|
HC TRIM SKIN LESION, SINGLE
|
Facility
|
IP
|
$544.00
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
902890267
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$108.80 |
| Max. Negotiated Rate |
$462.40 |
| Rate for Payer: Adventist Health Commercial |
$108.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$217.60
|
| Rate for Payer: EPIC Health Plan Senior |
$217.60
|
| Rate for Payer: Galaxy Health WC |
$462.40
|
| Rate for Payer: Global Benefits Group Commercial |
$326.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$345.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$320.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.56
|
| Rate for Payer: Multiplan Commercial |
$435.20
|
| Rate for Payer: Networks By Design Commercial |
$353.60
|
| Rate for Payer: Prime Health Services Commercial |
$462.40
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
|
IP
|
$12,768.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
909037247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,553.60 |
| Max. Negotiated Rate |
$10,852.80 |
| Rate for Payer: Adventist Health Commercial |
$2,553.60
|
| Rate for Payer: Cash Price |
$5,745.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,937.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,107.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,107.20
|
| Rate for Payer: Galaxy Health WC |
$10,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,660.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,107.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,533.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,064.32
|
| Rate for Payer: Multiplan Commercial |
$10,214.40
|
| Rate for Payer: Networks By Design Commercial |
$8,299.20
|
| Rate for Payer: Prime Health Services Commercial |
$10,852.80
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
|
OP
|
$12,768.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
909037247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,000.00 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,553.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,852.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,022.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,576.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$5,745.60
|
| Rate for Payer: Cash Price |
$5,745.60
|
| Rate for Payer: Cash Price |
$5,745.60
|
| Rate for Payer: Cigna of CA HMO |
$8,171.52
|
| Rate for Payer: Cigna of CA PPO |
$9,448.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,852.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,852.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,852.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,937.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,107.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,107.20
|
| Rate for Payer: Galaxy Health WC |
$10,852.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,660.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,326.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,107.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,500.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,533.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,064.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,937.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,937.60
|
| Rate for Payer: Multiplan Commercial |
$10,214.40
|
| Rate for Payer: Networks By Design Commercial |
$8,299.20
|
| Rate for Payer: Prime Health Services Commercial |
$10,852.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,660.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,384.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,852.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,852.80
|
| Rate for Payer: Vantage Medical Group Senior |
$10,852.80
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
|
OP
|
$12,471.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$969.48 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,494.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,600.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,859.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,353.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$5,611.95
|
| Rate for Payer: Cash Price |
$5,611.95
|
| Rate for Payer: Cash Price |
$5,611.95
|
| Rate for Payer: Cigna of CA HMO |
$7,981.44
|
| Rate for Payer: Cigna of CA PPO |
$9,228.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,600.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,600.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,600.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,729.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,988.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,988.40
|
| Rate for Payer: Galaxy Health WC |
$10,600.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,482.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$969.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,919.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,096.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,357.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,993.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,729.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,729.70
|
| Rate for Payer: Multiplan Commercial |
$9,976.80
|
| Rate for Payer: Networks By Design Commercial |
$8,106.15
|
| Rate for Payer: Prime Health Services Commercial |
$10,600.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,482.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,235.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,600.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,600.35
|
| Rate for Payer: Vantage Medical Group Senior |
$10,600.35
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
|
IP
|
$12,471.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,494.20 |
| Max. Negotiated Rate |
$10,600.35 |
| Rate for Payer: Adventist Health Commercial |
$2,494.20
|
| Rate for Payer: Cash Price |
$5,611.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,729.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,988.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,988.40
