|
| Rate for Payer: Networks By Design Commercial |
$980.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,666.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,176.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,176.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.59
|
| Rate for Payer: United Healthcare All Other HMO |
$715.99
|
| Rate for Payer: United Healthcare HMO Rider |
$700.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$641.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,666.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,666.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,666.00
|
|
|
HC SO AIRPLANE 2/2O JOINT CF
|
Facility
|
OP
|
$1,960.00
|
|
|
Service Code
|
CPT L3674
|
| Hospital Charge Code |
905353674
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$470.40 |
| Max. Negotiated Rate |
$1,666.00 |
| Rate for Payer: Adventist Health Commercial |
$803.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,666.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,078.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,470.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,186.39
|
| Rate for Payer: Blue Shield of California Commercial |
$993.72
|
| Rate for Payer: Blue Shield of California Commercial |
$1,507.24
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cigna of CA HMO |
$1,372.00
|
| Rate for Payer: Cigna of CA PPO |
$1,372.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,666.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,666.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,666.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,372.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$784.00
|
| Rate for Payer: EPIC Health Plan Senior |
$784.00
|
| Rate for Payer: Galaxy Health WC |
$1,666.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,176.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,276.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,244.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,443.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,156.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,372.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,372.00
|
| Rate for Payer: Multiplan Commercial |
$1,568.00
|
| Rate for Payer: Networks By Design Commercial |
$980.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,666.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,176.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,176.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.59
|
| Rate for Payer: United Healthcare All Other HMO |
$715.99
|
| Rate for Payer: United Healthcare HMO Rider |
$700.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$641.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,666.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,666.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,666.00
|
|
|
HC SO AIRPLANE 2/2O JOINT CF
|
Facility
|
IP
|
$1,960.00
|
|
|
Service Code
|
CPT L3674
|
| Hospital Charge Code |
905353674
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$392.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$392.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cigna of CA HMO |
$1,372.00
|
| Rate for Payer: Cigna of CA PPO |
$1,372.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,372.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$784.00
|
| Rate for Payer: EPIC Health Plan Senior |
$784.00
|
| Rate for Payer: Galaxy Health WC |
$1,666.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,176.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,244.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,156.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.40
|
| Rate for Payer: Multiplan Commercial |
$1,568.00
|
| Rate for Payer: Networks By Design Commercial |
$1,274.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,666.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.59
|
| Rate for Payer: United Healthcare All Other HMO |
$715.99
|
| Rate for Payer: United Healthcare HMO Rider |
$700.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$641.90
|
|
|
HC SO AIRPLANE 2/2O JOINT CF
|
Facility
|
IP
|
$1,960.00
|
|
|
Service Code
|
CPT L3674
|
| Hospital Charge Code |
915353674
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$392.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$392.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cash Price |
$1,960.00
|
| Rate for Payer: Cigna of CA HMO |
$1,372.00
|
| Rate for Payer: Cigna of CA PPO |
$1,372.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,372.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$784.00
|
| Rate for Payer: EPIC Health Plan Senior |
$784.00
|
| Rate for Payer: Galaxy Health WC |
$1,666.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,176.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,244.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,156.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$470.40
|
| Rate for Payer: Multiplan Commercial |
$1,568.00
|
| Rate for Payer: Networks By Design Commercial |
$1,274.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,666.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.59
|
| Rate for Payer: United Healthcare All Other HMO |
$715.99
|
| Rate for Payer: United Healthcare HMO Rider |
$700.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$641.90
|
|
|
HC SO AIRPLANE W/JOINT CF
|
Facility
|
OP
|
$1,825.00
|
|
|
Service Code
|
CPT L3673
|
| Hospital Charge Code |
905353673
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$438.00 |
| Max. Negotiated Rate |
$1,551.25 |
| Rate for Payer: Adventist Health Commercial |
$748.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,551.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,003.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,368.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,104.67
|
| Rate for Payer: Blue Shield of California Commercial |
$1,403.42
|
| Rate for Payer: Blue Shield of California Commercial |
$925.27
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cigna of CA HMO |
$1,277.50
|
| Rate for Payer: Cigna of CA PPO |
$1,277.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,551.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,551.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,551.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,277.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.00
|
| Rate for Payer: EPIC Health Plan Senior |
$730.00
|
| Rate for Payer: Galaxy Health WC |
$1,551.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,095.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,158.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$662.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,076.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,277.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,277.50
