|
HC TREAT WRIST BONE FX, W/O MANIP
|
Facility
|
IP
|
$2,390.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
900501374
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$478.00 |
| Max. Negotiated Rate |
$2,031.50 |
| Rate for Payer: Adventist Health Commercial |
$478.00
|
| Rate for Payer: Cash Price |
$1,075.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,673.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$956.00
|
| Rate for Payer: EPIC Health Plan Senior |
$956.00
|
| Rate for Payer: Galaxy Health WC |
$2,031.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,434.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,517.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,410.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$573.60
|
| Rate for Payer: Multiplan Commercial |
$1,912.00
|
| Rate for Payer: Networks By Design Commercial |
$1,553.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,031.50
|
|
|
HC TREAT WRIST BONE FX, W/O MANIP
|
Facility
|
OP
|
$2,390.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
900501374
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$297.10 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$478.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,075.50
|
| Rate for Payer: Cash Price |
$1,075.50
|
| Rate for Payer: Cash Price |
$1,075.50
|
| Rate for Payer: Cigna of CA HMO |
$1,529.60
|
| Rate for Payer: Cigna of CA PPO |
$1,768.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,673.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$2,031.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,434.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,517.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$297.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$573.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$399.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$1,912.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,553.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,031.50
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,434.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,195.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,195.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,195.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,195.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC TRI A 14 (WHEAT), IGE
|
Facility
|
OP
|
$13.72
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913732
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$170.73 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Adventist Health Commercial |
$3.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Blue Shield of California Commercial |
$11.47
|
| Rate for Payer: Blue Shield of California Commercial |
$6.32
|
| Rate for Payer: Blue Shield of California Commercial |
$7.59
|
| Rate for Payer: Blue Shield of California Commercial |
$9.56
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: Cigna of CA HMO |
$10.53
|
| Rate for Payer: Cigna of CA HMO |
$8.78
|
| Rate for Payer: Cigna of CA PPO |
$10.15
|
| Rate for Payer: Cigna of CA PPO |
$12.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$11.66
|
| Rate for Payer: Galaxy Health WC |
$13.99
|
| Rate for Payer: Global Benefits Group Commercial |
$8.23
|
| Rate for Payer: Global Benefits Group Commercial |
$9.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.17
|
| Rate for Payer: Multiplan Commercial |
$10.98
|
| Rate for Payer: Networks By Design Commercial |
$10.70
|
| Rate for Payer: Networks By Design Commercial |
$8.92
|
| Rate for Payer: Prime Health Services Commercial |
$11.66
|
| Rate for Payer: Prime Health Services Commercial |
$13.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC TRI A 14 (WHEAT), IGE
|
Facility
|
IP
|
$16.46
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913732
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$13.99 |
| Rate for Payer: Adventist Health Commercial |
$3.29
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.58
|
| Rate for Payer: EPIC Health Plan Senior |
$6.58
|
| Rate for Payer: Galaxy Health WC |
$13.99
|
| Rate for Payer: Global Benefits Group Commercial |
$9.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.95
|
| Rate for Payer: Multiplan Commercial |
$13.17
|
| Rate for Payer: Networks By Design Commercial |
$10.70
|
| Rate for Payer: Prime Health Services Commercial |
$13.99
|
|
|
HC TRI A 19 (WHEAT), IGE
|
Facility
|
OP
|
$13.72
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913733
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$170.73 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Adventist Health Commercial |
$3.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Blue Shield of California Commercial |
$11.47
|
| Rate for Payer: Blue Shield of California Commercial |
$6.32
|
| Rate for Payer: Blue Shield of California Commercial |
$7.59
|
| Rate for Payer: Blue Shield of California Commercial |
$9.56
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: Cash Price |
$6.17
|
| Rate for Payer: Cigna of CA HMO |
$10.53
|
| Rate for Payer: Cigna of CA HMO |
$8.78
|
| Rate for Payer: Cigna of CA PPO |
$10.15
|
| Rate for Payer: Cigna of CA PPO |
$12.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$11.66
|
| Rate for Payer: Galaxy Health WC |
$13.99
|
| Rate for Payer: Global Benefits Group Commercial |
$8.23
|
| Rate for Payer: Global Benefits Group Commercial |
$9.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.17
|
| Rate for Payer: Multiplan Commercial |
$10.98
|
| Rate for Payer: Networks By Design Commercial |
$10.70
|
| Rate for Payer: Networks By Design Commercial |
$8.92
|
| Rate for Payer: Prime Health Services Commercial |
$11.66
|
| Rate for Payer: Prime Health Services Commercial |
$13.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC TRI A 19 (WHEAT), IGE
|
Facility
|
IP
|
$16.46
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913733
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$13.99 |
| Rate for Payer: Adventist Health Commercial |
$3.29
|
| Rate for Payer: Cash Price |
$7.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.58
|
| Rate for Payer: EPIC Health Plan Senior |
$6.58
|
| Rate for Payer: Galaxy Health WC |
$13.99
|
| Rate for Payer: Global Benefits Group Commercial |
$9.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.95
|
| Rate for Payer: Multiplan Commercial |
$13.17
|
| Rate for Payer: Networks By Design Commercial |
$10.70
|
| Rate for Payer: Prime Health Services Commercial |
$13.99
|
|
|
HC TRICHROME TEST
|
Facility
|
IP
|
$552.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900911728
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$110.40 |
| Max. Negotiated Rate |
$469.20 |
