|
HC TRUSS ADDITION WATER PAD
|
Facility
|
OP
|
$162.00
|
|
|
Service Code
|
CPT L8320
|
| Hospital Charge Code |
905358320
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$38.88 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Adventist Health Commercial |
$66.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$137.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$89.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$121.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$98.06
|
| Rate for Payer: Blue Shield of California Commercial |
$82.13
|
| Rate for Payer: Blue Shield of California Commercial |
$124.58
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cigna of CA HMO |
$113.40
|
| Rate for Payer: Cigna of CA PPO |
$113.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$137.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$137.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$137.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$113.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.80
|
| Rate for Payer: EPIC Health Plan Senior |
$64.80
|
| Rate for Payer: Galaxy Health WC |
$137.70
|
| Rate for Payer: Global Benefits Group Commercial |
$97.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$45.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$102.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$51.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$95.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$113.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$113.40
|
| Rate for Payer: Multiplan Commercial |
$129.60
|
| Rate for Payer: Networks By Design Commercial |
$81.00
|
| Rate for Payer: Prime Health Services Commercial |
$137.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$97.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$97.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.80
|
| Rate for Payer: United Healthcare All Other HMO |
$59.18
|
| Rate for Payer: United Healthcare HMO Rider |
$57.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$137.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$137.70
|
| Rate for Payer: Vantage Medical Group Senior |
$137.70
|
|
|
HC TRUSS DOUBLE W/STANDARD PADS
|
Facility
|
IP
|
$389.00
|
|
|
Service Code
|
CPT L8310
|
| Hospital Charge Code |
905358310
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$77.80 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Galaxy Health WC |
$330.65
|
| Rate for Payer: Adventist Health Commercial |
$77.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$175.05
|
| Rate for Payer: Cash Price |
$175.05
|
| Rate for Payer: Cigna of CA HMO |
$272.30
|
| Rate for Payer: Cigna of CA PPO |
$272.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$272.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.60
|
| Rate for Payer: EPIC Health Plan Senior |
$155.60
|
| Rate for Payer: Global Benefits Group Commercial |
$233.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$229.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.36
|
| Rate for Payer: Multiplan Commercial |
$311.20
|
| Rate for Payer: Networks By Design Commercial |
$252.85
|
| Rate for Payer: Prime Health Services Commercial |
$330.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.99
|
| Rate for Payer: United Healthcare All Other HMO |
$142.10
|
| Rate for Payer: United Healthcare HMO Rider |
$139.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$127.40
|
|
|
HC TRUSS DOUBLE W/STANDARD PADS
|
Facility
|
OP
|
$389.00
|
|
|
Service Code
|
CPT L8310
|
| Hospital Charge Code |
905358310
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$93.36 |
| Max. Negotiated Rate |
$330.65 |
| Rate for Payer: Adventist Health Commercial |
$159.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$330.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$213.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$291.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$235.46
|
| Rate for Payer: Blue Shield of California Commercial |
$299.14
|
| Rate for Payer: Blue Shield of California Commercial |
$197.22
|
| Rate for Payer: Cash Price |
$175.05
|
| Rate for Payer: Cash Price |
$175.05
|
| Rate for Payer: Cigna of CA HMO |
$272.30
|
| Rate for Payer: Cigna of CA PPO |
$272.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$330.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$330.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$330.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$272.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.60
|
| Rate for Payer: EPIC Health Plan Senior |
$155.60
|
| Rate for Payer: Galaxy Health WC |
$330.65
|
| Rate for Payer: Global Benefits Group Commercial |
$233.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$191.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$247.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$216.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$229.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$272.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$272.30
|
| Rate for Payer: Multiplan Commercial |
$311.20
|
| Rate for Payer: Networks By Design Commercial |
$194.50
|
| Rate for Payer: Prime Health Services Commercial |
$330.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$233.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$233.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.99
|