|
| Rate for Payer: Galaxy Health WC |
$10,600.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,482.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,919.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,357.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,993.04
|
| Rate for Payer: Multiplan Commercial |
$9,976.80
|
| Rate for Payer: Networks By Design Commercial |
$8,106.15
|
| Rate for Payer: Prime Health Services Commercial |
$10,600.35
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
|
IP
|
$21,205.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
909037246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,241.00 |
| Max. Negotiated Rate |
$18,024.25 |
| Rate for Payer: Adventist Health Commercial |
$4,241.00
|
| Rate for Payer: Cash Price |
$9,542.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,843.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,482.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,482.00
|
| Rate for Payer: Galaxy Health WC |
$18,024.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,723.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,465.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,510.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,089.20
|
| Rate for Payer: Multiplan Commercial |
$16,964.00
|
| Rate for Payer: Networks By Design Commercial |
$13,783.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,024.25
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
|
OP
|
$21,205.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
909037246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,924.01 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$4,241.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$9,542.25
|
| Rate for Payer: Cash Price |
$9,542.25
|
| Rate for Payer: Cash Price |
$9,542.25
|
| Rate for Payer: Cigna of CA HMO |
$13,571.20
|
| Rate for Payer: Cigna of CA PPO |
$15,691.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,843.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$18,024.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,723.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,293.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,465.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,725.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,089.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,223.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$16,964.00
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$13,783.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,024.25
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,723.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,602.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
|
OP
|
$24,943.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
909037248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,924.01 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$4,988.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$11,224.35
|
| Rate for Payer: Cash Price |
$11,224.35
|
| Rate for Payer: Cash Price |
$11,224.35
|
| Rate for Payer: Cigna of CA HMO |
$15,963.52
|
| Rate for Payer: Cigna of CA PPO |
$18,457.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,460.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$21,201.55
|
| Rate for Payer: Global Benefits Group Commercial |
$14,965.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,271.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,838.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,568.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,986.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,223.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$19,954.40
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$16,212.95
|
| Rate for Payer: Prime Health Services Commercial |
$21,201.55
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,965.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,471.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
|
IP
|
$24,943.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
909037248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,988.60 |
| Max. Negotiated Rate |
$21,201.55 |
| Rate for Payer: Adventist Health Commercial |
$4,988.60
|
| Rate for Payer: Cash Price |
$11,224.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,460.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,977.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,977.20
|
| Rate for Payer: Galaxy Health WC |
$21,201.55
|
| Rate for Payer: Global Benefits Group Commercial |
$14,965.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,838.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,716.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,986.32
|
| Rate for Payer: Multiplan Commercial |
$19,954.40
|
| Rate for Payer: Networks By Design Commercial |
$16,212.95
|
| Rate for Payer: Prime Health Services Commercial |
$21,201.55
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP
|
Facility
|
IP
|
$373.00
|
|
|
Service Code
|
CPT 92508
|
| Hospital Charge Code |
908600386
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$317.05 |
| Rate for Payer: Adventist Health Commercial |
$74.60
|
| Rate for Payer: Cash Price |
$167.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.20
|
| Rate for Payer: EPIC Health Plan Senior |
$149.20
|
| Rate for Payer: Galaxy Health WC |
$317.05
|
| Rate for Payer: Global Benefits Group Commercial |
$223.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$236.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.52
|
| Rate for Payer: Multiplan Commercial |
$298.40
|
| Rate for Payer: Networks By Design Commercial |
$242.45
|
| Rate for Payer: Prime Health Services Commercial |
$317.05
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP
|
Facility
|
OP
|
$373.00
|
|
|
Service Code
|
CPT 92508
|
| Hospital Charge Code |
908600386
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$152.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$176.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$279.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$167.85
|
| Rate for Payer: Cash Price |
