|
HC VASOPNEUMATIC DEVICE MCARE COMM
|
Facility
|
OP
|
$279.00
|
|
|
Service Code
|
CPT 97016
|
| Hospital Charge Code |
900407041
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.72 |
| Max. Negotiated Rate |
$457.00 |
| Rate for Payer: Adventist Health Commercial |
$114.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$183.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$237.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$153.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$209.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cash Price |
$125.55
|
| Rate for Payer: Cigna of CA HMO |
$178.56
|
| Rate for Payer: Cigna of CA PPO |
$206.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$237.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$237.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$237.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.60
|
| Rate for Payer: EPIC Health Plan Senior |
$111.60
|
| Rate for Payer: Galaxy Health WC |
$237.15
|
| Rate for Payer: Global Benefits Group Commercial |
$167.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$172.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$195.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$195.30
|
| Rate for Payer: Multiplan Commercial |
$223.20
|
| Rate for Payer: Networks By Design Commercial |
$181.35
|
| Rate for Payer: Prime Health Services Commercial |
$237.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$167.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$167.40
|
| 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 |
$237.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$237.15
|
| Rate for Payer: Vantage Medical Group Senior |
$237.15
|
|
|
HC VAT PIV KIT
|
Facility
|
IP
|
$67.16
|
|
| Hospital Charge Code |
901698272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$57.09 |
| Rate for Payer: Adventist Health Commercial |
$13.43
|
| Rate for Payer: Cash Price |
$30.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.86
|
| Rate for Payer: EPIC Health Plan Senior |
$26.86
|
| Rate for Payer: Galaxy Health WC |
$57.09
|
| Rate for Payer: Global Benefits Group Commercial |
$40.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.12
|
| Rate for Payer: Multiplan Commercial |
$53.73
|
| Rate for Payer: Networks By Design Commercial |
$43.65
|
| Rate for Payer: Prime Health Services Commercial |
$57.09
|
|
|
HC VAT PIV KIT
|
Facility
|
OP
|
$67.16
|
|
| Hospital Charge Code |
901698272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$57.09 |
| Rate for Payer: Adventist Health Commercial |
$13.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$44.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$57.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.24
|
| Rate for Payer: Cash Price |
$30.22
|
| Rate for Payer: Cigna of CA HMO |
$42.98
|
| Rate for Payer: Cigna of CA PPO |
$49.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$57.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$57.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.86
|
| Rate for Payer: EPIC Health Plan Senior |
$26.86
|
| Rate for Payer: Galaxy Health WC |
$57.09
|
| Rate for Payer: Global Benefits Group Commercial |
$40.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.01
|
| Rate for Payer: Multiplan Commercial |
$53.73
|
| Rate for Payer: Networks By Design Commercial |
$43.65
|
| Rate for Payer: Prime Health Services Commercial |
$57.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.58
|
| Rate for Payer: United Healthcare All Other HMO |
$33.58
|
| Rate for Payer: United Healthcare HMO Rider |
$33.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$57.09
|
| Rate for Payer: Vantage Medical Group Senior |
$57.09
|
|
|
HC VEEG 21-12HR INTMT MNTRD
|
Facility
|
IP
|
$923.00
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
900605712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$184.60 |
| Max. Negotiated Rate |
$784.55 |
| Rate for Payer: Adventist Health Commercial |
$184.60
|
| Rate for Payer: Cash Price |
$415.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$369.20
|
| Rate for Payer: EPIC Health Plan Senior |
$369.20
|
| Rate for Payer: Galaxy Health WC |
$784.55
|
| Rate for Payer: Global Benefits Group Commercial |
$553.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$571.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.52
|
| Rate for Payer: Multiplan Commercial |
$738.40
|
| Rate for Payer: Networks By Design Commercial |
$599.95
|
| Rate for Payer: Prime Health Services Commercial |
$784.55
|
|
|
HC VEEG 21-12HR INTMT MNTRD
|
Facility
|
OP
|
$923.00
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
900605712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$184.60 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$184.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$605.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$566.81
|
| Rate for Payer: Blue Shield of California Commercial |
$564.88
|
| Rate for Payer: Blue Shield of California EPN |
$372.89
|
| Rate for Payer: Cash Price |
$415.35
|
| Rate for Payer: Cash Price |
$415.35
|
| Rate for Payer: Cash Price |
$415.35
|
| Rate for Payer: Cigna of CA HMO |
$590.72
|
| Rate for Payer: Cigna of CA PPO |
$683.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$784.55
|
| Rate for Payer: Global Benefits Group Commercial |
$553.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$626.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$738.40
|
| Rate for Payer: Networks By Design Commercial |
$599.95
|
| Rate for Payer: Prime Health Services Commercial |
$784.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$553.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$553.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC VEEG 21-12HR UNMNTRD
|
Facility
|
OP
|
$923.00
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
900605711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$184.60 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$184.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$605.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$566.81