|
| Rate for Payer: Multiplan Commercial |
$1,460.00
|
| Rate for Payer: Networks By Design Commercial |
$912.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,551.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,095.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,095.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$684.92
|
| Rate for Payer: United Healthcare All Other HMO |
$666.67
|
| Rate for Payer: United Healthcare HMO Rider |
$652.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$597.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,551.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,551.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,551.25
|
|
|
HC SO AIRPLANE W/JOINT CF
|
Facility
|
IP
|
$1,825.00
|
|
|
Service Code
|
CPT L3673
|
| Hospital Charge Code |
905353673
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$365.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$365.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cash Price |
$1,825.00
|
| Rate for Payer: Cigna of CA HMO |
$1,277.50
|
| Rate for Payer: Cigna of CA PPO |
$1,277.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,277.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.00
|
| Rate for Payer: EPIC Health Plan Senior |
$730.00
|
| Rate for Payer: Galaxy Health WC |
$1,551.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,095.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,158.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,076.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.00
|
| Rate for Payer: Multiplan Commercial |
$1,460.00
|
| Rate for Payer: Networks By Design Commercial |
$1,186.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,551.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$684.92
|
| Rate for Payer: United Healthcare All Other HMO |
$666.67
|
| Rate for Payer: United Healthcare HMO Rider |
$652.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$597.69
|
|
|
HC SO AIRPLANE W/O JNTS CF
|
Facility
|
IP
|
$1,675.00
|
|
|
Service Code
|
CPT L3672
|
| Hospital Charge Code |
905353672
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$335.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$335.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna of CA HMO |
$1,172.50
|
| Rate for Payer: Cigna of CA PPO |
$1,172.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,172.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$670.00
|
| Rate for Payer: EPIC Health Plan Senior |
$670.00
|
| Rate for Payer: Galaxy Health WC |
$1,423.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,063.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$988.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$402.00
|
| Rate for Payer: Multiplan Commercial |
$1,340.00
|
| Rate for Payer: Networks By Design Commercial |
$1,088.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,423.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$628.63
|
| Rate for Payer: United Healthcare All Other HMO |
$611.88
|
| Rate for Payer: United Healthcare HMO Rider |
$598.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.56
|
|
|
HC SO AIRPLANE W/O JNTS CF
|
Facility
|
OP
|
$1,675.00
|
|
|
Service Code
|
CPT L3672
|
| Hospital Charge Code |
905353672
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$402.00 |
| Max. Negotiated Rate |
$1,423.75 |
| Rate for Payer: Adventist Health Commercial |
$686.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,423.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$921.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,256.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,013.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,288.08
|
| Rate for Payer: Blue Shield of California Commercial |
$849.23
|
| Rate for Payer: Cash Price |
$1,675.00
|
| Rate for Payer: Cigna of CA HMO |
$1,172.50
|
| Rate for Payer: Cigna of CA PPO |
$1,172.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,423.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,423.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,423.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,172.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$670.00
|
| Rate for Payer: EPIC Health Plan Senior |
$670.00
|
| Rate for Payer: Galaxy Health WC |
$1,423.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,005.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,063.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$608.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$988.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$402.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,172.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,172.50
|
| Rate for Payer: Multiplan Commercial |
$1,340.00
|
| Rate for Payer: Networks By Design Commercial |
$837.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,423.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,005.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,005.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$628.63
|
| Rate for Payer: United Healthcare All Other HMO |
$611.88
|
| Rate for Payer: United Healthcare HMO Rider |
$598.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,423.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,423.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,423.75
|
|
|
HC SO CAP DESIGN W/O JNTS CF
|
Facility
|
IP
|
$1,345.00
|
|
|
Service Code
|
CPT L3671
|
| Hospital Charge Code |
905353671
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$269.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$269.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,345.00
|
| Rate for Payer: Cash Price |
$1,345.00
|
| Rate for Payer: Cigna of CA HMO |
$941.50
|
| Rate for Payer: Cigna of CA PPO |
$941.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$941.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.00
|
| Rate for Payer: EPIC Health Plan Senior |
$538.00
|
| Rate for Payer: Galaxy Health WC |
$1,143.25
|
| Rate for Payer: Global Benefits Group Commercial |
$807.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$854.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$793.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.80
|
| Rate for Payer: Multiplan Commercial |
$1,076.00
|
| Rate for Payer: Networks By Design Commercial |
$874.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,143.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$504.78
|
| Rate for Payer: United Healthcare All Other HMO |
$491.33
|
| Rate for Payer: United Healthcare HMO Rider |
$480.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.49
|
|
|
HC SO CAP DESIGN W/O JNTS CF
|
Facility
|
OP
|
$1,345.00
|
|
|