$167.85
|
| Rate for Payer: Cash Price |
$167.85
|
| Rate for Payer: Cash Price |
$167.85
|
| Rate for Payer: Cigna of CA HMO |
$238.72
|
| Rate for Payer: Cigna of CA PPO |
$276.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.20
|
| Rate for Payer: EPIC Health Plan Senior |
$149.20
|
| Rate for Payer: Galaxy Health WC |
$317.05
|
| Rate for Payer: Global Benefits Group Commercial |
$223.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$236.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.10
|
| Rate for Payer: Multiplan Commercial |
$298.40
|
| Rate for Payer: Networks By Design Commercial |
$242.45
|
| Rate for Payer: Prime Health Services Commercial |
$317.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$223.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$223.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$317.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.05
|
| Rate for Payer: Vantage Medical Group Senior |
$317.05
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP MCAL
|
Facility
|
OP
|
$879.00
|
|
|
Service Code
|
CPT X4302
|
| Hospital Charge Code |
907000038
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$44.64 |
| Max. Negotiated Rate |
$747.15 |
| Rate for Payer: Adventist Health Commercial |
$360.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$576.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$483.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$659.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Cigna of CA HMO |
$562.56
|
| Rate for Payer: Cigna of CA PPO |
$650.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$747.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$747.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.60
|
| Rate for Payer: EPIC Health Plan Senior |
$351.60
|
| Rate for Payer: Galaxy Health WC |
$747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$527.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$558.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$518.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$615.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$615.30
|
| Rate for Payer: Multiplan Commercial |
$703.20
|
| Rate for Payer: Networks By Design Commercial |
$571.35
|
| Rate for Payer: Prime Health Services Commercial |
$747.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$527.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$527.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$747.15
|
| Rate for Payer: Vantage Medical Group Senior |
$747.15
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP MCAL
|
Facility
|
IP
|
$879.00
|
|
|
Service Code
|
CPT X4302
|
| Hospital Charge Code |
907000038
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$175.80 |
| Max. Negotiated Rate |
$747.15 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Cash Price |
$395.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.60
|
| Rate for Payer: EPIC Health Plan Senior |
$351.60
|
| Rate for Payer: Galaxy Health WC |
$747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$527.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$558.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$518.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.96
|
| Rate for Payer: Multiplan Commercial |
$703.20
|
| Rate for Payer: Networks By Design Commercial |
$571.35
|
| Rate for Payer: Prime Health Services Commercial |
$747.15
|
|
|
HC TRMNT SPEECH/LANG/VOICE INDIV MCAL
|
Facility
|
OP
|
$642.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000041
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$49.93 |
| Max. Negotiated Rate |
$545.70 |
| Rate for Payer: Adventist Health Commercial |
$263.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$525.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$545.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$481.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$288.90
|
| Rate for Payer: Cash Price |
$288.90
|
| Rate for Payer: Cash Price |
$288.90
|
| Rate for Payer: Cash Price |
$288.90
|
| Rate for Payer: Cigna of CA HMO |
$410.88
|
| Rate for Payer: Cigna of CA PPO |
$475.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$545.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$545.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$545.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$449.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Senior |
$256.80
|
| Rate for Payer: Galaxy Health WC |
$545.70
|
| Rate for Payer: Global Benefits Group Commercial |
$385.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$49.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$407.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$378.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.40
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: Networks By Design Commercial |
$417.30
|
| Rate for Payer: Prime Health Services Commercial |
$545.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$385.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$385.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$545.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$545.70
|
| Rate for Payer: Vantage Medical Group Senior |
$545.70
|
|
|
HC TRMNT SPEECH/LANG/VOICE INDIV MCAL
|
Facility
|
IP
|
$642.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000041
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$128.40 |
| Max. Negotiated Rate |
$545.70 |
| Rate for Payer: Adventist Health Commercial |
$128.40
|
| Rate for Payer: Cash Price |
$288.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$449.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Senior |
$256.80
|
| Rate for Payer: Galaxy Health WC |
$545.70
|
| Rate for Payer: Global Benefits Group Commercial |
$385.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$407.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$378.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.08
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: Networks By Design Commercial |
$417.30
|
| Rate for Payer: Prime Health Services Commercial |
$545.70
|
|
|
HC TRMNT STRESS MANAGEMENT
|
Facility
|
IP
|