|
| Rate for Payer: Blue Shield of California Commercial |
$564.88
|
| Rate for Payer: Blue Shield of California EPN |
$372.89
|
| Rate for Payer: Cash Price |
$415.35
|
| Rate for Payer: Cash Price |
$415.35
|
| Rate for Payer: Cash Price |
$415.35
|
| Rate for Payer: Cigna of CA HMO |
$590.72
|
| Rate for Payer: Cigna of CA PPO |
$683.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$593.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$534.14
|
| Rate for Payer: EPIC Health Plan Senior |
$395.66
|
| Rate for Payer: Galaxy Health WC |
$784.55
|
| Rate for Payer: Global Benefits Group Commercial |
$553.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$648.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$372.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$395.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$498.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$530.18
|
| Rate for Payer: Multiplan Commercial |
$738.40
|
| Rate for Payer: Networks By Design Commercial |
$599.95
|
| Rate for Payer: Prime Health Services Commercial |
$784.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$553.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$553.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$593.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.23
|
| Rate for Payer: Vantage Medical Group Senior |
$395.66
|
|
|
HC VEEG 21-12HR UNMNTRD
|
Facility
|
IP
|
$923.00
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
900605711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$184.60 |
| Max. Negotiated Rate |
$784.55 |
| Rate for Payer: Adventist Health Commercial |
$184.60
|
| Rate for Payer: Cash Price |
$415.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$369.20
|
| Rate for Payer: EPIC Health Plan Senior |
$369.20
|
| Rate for Payer: Galaxy Health WC |
$784.55
|
| Rate for Payer: Global Benefits Group Commercial |
$553.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$571.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.52
|
| Rate for Payer: Multiplan Commercial |
$738.40
|
| Rate for Payer: Networks By Design Commercial |
$599.95
|
| Rate for Payer: Prime Health Services Commercial |
$784.55
|
|
|
HC VEEG 2-12HR CONT MNTRD
|
Facility
|
IP
|
$1,771.00
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
900605713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,505.35 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,181.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,096.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.04
|
| Rate for Payer: Multiplan Commercial |
$1,416.80
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
|
|
HC VEEG 2-12HR CONT MNTRD
|
Facility
|
OP
|
$1,771.00
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
900605713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,161.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,087.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,083.85
|
| Rate for Payer: Blue Shield of California EPN |
$715.48
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cigna of CA HMO |
$1,133.44
|
| Rate for Payer: Cigna of CA PPO |
$1,310.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,225.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,181.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,386.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$849.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$1,416.80
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,062.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,062.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
|
IP
|
$3,315.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$2,817.75 |
| Rate for Payer: Adventist Health Commercial |
$663.00
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.00
|
| Rate for Payer: Galaxy Health WC |
$2,817.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,051.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.60
|
| Rate for Payer: Multiplan Commercial |
$2,652.00
|
| Rate for Payer: Networks By Design Commercial |
$2,154.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,817.75
|
|
|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
|
OP
|
$3,315.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$2,817.75 |
| Rate for Payer: Adventist Health Commercial |
$663.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,174.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,939.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,421.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,292.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,035.74
|
| Rate for Payer: Blue Shield of California Commercial |
$2,028.78
|
| Rate for Payer: Blue Shield of California EPN |
$1,339.26
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Cigna of CA HMO |
$2,121.60
|
| Rate for Payer: Cigna of CA PPO |
$2,453.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,939.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,421.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,292.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,745.14
|
| Rate for Payer: EPIC Health Plan Senior |
$1,292.70
|
| Rate for Payer: Galaxy Health WC |
$2,817.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,120.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,965.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,292.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,222.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,292.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,628.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,732.22
|
| Rate for Payer: Multiplan Commercial |
$2,652.00
|
| Rate for Payer: Networks By Design Commercial |