| Rate for Payer: Adventist Health Commercial |
$110.40
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$386.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.80
|
| Rate for Payer: EPIC Health Plan Senior |
$220.80
|
| Rate for Payer: Galaxy Health WC |
$469.20
|
| Rate for Payer: Global Benefits Group Commercial |
$331.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$350.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.48
|
| Rate for Payer: Multiplan Commercial |
$441.60
|
| Rate for Payer: Networks By Design Commercial |
$358.80
|
| Rate for Payer: Prime Health Services Commercial |
$469.20
|
|
|
HC TRICHROME TEST
|
Facility
|
OP
|
$552.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900911728
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.00 |
| Max. Negotiated Rate |
$476.64 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
| Rate for Payer: Adventist Health Commercial |
$110.40
|
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$476.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$476.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.02
|
| Rate for Payer: Blue Shield of California Commercial |
$44.72
|
| Rate for Payer: Blue Shield of California Commercial |
$254.47
|
| Rate for Payer: Blue Shield of California Commercial |
$67.61
|
| Rate for Payer: Blue Shield of California Commercial |
$384.74
|
| Rate for Payer: Cash Price |
$43.65
|
| Rate for Payer: Cash Price |
$43.65
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cigna of CA HMO |
$62.08
|
| Rate for Payer: Cigna of CA HMO |
$353.28
|
| Rate for Payer: Cigna of CA PPO |
$408.48
|
| Rate for Payer: Cigna of CA PPO |
$71.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$386.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$469.20
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$331.20
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$57.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$57.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$350.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$65.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$65.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: Multiplan Commercial |
$441.60
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: Networks By Design Commercial |
$358.80
|
| Rate for Payer: Prime Health Services Commercial |
$469.20
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$331.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$331.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
|
|
HC TRIGLYCERIDES
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$83.30 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC TRIGLYCERIDES
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$59.07 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.07
|
| Rate for Payer: Blue Shield of California Commercial |
$45.18
|
| Rate for Payer: Blue Shield of California Commercial |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$68.31
|
| Rate for Payer: Blue Shield of California Commercial |
$29.27
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.47
|
| Rate for Payer: EPIC Health Plan Senior |
$6.31
|
| Rate for Payer: EPIC Health Plan Senior |
$6.31
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$33.60
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
|
|
HC TRIGLYCERIDES BODY FLUID
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900912247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$59.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.07
|
| Rate for Payer: Blue Shield of California Commercial |
$25.82
|
| Rate for Payer: Blue Shield of California Commercial |
$24.89
|
| Rate for Payer: Blue Shield of California Commercial |
$39.03
|
| Rate for Payer: Blue Shield of California Commercial |
$37.64
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.47
|
| Rate for Payer: EPIC Health Plan Senior |
$6.31
|
| Rate for Payer: EPIC Health Plan Senior |
$6.31
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$44.80
|
| Rate for Payer: Multiplan Commercial |
$43.20
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
|
|
HC TRIGLYCERIDES BODY FLUID
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900912247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$47.60 |
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.40
|
| Rate for Payer: EPIC Health Plan Senior |
$22.40
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.44
|
| Rate for Payer: Multiplan Commercial |
$44.80
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
|
|
HC TRIGLYCERIDES INDIVIDUAL
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910526
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$59.07 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.07
|
| Rate for Payer: Blue Shield of California Commercial |
$45.18
|
| Rate for Payer: Blue Shield of California Commercial |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$68.31
|
| Rate for Payer: Blue Shield of California Commercial |
$29.27
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.47
|
| Rate for Payer: EPIC Health Plan Senior |
$6.31
|
| Rate for Payer: EPIC Health Plan Senior |
$6.31
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Multiplan Commercial |
$33.60
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
|
|
HC TRIGLYCERIDES INDIVIDUAL
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910526
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$83.30 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC TRIIODOTHYRONINE, FREE
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
900912135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.00 |
| Max. Negotiated Rate |
$259.25 |
| Rate for Payer: Adventist Health Commercial |
$61.00
|
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$213.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.00
|
| Rate for Payer: EPIC Health Plan Senior |
$122.00
|
| Rate for Payer: Galaxy Health WC |
$259.25
|
| Rate for Payer: Global Benefits Group Commercial |
$183.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$193.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$179.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.20
|
| Rate for Payer: Multiplan Commercial |
$244.00
|
| Rate for Payer: Networks By Design Commercial |
$198.25
|
| Rate for Payer: Prime Health Services Commercial |
$259.25
|
|
|
HC TRIIODOTHYRONINE, FREE
|
Facility
|
OP
|
$173.00
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
900912135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$174.90 |
| Rate for Payer: Adventist Health Commercial |
$34.60
|
| Rate for Payer: Adventist Health Commercial |