| Rate for Payer: United Healthcare All Other HMO |
$142.10
|
| Rate for Payer: United Healthcare HMO Rider |
$139.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$127.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$330.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$330.65
|
| Rate for Payer: Vantage Medical Group Senior |
$330.65
|
|
|
HC TRUSS SINGLE W/STANDARD PAD
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT L8300
|
| Hospital Charge Code |
905358300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$36.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cigna of CA HMO |
$126.70
|
| Rate for Payer: Cigna of CA PPO |
$126.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.40
|
| Rate for Payer: EPIC Health Plan Senior |
$72.40
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.44
|
| Rate for Payer: Multiplan Commercial |
$144.80
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.93
|
| Rate for Payer: United Healthcare All Other HMO |
$66.12
|
| Rate for Payer: United Healthcare HMO Rider |
$64.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.28
|
|
|
HC TRUSS SINGLE W/STANDARD PAD
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT L8300
|
| Hospital Charge Code |
905358300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$43.44 |
| Max. Negotiated Rate |
$153.85 |
| Rate for Payer: Adventist Health Commercial |
$74.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$153.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.56
|
| Rate for Payer: Blue Shield of California Commercial |
$91.77
|
| Rate for Payer: Blue Shield of California Commercial |
$139.19
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cigna of CA HMO |
$126.70
|
| Rate for Payer: Cigna of CA PPO |
$126.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$153.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$153.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.40
|
| Rate for Payer: EPIC Health Plan Senior |
$72.40
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$121.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$126.70
|
| Rate for Payer: Multiplan Commercial |
$144.80
|
| Rate for Payer: Networks By Design Commercial |
$90.50
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.93
|
| Rate for Payer: United Healthcare All Other HMO |
$66.12
|
| Rate for Payer: United Healthcare HMO Rider |
$64.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$153.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.85
|
| Rate for Payer: Vantage Medical Group Senior |
$153.85
|
|
|
HC TRUWAVE DBL A-LINE CVP
|
Facility
|
OP
|
$268.66
|
|
| Hospital Charge Code |
901698617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.73 |
| Max. Negotiated Rate |
$228.36 |
| Rate for Payer: Adventist Health Commercial |
$53.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$176.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$228.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$201.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.40
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cigna of CA HMO |
$171.94
|
| Rate for Payer: Cigna of CA PPO |
$198.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$228.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$228.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$228.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$188.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.46
|
| Rate for Payer: EPIC Health Plan Senior |
$107.46
|
| Rate for Payer: Galaxy Health WC |
$228.36
|
| Rate for Payer: Global Benefits Group Commercial |
$161.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$97.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$158.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$188.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$188.06
|
| Rate for Payer: Multiplan Commercial |
$214.93
|
| Rate for Payer: Networks By Design Commercial |
$174.63
|
| Rate for Payer: Prime Health Services Commercial |
$228.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$161.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.33
|
| Rate for Payer: United Healthcare All Other HMO |
$134.33
|
| Rate for Payer: United Healthcare HMO Rider |
$134.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$134.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$228.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$228.36
|
| Rate for Payer: Vantage Medical Group Senior |
$228.36
|
|
|
HC TRUWAVE DBL A-LINE CVP
|
Facility
|
IP
|
$268.66
|
|
| Hospital Charge Code |
901698617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.73 |
| Max. Negotiated Rate |
$228.36 |
| Rate for Payer: Adventist Health Commercial |
$53.73
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$188.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.46
|
| Rate for Payer: EPIC Health Plan Senior |
$107.46
|
| Rate for Payer: Galaxy Health WC |
$228.36
|
| Rate for Payer: Global Benefits Group Commercial |
$161.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$158.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.48
|
| Rate for Payer: Multiplan Commercial |
$214.93
|
| Rate for Payer: Networks By Design Commercial |
$174.63
|
| Rate for Payer: Prime Health Services Commercial |
$228.36
|
|
|
HC TRYPSIN STOOL
|
Facility
|
IP
|
$449.00
|
|
|
Service Code
|
CPT 84488
|
| Hospital Charge Code |
900910231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$89.80 |