$2,154.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,817.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,989.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,989.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,292.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,939.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,421.97
|
| Rate for Payer: Vantage Medical Group Senior |
$1,292.70
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
|
IP
|
$1,771.00
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,505.35 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,181.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,096.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.04
|
| Rate for Payer: Multiplan Commercial |
$1,416.80
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
|
OP
|
$1,771.00
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,161.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,087.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,083.85
|
| Rate for Payer: Blue Shield of California EPN |
$715.48
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cigna of CA HMO |
$1,133.44
|
| Rate for Payer: Cigna of CA PPO |
$1,310.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,097.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,181.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,241.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$849.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$1,416.80
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,062.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,062.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
|
OP
|
$1,771.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$2,039.00 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,161.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,087.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1,083.85
|
| Rate for Payer: Blue Shield of California EPN |
$715.48
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cigna of CA HMO |
$1,133.44
|
| Rate for Payer: Cigna of CA PPO |
$1,310.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$445.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,181.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$503.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$849.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$1,416.80
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,062.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,062.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
|
IP
|
$1,771.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,505.35 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,181.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$674.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,096.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.04
|
| Rate for Payer: Multiplan Commercial |
$1,416.80
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
IP
|
$395.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.00 |
| Max. Negotiated Rate |
$335.75 |
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.00
|
| Rate for Payer: EPIC Health Plan Senior |
$158.00
|
| Rate for Payer: Galaxy Health WC |
$335.75
|
| Rate for Payer: Global Benefits Group Commercial |
$237.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$263.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$244.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.80
|
| Rate for Payer: Multiplan Commercial |
$316.00
|
| Rate for Payer: Networks By Design Commercial |
$256.75
|
| Rate for Payer: Prime Health Services Commercial |
$335.75
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
OP
|
$395.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$43.78 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$335.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$217.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$296.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Cigna of CA HMO |
$252.80
|
| Rate for Payer: Cigna of CA PPO |
$292.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$335.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$335.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.00
|
| Rate for Payer: EPIC Health Plan Senior |
$158.00
|
| Rate for Payer: Galaxy Health WC |
$335.75
|
| Rate for Payer: Global Benefits Group Commercial |
$237.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$263.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$244.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$276.50
|
| Rate for Payer: Multiplan Commercial |
$316.00
|
| Rate for Payer: Networks By Design Commercial |
$256.75
|
| Rate for Payer: Prime Health Services Commercial |
$335.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$237.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| 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 |
$335.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.75
|
| Rate for Payer: Vantage Medical Group Senior |
$335.75
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
IP
|
$395.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.00 |
| Max. Negotiated Rate |
$335.75 |
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.00
|
| Rate for Payer: EPIC Health Plan Senior |
$158.00
|
| Rate for Payer: Galaxy Health WC |
$335.75
|
| Rate for Payer: Global Benefits Group Commercial |
$237.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$263.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$244.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.80
|
| Rate for Payer: Multiplan Commercial |
$316.00
|
| Rate for Payer: Networks By Design Commercial |
$256.75
|
| Rate for Payer: Prime Health Services Commercial |
$335.75
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
OP
|
$395.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.51 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$335.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$217.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$296.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Cigna of CA HMO |
$252.80
|
| Rate for Payer: Cigna of CA PPO |