Service Code
|
CPT L3671
|
| Hospital Charge Code |
905353671
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$322.80 |
| Max. Negotiated Rate |
$1,143.25 |
| Rate for Payer: Adventist Health Commercial |
$551.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,143.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$739.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$814.13
|
| Rate for Payer: Blue Shield of California Commercial |
$681.91
|
| Rate for Payer: Blue Shield of California Commercial |
$1,034.31
|
| Rate for Payer: Cash Price |
$1,345.00
|
| Rate for Payer: Cash Price |
$1,345.00
|
| Rate for Payer: Cigna of CA HMO |
$941.50
|
| Rate for Payer: Cigna of CA PPO |
$941.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,143.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,143.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,143.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$941.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.00
|
| Rate for Payer: EPIC Health Plan Senior |
$538.00
|
| Rate for Payer: Galaxy Health WC |
$1,143.25
|
| Rate for Payer: Global Benefits Group Commercial |
$807.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$866.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$854.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$979.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$793.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$941.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$941.50
|
| Rate for Payer: Multiplan Commercial |
$1,076.00
|
| Rate for Payer: Networks By Design Commercial |
$672.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,143.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$807.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$807.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$504.78
|
| Rate for Payer: United Healthcare All Other HMO |
$491.33
|
| Rate for Payer: United Healthcare HMO Rider |
$480.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,143.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,143.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,143.25
|
|
|
HC SO CAP DESIGN W/O JNTS CF
|
Facility
|
OP
|
$1,345.00
|
|
|
Service Code
|
CPT L3671
|
| Hospital Charge Code |
915353671
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$322.80 |
| Max. Negotiated Rate |
$1,143.25 |
| Rate for Payer: Adventist Health Commercial |
$551.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,143.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$739.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,008.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$814.13
|
| Rate for Payer: Blue Shield of California Commercial |
$681.91
|
| Rate for Payer: Blue Shield of California Commercial |
$1,034.31
|
| Rate for Payer: Cash Price |
$1,345.00
|
| Rate for Payer: Cash Price |
$1,345.00
|
| Rate for Payer: Cigna of CA HMO |
$941.50
|
| Rate for Payer: Cigna of CA PPO |
$941.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,143.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,143.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,143.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$941.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.00
|
| Rate for Payer: EPIC Health Plan Senior |
$538.00
|
| Rate for Payer: Galaxy Health WC |
$1,143.25
|
| Rate for Payer: Global Benefits Group Commercial |
$807.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$866.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$854.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$979.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$793.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$941.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$941.50
|
| Rate for Payer: Multiplan Commercial |
$1,076.00
|
| Rate for Payer: Networks By Design Commercial |
$672.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,143.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$807.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$807.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$504.78
|
| Rate for Payer: United Healthcare All Other HMO |
$491.33
|
| Rate for Payer: United Healthcare HMO Rider |
$480.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,143.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,143.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,143.25
|
|
|
HC SO CAP DESIGN W/O JNTS CF
|
Facility
|
IP
|
$1,345.00
|
|
|
Service Code
|
CPT L3671
|
| Hospital Charge Code |
915353671
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$269.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$269.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,345.00
|
| Rate for Payer: Cash Price |
$1,345.00
|
| Rate for Payer: Cigna of CA HMO |
$941.50
|
| Rate for Payer: Cigna of CA PPO |
$941.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$941.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$538.00
|
| Rate for Payer: EPIC Health Plan Senior |
$538.00
|
| Rate for Payer: Galaxy Health WC |
$1,143.25
|
| Rate for Payer: Global Benefits Group Commercial |
$807.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$854.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$793.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.80
|
| Rate for Payer: Multiplan Commercial |
$1,076.00
|
| Rate for Payer: Networks By Design Commercial |
$874.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,143.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$504.78
|
| Rate for Payer: United Healthcare All Other HMO |
$491.33
|
| Rate for Payer: United Healthcare HMO Rider |
$480.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.49
|
|
|
HC SOCC FANCONI COMPLEM ASSAY
|
Facility
|
IP
|
$1,699.00
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
900914675
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$339.80 |
| Max. Negotiated Rate |
$1,444.15 |
| Rate for Payer: Adventist Health Commercial |
$339.80
|
| Rate for Payer: Cash Price |
$764.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,189.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$679.60
|
| Rate for Payer: EPIC Health Plan Senior |
$679.60
|
| Rate for Payer: Galaxy Health WC |
$1,444.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,019.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,078.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,002.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.76
|
| Rate for Payer: Multiplan Commercial |
$1,359.20
|
| Rate for Payer: Networks By Design Commercial |
$1,104.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,444.15
|
|
|
HC SOCC FANCONI COMPLEM ASSAY
|
Facility
|
OP
|
$1,699.00
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
900914675
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$312.85 |