| Max. Negotiated Rate |
$381.65 |
| Rate for Payer: Adventist Health Commercial |
$89.80
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$314.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$179.60
|
| Rate for Payer: EPIC Health Plan Senior |
$179.60
|
| Rate for Payer: Galaxy Health WC |
$381.65
|
| Rate for Payer: Global Benefits Group Commercial |
$269.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$285.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$264.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.76
|
| Rate for Payer: Multiplan Commercial |
$359.20
|
| Rate for Payer: Networks By Design Commercial |
$291.85
|
| Rate for Payer: Prime Health Services Commercial |
$381.65
|
|
|
HC TRYPSIN STOOL
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 84488
|
| Hospital Charge Code |
900910231
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.91 |
| Max. Negotiated Rate |
$75.33 |
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Adventist Health Commercial |
$89.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.33
|
| Rate for Payer: Blue Shield of California Commercial |
$206.99
|
| Rate for Payer: Blue Shield of California Commercial |
$14.29
|
| Rate for Payer: Blue Shield of California Commercial |
$312.95
|
| Rate for Payer: Blue Shield of California Commercial |
$21.61
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cigna of CA HMO |
$287.36
|
| Rate for Payer: Cigna of CA HMO |
$19.84
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Cigna of CA PPO |
$332.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$314.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$8.03
|
| Rate for Payer: EPIC Health Plan Senior |
$8.03
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Galaxy Health WC |
$381.65
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Global Benefits Group Commercial |
$269.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$285.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.78
|
| Rate for Payer: Multiplan Commercial |
$359.20
|
| Rate for Payer: Multiplan Commercial |
$24.80
|
| Rate for Payer: Networks By Design Commercial |
$291.85
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
| Rate for Payer: Prime Health Services Commercial |
$381.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$269.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$269.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.91
|
| Rate for Payer: United Healthcare All Other HMO |
$5.91
|
| Rate for Payer: United Healthcare All Other HMO |
$5.91
|
| Rate for Payer: United Healthcare HMO Rider |
$5.91
|
| Rate for Payer: United Healthcare HMO Rider |
$5.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.91
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.30
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Vantage Medical Group Senior |
$7.30
|
| Rate for Payer: Vantage Medical Group Senior |
$7.30
|
|
|
HC TSH (THYROTROPIN)
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
900910829
|
|
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 TSH (THYROTROPIN)
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
900910829
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.61 |
| Max. Negotiated Rate |
$173.44 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Vantage Medical Group Senior |
$16.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16.80
|
| Rate for Payer: Adventist Health Commercial |
$21.80
|
| Rate for Payer: Adventist Health Commercial |
$61.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$173.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$173.44
|
| Rate for Payer: Blue Shield of California Commercial |
$140.60
|
| Rate for Payer: Blue Shield of California Commercial |
$50.25
|
| Rate for Payer: Blue Shield of California Commercial |
$212.59
|
| Rate for Payer: Blue Shield of California Commercial |
$75.97
|
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Cash Price |
$137.25
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Cigna of CA HMO |
$195.20
|
| Rate for Payer: Cigna of CA HMO |
$69.76
|
| Rate for Payer: Cigna of CA PPO |
$80.66
|
| Rate for Payer: Cigna of CA PPO |
$225.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$76.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$213.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.72
|
| Rate for Payer: EPIC Health Plan Senior |
$18.48
|
| Rate for Payer: EPIC Health Plan Senior |
$18.48
|
| Rate for Payer: Galaxy Health WC |
$92.65
|
| Rate for Payer: Galaxy Health WC |
$259.25
|
| Rate for Payer: Global Benefits Group Commercial |
$65.40
|
| Rate for Payer: Global Benefits Group Commercial |
$183.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$69.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$193.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$28.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$28.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.51
|
| Rate for Payer: Multiplan Commercial |
$244.00
|
| Rate for Payer: Multiplan Commercial |
$87.20
|
| Rate for Payer: Networks By Design Commercial |
$198.25
|
| Rate for Payer: Networks By Design Commercial |
$70.85
|
| Rate for Payer: Prime Health Services Commercial |
$92.65
|
| Rate for Payer: Prime Health Services Commercial |