$292.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$335.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$335.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.00
|
| Rate for Payer: EPIC Health Plan Senior |
$158.00
|
| Rate for Payer: Galaxy Health WC |
$335.75
|
| Rate for Payer: Global Benefits Group Commercial |
$237.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$263.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$244.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$276.50
|
| Rate for Payer: Multiplan Commercial |
$316.00
|
| Rate for Payer: Networks By Design Commercial |
$256.75
|
| Rate for Payer: Prime Health Services Commercial |
$335.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$237.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$197.50
|
| Rate for Payer: United Healthcare All Other HMO |
$197.50
|
| Rate for Payer: United Healthcare HMO Rider |
$197.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$197.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$335.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.75
|
| Rate for Payer: Vantage Medical Group Senior |
$335.75
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
|
OP
|
$878.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.60 |
| Max. Negotiated Rate |
$746.30 |
| Rate for Payer: Adventist Health Commercial |
$175.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$575.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$585.77
|
| Rate for Payer: Blue Shield of California Commercial |
$537.34
|
| Rate for Payer: Blue Shield of California EPN |
$354.71
|
| Rate for Payer: Cash Price |
$395.10
|
| Rate for Payer: Cash Price |
$395.10
|
| Rate for Payer: Cigna of CA HMO |
$561.92
|
| Rate for Payer: Cigna of CA PPO |
$649.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.63
|
| Rate for Payer: EPIC Health Plan Senior |
$307.13
|
| Rate for Payer: Galaxy Health WC |
$746.30
|
| Rate for Payer: Global Benefits Group Commercial |
$526.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$503.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$307.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$585.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$307.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.55
|
| Rate for Payer: Multiplan Commercial |
$702.40
|
| Rate for Payer: Networks By Design Commercial |
$570.70
|
| Rate for Payer: Prime Health Services Commercial |
$746.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$526.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$526.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$307.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Vantage Medical Group Senior |
$307.13
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
|
IP
|
$878.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$175.60 |
| Max. Negotiated Rate |
$746.30 |
| Rate for Payer: Adventist Health Commercial |
$175.60
|
| Rate for Payer: Cash Price |
$395.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.20
|
| Rate for Payer: EPIC Health Plan Senior |
$351.20
|
| Rate for Payer: Galaxy Health WC |
$746.30
|
| Rate for Payer: Global Benefits Group Commercial |
$526.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$585.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$543.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.72
|
| Rate for Payer: Multiplan Commercial |
$702.40
|
| Rate for Payer: Networks By Design Commercial |
$570.70
|
| Rate for Payer: Prime Health Services Commercial |
$746.30
|
|
|
HC VENA CAVA FILTER
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC VENA CAVA FILTER
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
IP
|
$601.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.20 |
| Max. Negotiated Rate |
$510.85 |
| Rate for Payer: Adventist Health Commercial |
$120.20
|
| Rate for Payer: Cash Price |
$270.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$240.40
|
| Rate for Payer: EPIC Health Plan Senior |
$240.40
|
| Rate for Payer: Galaxy Health WC |
$510.85
|
| Rate for Payer: Global Benefits Group Commercial |
$360.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$400.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$228.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$372.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.24
|
| Rate for Payer: Multiplan Commercial |
$480.80
|
| Rate for Payer: Networks By Design Commercial |
$390.65
|
| Rate for Payer: Prime Health Services Commercial |
$510.85
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
OP
|
$601.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.89 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$120.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$270.45
|
| Rate for Payer: Cash Price |
$270.45
|
| Rate for Payer: Cash Price |
$270.45
|
| Rate for Payer: Cigna of CA HMO |
$384.64
|
| Rate for Payer: Cigna of CA PPO |
$444.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$760.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$557.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$684.48
|
| Rate for Payer: EPIC Health Plan Senior |
$507.02
|
| Rate for Payer: Galaxy Health WC |
$510.85
|
| Rate for Payer: Global Benefits Group Commercial |
$360.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$831.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$400.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$638.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$679.41
|
| Rate for Payer: Multiplan Commercial |
$480.80
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$390.65
|
| Rate for Payer: Prime Health Services Commercial |
$510.85
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$360.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$300.50
|
| Rate for Payer: United Healthcare All Other HMO |
$300.50
|
| Rate for Payer: United Healthcare HMO Rider |
$300.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Vantage Medical Group Senior |
$507.02
|
|