$246.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$209.10 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$172.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.40
|
| Rate for Payer: EPIC Health Plan Senior |
$98.40
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$156.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$145.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.04
|
| Rate for Payer: Multiplan Commercial |
$196.80
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
|
|
HC TRMNT STRESS MANAGEMENT
|
Facility
|
OP
|
$246.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$342.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$228.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cigna of CA HMO |
$157.44
|
| Rate for Payer: Cigna of CA PPO |
$182.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$342.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$228.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$172.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.68
|
| Rate for Payer: EPIC Health Plan Senior |
$251.12
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$374.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$228.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$156.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$245.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$287.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$305.91
|
| Rate for Payer: Multiplan Commercial |
$196.80
|
| Rate for Payer: Multiplan WC |
$325.28
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
| Rate for Payer: Prime Health Services WC |
$321.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.00
|
| Rate for Payer: United Healthcare All Other HMO |
$123.00
|
| Rate for Payer: United Healthcare HMO Rider |
$123.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$228.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$342.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$228.29
|
|
|
HC TROPONIN - I
|
Facility
|
IP
|
$1,014.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900910994
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$202.80 |
| Max. Negotiated Rate |
$861.90 |
| Rate for Payer: Adventist Health Commercial |
$202.80
|
| Rate for Payer: Cash Price |
$456.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$709.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$405.60
|
| Rate for Payer: EPIC Health Plan Senior |
$405.60
|
| Rate for Payer: Galaxy Health WC |
$861.90
|
| Rate for Payer: Global Benefits Group Commercial |
$608.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$598.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$243.36
|
| Rate for Payer: Multiplan Commercial |
$811.20
|
| Rate for Payer: Networks By Design Commercial |
$659.10
|
| Rate for Payer: Prime Health Services Commercial |
$861.90
|
|
|
HC TROPONIN - I
|
Facility
|
OP
|
$1,014.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900910994
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$861.90 |
| Rate for Payer: Adventist Health Commercial |
$202.80
|
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$196.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$196.93
|
| Rate for Payer: Blue Shield of California Commercial |
$25.82
|
| Rate for Payer: Blue Shield of California Commercial |
$467.45
|
| Rate for Payer: Blue Shield of California Commercial |
$39.03
|
| Rate for Payer: Blue Shield of California Commercial |
$706.76
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$456.30
|
| Rate for Payer: Cash Price |
$456.30
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA HMO |
$648.96
|
| Rate for Payer: Cigna of CA PPO |
$750.36
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$709.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.58
|
| Rate for Payer: EPIC Health Plan Senior |
$13.72
|
| Rate for Payer: EPIC Health Plan Senior |
$13.72
|
| Rate for Payer: Galaxy Health WC |
$861.90
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Global Benefits Group Commercial |
$608.40
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.45
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$243.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Multiplan Commercial |
$44.80
|
| Rate for Payer: Multiplan Commercial |
$811.20
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: Networks By Design Commercial |
$659.10
|
| Rate for Payer: Prime Health Services Commercial |
$861.90
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$608.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$608.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
|
|
HC TROPONIN-T
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900912119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$196.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$196.93
|
| Rate for Payer: Blue Shield of California Commercial |
$35.96
|
| Rate for Payer: Blue Shield of California Commercial |
$145.22
|
| Rate for Payer: Blue Shield of California Commercial |
$54.37
|
| Rate for Payer: Blue Shield of California Commercial |
$219.56
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$141.75
|
| Rate for Payer: Cash Price |
$141.75
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA HMO |
$201.60
|
| Rate for Payer: Cigna of CA PPO |
$233.10
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$220.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.58
|
| Rate for Payer: EPIC Health Plan Senior |
$13.72
|
| Rate for Payer: EPIC Health Plan Senior |
$13.72
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.45
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$200.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$252.00
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$189.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$189.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
|
|
HC TROPONIN-T
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900912119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Cash Price |
$141.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$220.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.00
|
| Rate for Payer: EPIC Health Plan Senior |
$126.00