$259.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$65.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$183.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$65.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$183.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.61
|
| Rate for Payer: United Healthcare All Other HMO |
$13.61
|
| Rate for Payer: United Healthcare All Other HMO |
$13.61
|
| Rate for Payer: United Healthcare HMO Rider |
$13.61
|
| Rate for Payer: United Healthcare HMO Rider |
$13.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.61
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.20
|
|
|
HC T-STRAP PADDED ADDITION LE
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT L2270
|
| Hospital Charge Code |
915352270
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: Adventist Health Commercial |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.90
|
| Rate for Payer: Blue Shield of California Commercial |
$86.19
|
| Rate for Payer: Blue Shield of California Commercial |
$130.73
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$144.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$144.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$144.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$72.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.80
|
| Rate for Payer: United Healthcare All Other HMO |
$62.10
|
| Rate for Payer: United Healthcare HMO Rider |
$60.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$144.50
|
| Rate for Payer: Vantage Medical Group Senior |
$144.50
|
|
|
HC T-STRAP PADDED ADDITION LE
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT L2270
|
| Hospital Charge Code |
905352270
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: Adventist Health Commercial |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.90
|
| Rate for Payer: Blue Shield of California Commercial |
$86.19
|
| Rate for Payer: Blue Shield of California Commercial |
$130.73
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$144.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$144.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$144.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$72.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$81.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.80
|
| Rate for Payer: United Healthcare All Other HMO |
$62.10
|
| Rate for Payer: United Healthcare HMO Rider |
$60.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$144.50
|
| Rate for Payer: Vantage Medical Group Senior |
$144.50
|
|
|
HC T-STRAP PADDED ADDITION LE
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT L2270
|
| Hospital Charge Code |
905352270
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.80
|
| Rate for Payer: United Healthcare All Other HMO |
$62.10
|
| Rate for Payer: United Healthcare HMO Rider |
$60.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.67
|
|
|
HC T-STRAP PADDED ADDITION LE
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT L2270
|
| Hospital Charge Code |
915352270
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO |
$119.00
|
| Rate for Payer: Cigna of CA PPO |
$119.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.80
|
| Rate for Payer: United Healthcare All Other HMO |
$62.10
|
| Rate for Payer: United Healthcare HMO Rider |
$60.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.67
|
|
|
HC TTG IGA
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913669
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC TTG IGA
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913669
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$241.47 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Adventist Health Commercial |
$9.80
|
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.47
|
| Rate for Payer: Blue Shield of California Commercial |
$29.50
|
| Rate for Payer: Blue Shield of California Commercial |
$22.59
|
| Rate for Payer: Blue Shield of California Commercial |
$44.61
|
| Rate for Payer: Blue Shield of California Commercial |
$34.15
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA HMO |
$31.36
|
| Rate for Payer: Cigna of CA PPO |
$36.26
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Networks By Design Commercial |
$31.85
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
|
|
HC TTG IGA
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
900913715
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$68.13 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.42
|
| Rate for Payer: Blue Shield of California Commercial |
$11.15
|
| Rate for Payer: Blue Shield of California Commercial |
$6.45
|
| Rate for Payer: Blue Shield of California Commercial |
$7.38
|
| Rate for Payer: Blue Shield of California Commercial |
$9.76
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna of CA HMO |
$10.24
|
| Rate for Payer: Cigna of CA HMO |
$8.96
|
| Rate for Payer: Cigna of CA PPO |
$10.36
|
| Rate for Payer: Cigna of CA PPO |
$11.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$11.20
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC TTG IGA
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
900913715
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
|
|
HC TTG IGG
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
900913716
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
|
|
HC TTG IGG
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913670
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$54.40 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Senior |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC TTG IGG