$61.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$140.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$140.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$174.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$174.90
|
| Rate for Payer: Blue Shield of California Commercial |
$140.60
|
| Rate for Payer: Blue Shield of California Commercial |
$120.58
|
| Rate for Payer: Blue Shield of California Commercial |
$212.59
|
| Rate for Payer: Blue Shield of California Commercial |
$79.75
|
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Cash Price |
$77.85
|
| Rate for Payer: Cash Price |
$77.85
|
| Rate for Payer: Cigna of CA HMO |
$195.20
|
| Rate for Payer: Cigna of CA HMO |
$110.72
|
| Rate for Payer: Cigna of CA PPO |
$128.02
|
| Rate for Payer: Cigna of CA PPO |
$225.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$121.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$213.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.95
|
| Rate for Payer: EPIC Health Plan Senior |
$18.63
|
| Rate for Payer: EPIC Health Plan Senior |
$18.63
|
| Rate for Payer: Galaxy Health WC |
$147.05
|
| Rate for Payer: Galaxy Health WC |
$259.25
|
| Rate for Payer: Global Benefits Group Commercial |
$103.80
|
| Rate for Payer: Global Benefits Group Commercial |
$183.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.78
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$193.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.70
|
| Rate for Payer: Multiplan Commercial |
$244.00
|
| Rate for Payer: Multiplan Commercial |
$138.40
|
| Rate for Payer: Networks By Design Commercial |
$198.25
|
| Rate for Payer: Networks By Design Commercial |
$112.45
|
| Rate for Payer: Prime Health Services Commercial |
$147.05
|
| Rate for Payer: Prime Health Services Commercial |
$259.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$183.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$183.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.72
|
| Rate for Payer: United Healthcare All Other HMO |
$13.72
|
| Rate for Payer: United Healthcare All Other HMO |
$13.72
|
| Rate for Payer: United Healthcare HMO Rider |
$13.72
|
| Rate for Payer: United Healthcare HMO Rider |
$13.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.72
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: Vantage Medical Group Senior |
$16.94
|
| Rate for Payer: Vantage Medical Group Senior |
$16.94
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$208.55
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cigna of CA HMO |
$208.00
|
| Rate for Payer: Cigna of CA PPO |
$240.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$117.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$162.50
|
| Rate for Payer: United Healthcare All Other HMO |
$162.50
|
| Rate for Payer: United Healthcare HMO Rider |
$162.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$162.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cigna of CA HMO |
$208.00
|
| Rate for Payer: Cigna of CA PPO |
$240.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$117.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$162.50
|
| Rate for Payer: United Healthcare All Other HMO |
$162.50
|
| Rate for Payer: United Healthcare HMO Rider |
$162.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$162.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$2,601.00 |
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cigna of CA HMO |
$208.00
|
| Rate for Payer: Cigna of CA PPO |
$240.50
|
| Rate for Payer: Adventist Health Commercial |
$133.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$117.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Multiplan WC |
$120.25
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: Prime Health Services WC |
$119.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC TRIM SKIN LESION, 2 TO 4
|
Facility
|
IP
|
$555.00
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
902890346
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$111.00 |
| Max. Negotiated Rate |
$471.75 |
| Rate for Payer: Adventist Health Commercial |
$111.00
|
| Rate for Payer: Cash Price |
$249.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$388.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.00
|
| Rate for Payer: EPIC Health Plan Senior |
$222.00
|
| Rate for Payer: Galaxy Health WC |
$471.75
|
| Rate for Payer: Global Benefits Group Commercial |
$333.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$352.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.20
|
| Rate for Payer: Multiplan Commercial |
$444.00
|
| Rate for Payer: Networks By Design Commercial |
$360.75
|
| Rate for Payer: Prime Health Services Commercial |
$471.75
|
|
|
HC TRIM SKIN LESION, 2 TO 4
|
Facility
|
OP
|
$555.00
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
902890346
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$48.11 |
| Max. Negotiated Rate |
$2,601.00 |
| Rate for Payer: Adventist Health Commercial |
$227.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$249.75
|
| Rate for Payer: Cash Price |
$249.75
|
| Rate for Payer: Cash Price |
$249.75
|
| Rate for Payer: Cigna of CA HMO |
$355.20
|
| Rate for Payer: Cigna of CA PPO |
$410.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$388.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$471.75
|
| Rate for Payer: Global Benefits Group Commercial |
$333.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$352.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$325.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$444.00
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$360.75
|
| Rate for Payer: Prime Health Services Commercial |
$471.75
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$333.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$333.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC TRIM SKIN LESION, SINGLE
|
Facility
|
OP
|
$544.00
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
902890267
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$2,601.00 |
| Rate for Payer: Adventist Health Commercial |
$223.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$125.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cigna of CA HMO |
$348.16
|
| Rate for Payer: Cigna of CA PPO |
$402.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$462.40
|
| Rate for Payer: Global Benefits Group Commercial |
$326.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$345.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$325.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$435.20
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$353.60
|
| Rate for Payer: Prime Health Services Commercial |
$462.40
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$326.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$326.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