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$200.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$185.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.60
|
| Rate for Payer: Multiplan Commercial |
$252.00
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
|
IP
|
$55,402.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906811498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,080.40 |
| Max. Negotiated Rate |
$47,091.70 |
| Rate for Payer: Adventist Health Commercial |
$11,080.40
|
| Rate for Payer: Cash Price |
$24,930.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38,781.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,160.80
|
| Rate for Payer: EPIC Health Plan Senior |
$22,160.80
|
| Rate for Payer: Galaxy Health WC |
$47,091.70
|
| Rate for Payer: Global Benefits Group Commercial |
$33,241.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35,180.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$32,687.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,296.48
|
| Rate for Payer: Multiplan Commercial |
$44,321.60
|
| Rate for Payer: Networks By Design Commercial |
$36,011.30
|
| Rate for Payer: Prime Health Services Commercial |
$47,091.70
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
|
OP
|
$55,402.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906811498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$701.77 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$11,080.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,934.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,638.65
|
| Rate for Payer: Blue Shield of California Commercial |
$5,508.41
|
| Rate for Payer: Cash Price |
$24,930.90
|
| Rate for Payer: Cash Price |
$24,930.90
|
| Rate for Payer: Cash Price |
$24,930.90
|
| Rate for Payer: Cigna of CA HMO |
$35,457.28
|
| Rate for Payer: Cigna of CA PPO |
$40,997.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$38,781.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,251.12
|
| Rate for Payer: Galaxy Health WC |
$47,091.70
|
| Rate for Payer: Global Benefits Group Commercial |
$33,241.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$40,628.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$701.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35,180.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$793.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,683.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,296.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,214.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$44,321.60
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$36,011.30
|
| Rate for Payer: Prime Health Services Commercial |
$47,091.70
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33,241.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,701.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,773.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRT DEVICES COMPLEX
|
Facility
|
OP
|
$3,437.00
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
904810506
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$188.48 |
| Max. Negotiated Rate |
$2,921.45 |
| Rate for Payer: Adventist Health Commercial |
$687.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$660.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$722.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$529.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$481.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$959.09
|
| Rate for Payer: Blue Shield of California Commercial |
$2,192.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,446.98
|
| Rate for Payer: Cash Price |
$1,546.65
|
| Rate for Payer: Cash Price |
$1,546.65
|
| Rate for Payer: Cash Price |
$1,546.65
|
| Rate for Payer: Cigna of CA HMO |
$2,199.68
|
| Rate for Payer: Cigna of CA PPO |
$2,543.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$722.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$529.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$481.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,405.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$794.61
|
| Rate for Payer: EPIC Health Plan Senior |
$529.74
|
| Rate for Payer: Galaxy Health WC |
$2,921.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$789.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$188.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$481.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,182.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$213.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$674.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$824.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$606.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$645.32
|
| Rate for Payer: Multiplan Commercial |
$2,749.60
|
| Rate for Payer: Networks By Design Commercial |
$2,234.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,921.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,062.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$481.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$722.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$529.74
|
| Rate for Payer: Vantage Medical Group Senior |
$481.58
|
|
|
HC TRT DEVICES COMPLEX
|
Facility
|
IP
|
$3,437.00
|
|
|
Service Code
|
CPT 77334
|
| Hospital Charge Code |
904810506
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$687.40 |
| Max. Negotiated Rate |
$2,921.45 |
| Rate for Payer: Adventist Health Commercial |
$687.40
|
| Rate for Payer: Cash Price |
$1,546.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,405.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,374.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,374.80
|
| Rate for Payer: Galaxy Health WC |
$2,921.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,062.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,182.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,027.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$824.88
|
| Rate for Payer: Multiplan Commercial |
$2,749.60
|
| Rate for Payer: Networks By Design Commercial |
$2,234.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,921.45
|
|