| Max. Negotiated Rate |
$1,444.15 |
| Rate for Payer: Adventist Health Commercial |
$339.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$312.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,444.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$934.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,274.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,090.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,184.20
|
| Rate for Payer: Blue Shield of California Commercial |
$783.24
|
| Rate for Payer: Cash Price |
$764.55
|
| Rate for Payer: Cash Price |
$764.55
|
| Rate for Payer: Cigna of CA HMO |
$1,087.36
|
| Rate for Payer: Cigna of CA PPO |
$1,257.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,444.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,444.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,444.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,189.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$679.60
|
| Rate for Payer: EPIC Health Plan Senior |
$679.60
|
| Rate for Payer: Galaxy Health WC |
$1,444.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,019.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,078.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,002.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,189.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,189.30
|
| Rate for Payer: Multiplan Commercial |
$1,359.20
|
| Rate for Payer: Networks By Design Commercial |
$1,104.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,444.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,019.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,019.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$849.50
|
| Rate for Payer: United Healthcare All Other HMO |
$849.50
|
| Rate for Payer: United Healthcare HMO Rider |
$849.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$849.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,444.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,444.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1,444.15
|
|
|
HC SOCDX ALLOSURE COLLECTION
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
900915321
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12.00
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
|
|
HC SOCDX ALLOSURE COLLECTION
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
900915321
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.25
|
| Rate for Payer: Blue Shield of California Commercial |
$20.91
|
| Rate for Payer: Blue Shield of California Commercial |
$13.83
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna of CA HMO |
$19.20
|
| Rate for Payer: Cigna of CA PPO |
$22.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12.00
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.00
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.33
|
| Rate for Payer: United Healthcare All Other HMO |
$5.33
|
| Rate for Payer: United Healthcare HMO Rider |
$5.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.50
|
| Rate for Payer: Vantage Medical Group Senior |
$25.50
|
|
|
HC SOCIAL WORK CONF PARTICP 15 MIN
|
Facility
|
IP
|
$50.00
|
|
| Hospital Charge Code |
908603067
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Senior |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
|
|
HC SOCIAL WORK CONF PARTICP 15 MIN
|
Facility
|
OP
|
$50.00
|
|
| Hospital Charge Code |
908603067
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.09
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Senior |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.50
|
| Rate for Payer: Vantage Medical Group Senior |
$42.50
|
|
|
HC SOCIAL WORKER CONF COORD
|
Facility
|
OP
|
$270.00
|
|
| Hospital Charge Code |
908600158
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$202.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$173.26
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cigna of CA HMO |
$172.80
|
| Rate for Payer: Cigna of CA PPO |
$199.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$229.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$229.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$189.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$171.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$98.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$159.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$189.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$189.00
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$162.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$135.00
|
| Rate for Payer: United Healthcare All Other HMO |
$135.00
|
| Rate for Payer: United Healthcare HMO Rider |
$135.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$135.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.50
|
| Rate for Payer: Vantage Medical Group Senior |
$229.50
|
|
|
HC SOCIAL WORKER CONF COORD
|
Facility
|
OP
|
$236.00
|
|
| Hospital Charge Code |
912164301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$200.60 |
| Rate for Payer: Adventist Health Commercial |
$47.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$154.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.44
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna of CA HMO |
$151.04
|
| Rate for Payer: Cigna of CA PPO |
$174.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$200.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$200.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$200.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$85.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$165.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$165.20
|
| Rate for Payer: Multiplan Commercial |
$188.80
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$118.00
|
| Rate for Payer: United Healthcare All Other HMO |
$118.00
|
| Rate for Payer: United Healthcare HMO Rider |
$118.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$200.60
|
| Rate for Payer: Vantage Medical Group Senior |
$200.60
|
|
|
HC SOCIAL WORKER CONF COORD
|
Facility
|
IP
|
$236.00
|
|
| Hospital Charge Code |
912164301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$200.60 |
| Rate for Payer: Adventist Health Commercial |
$47.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.64
|
| Rate for Payer: Multiplan Commercial |
$188.80
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC SOCIAL WORKER CONF COORD
|
Facility
|
IP
|
$270.00
|
|
| Hospital Charge Code |
908600158
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$229.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$189.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$171.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$159.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.80
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
|