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
900913670
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$241.47 |
| Rate for Payer: Adventist Health Commercial |
$9.80
|
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.47
|
| Rate for Payer: Blue Shield of California Commercial |
$29.50
|
| Rate for Payer: Blue Shield of California Commercial |
$22.59
|
| Rate for Payer: Blue Shield of California Commercial |
$44.61
|
| Rate for Payer: Blue Shield of California Commercial |
$34.15
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA HMO |
$31.36
|
| Rate for Payer: Cigna of CA PPO |
$36.26
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$51.20
|
| Rate for Payer: Multiplan Commercial |
$39.20
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Networks By Design Commercial |
$31.85
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC TTG IGG
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
900913716
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$68.13 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Adventist Health Commercial |
$3.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.42
|
| Rate for Payer: Blue Shield of California Commercial |
$11.15
|
| Rate for Payer: Blue Shield of California Commercial |
$6.45
|
| Rate for Payer: Blue Shield of California Commercial |
$7.38
|
| Rate for Payer: Blue Shield of California Commercial |
$9.76
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cigna of CA HMO |
$10.24
|
| Rate for Payer: Cigna of CA HMO |
$8.96
|
| Rate for Payer: Cigna of CA PPO |
$10.36
|
| Rate for Payer: Cigna of CA PPO |
$11.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: EPIC Health Plan Senior |
$12.68
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Galaxy Health WC |
$13.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Global Benefits Group Commercial |
$9.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$19.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$11.20
|
| Rate for Payer: Networks By Design Commercial |
$10.40
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
| Rate for Payer: Prime Health Services Commercial |
$13.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare All Other HMO |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare HMO Rider |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.68
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
|
|
HC TTS BIVNA NEO/PEDS FLXTD 3.0FR
|
Facility
|
OP
|
$983.85
|
|
| Hospital Charge Code |
900800901
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$196.77 |
| Max. Negotiated Rate |
$836.27 |
| Rate for Payer: Adventist Health Commercial |
$196.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$645.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$836.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$541.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$737.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$631.34
|
| Rate for Payer: Cash Price |
$442.73
|
| Rate for Payer: Cigna of CA HMO |
$629.66
|
| Rate for Payer: Cigna of CA PPO |
$728.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$836.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$836.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$836.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$688.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$393.54
|
| Rate for Payer: EPIC Health Plan Senior |
$393.54
|
| Rate for Payer: Galaxy Health WC |
$836.27
|
| Rate for Payer: Global Benefits Group Commercial |
$590.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$624.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$357.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$580.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$688.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.70
|
| Rate for Payer: Multiplan Commercial |
$787.08
|
| Rate for Payer: Networks By Design Commercial |
$639.50
|
| Rate for Payer: Prime Health Services Commercial |
$836.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$590.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$590.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.93
|
| Rate for Payer: United Healthcare All Other HMO |
$491.93
|
| Rate for Payer: United Healthcare HMO Rider |
$491.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$836.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$836.27
|
| Rate for Payer: Vantage Medical Group Senior |
$836.27
|
|
|
HC TTS BIVNA NEO/PEDS FLXTD 3.0FR
|
Facility
|
IP
|
$983.85
|
|
| Hospital Charge Code |
900800901
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$196.77 |
| Max. Negotiated Rate |
$836.27 |
| Rate for Payer: Adventist Health Commercial |
$196.77
|
| Rate for Payer: Cash Price |
$442.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$688.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$393.54
|
| Rate for Payer: EPIC Health Plan Senior |
$393.54
|
| Rate for Payer: Galaxy Health WC |
$836.27
|
| Rate for Payer: Global Benefits Group Commercial |
$590.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$624.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$580.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.12
|
| Rate for Payer: Multiplan Commercial |
$787.08
|
| Rate for Payer: Networks By Design Commercial |
$639.50
|
| Rate for Payer: Prime Health Services Commercial |
$836.27
|
|
