|
HC WALK AIDE ELECTRODES 1PK(4)
|
Facility
|
OP
|
$35.00
|
|
|
Service Code
|
CPT L2999
|
| Hospital Charge Code |
915380018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$29.75 |
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.49
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cigna of CA HMO |
$22.40
|
| Rate for Payer: Cigna of CA PPO |
$25.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$28.00
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.50
|
| Rate for Payer: United Healthcare All Other HMO |
$17.50
|
| Rate for Payer: United Healthcare HMO Rider |
$17.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.75
|
| Rate for Payer: Vantage Medical Group Senior |
$29.75
|
|
|
HC WALNUT TREE IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900901631
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$156.13 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.13
|
| Rate for Payer: Blue Shield of California Commercial |
$44.15
|
| Rate for Payer: Blue Shield of California EPN |
$29.17
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$52.80
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC WALNUT TREE IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900901631
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Multiplan Commercial |
$52.80
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC WART DESTRUCTION MULTIPLE
|
Facility
|
OP
|
$8,879.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
910400034
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$9,590.00 |
| Rate for Payer: Adventist Health Commercial |
$1,775.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$3,995.55
|
| Rate for Payer: Cash Price |
$3,995.55
|
| Rate for Payer: Cash Price |
$3,995.55
|
| Rate for Payer: Cigna of CA HMO |
$5,682.56
|
| Rate for Payer: Cigna of CA PPO |
$6,570.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.22
|
| Rate for Payer: Galaxy Health WC |
$7,547.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,327.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$206.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,922.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,130.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.45
|
| Rate for Payer: Multiplan Commercial |
$7,103.20
|
| Rate for Payer: Networks By Design Commercial |
$5,771.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,547.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,327.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,327.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,439.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,439.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,439.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,439.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,324.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC WART DESTRUCTION MULTIPLE
|
Facility
|
IP
|
$8,879.00
|
|
|
Service Code
|
CPT 56515
|
| Hospital Charge Code |
910400034
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,775.80 |
| Max. Negotiated Rate |
$7,547.15 |
| Rate for Payer: Adventist Health Commercial |
$1,775.80
|
| Rate for Payer: Cash Price |
$3,995.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,551.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,551.60
|
| Rate for Payer: Galaxy Health WC |
$7,547.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,327.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,922.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,382.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,496.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,130.96
|
| Rate for Payer: Multiplan Commercial |
$7,103.20
|
| Rate for Payer: Networks By Design Commercial |
$5,771.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,547.15
|
|
|
HC WART DESTRUCTION SINGLE
|
Facility
|
OP
|
$7,431.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
910400033
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$303.11 |
| Max. Negotiated Rate |
$6,316.35 |
| Rate for Payer: Adventist Health Commercial |
$1,486.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$3,343.95
|
| Rate for Payer: Cash Price |
$3,343.95
|
| Rate for Payer: Cash Price |
$3,343.95
|
| Rate for Payer: Cigna of CA HMO |
$4,755.84
|
| Rate for Payer: Cigna of CA PPO |
$5,498.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.22
|
| Rate for Payer: Galaxy Health WC |
$6,316.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,458.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$303.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,956.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,783.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.45
|
| Rate for Payer: Multiplan Commercial |
$5,944.80
|
| Rate for Payer: Networks By Design Commercial |
$4,830.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,316.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,458.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,458.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,715.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,715.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,715.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,715.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,324.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC WART DESTRUCTION SINGLE
|
Facility
|
IP
|
$7,431.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
910400033
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,486.20 |
| Max. Negotiated Rate |
$6,316.35 |
| Rate for Payer: Adventist Health Commercial |
$1,486.20
|
| Rate for Payer: Cash Price |
$3,343.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,972.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,972.40
|
| Rate for Payer: Galaxy Health WC |
$6,316.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,458.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,956.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,831.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,599.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,783.44
|
| Rate for Payer: Multiplan Commercial |
$5,944.80
|
| Rate for Payer: Networks By Design Commercial |
$4,830.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,316.35
|
|
|
HC WASHING OF COMPONENTS RBC
|
Facility
|
OP
|
$397.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904568
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.44 |
| Max. Negotiated Rate |
$337.45 |
| Rate for Payer: Adventist Health Commercial |
$79.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$260.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.80
|
| Rate for Payer: Blue Shield of California Commercial |
$265.59
|
| Rate for Payer: Blue Shield of California EPN |
$175.47
|
| Rate for Payer: Cash Price |
$178.65
|
| Rate for Payer: Cash Price |
$178.65
|
| Rate for Payer: Cigna of CA HMO |
$254.08
|
| Rate for Payer: Cigna of CA PPO |
$293.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.01
|
| Rate for Payer: EPIC Health Plan Senior |
$31.12
|
| Rate for Payer: Galaxy Health WC |
$337.45
|
| Rate for Payer: Global Benefits Group Commercial |
$238.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$51.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$264.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.70
|
| Rate for Payer: Multiplan Commercial |
$317.60
|
| Rate for Payer: Networks By Design Commercial |
$258.05
|
| Rate for Payer: Prime Health Services Commercial |
$337.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$238.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$238.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.44
|
| Rate for Payer: United Healthcare All Other HMO |
$20.44
|
| Rate for Payer: United Healthcare HMO Rider |
$20.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.44
|
| Rate for Payer: Upland Medical Group Pediatric |
$31.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.23
|
| Rate for Payer: Vantage Medical Group Senior |
$31.12
|
|
|
HC WASHING OF COMPONENTS RBC
|
Facility
|
IP
|
$397.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904568
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$337.45 |
| Rate for Payer: Adventist Health Commercial |
$79.40
|
| Rate for Payer: Cash Price |
$178.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.80
|
| Rate for Payer: EPIC Health Plan Senior |
$158.80
|
| Rate for Payer: Galaxy Health WC |
$337.45
|
| Rate for Payer: Global Benefits Group Commercial |
$238.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$264.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$245.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.28
|
| Rate for Payer: Multiplan Commercial |
$317.60
|
| Rate for Payer: Networks By Design Commercial |
$258.05
|
| Rate for Payer: Prime Health Services Commercial |
$337.45
|
|
|
HC WASP VENOM IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913640
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Multiplan Commercial |
$52.80
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC WASP VENOM IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913640
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$156.13 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.13
|
| Rate for Payer: Blue Shield of California Commercial |
$44.15
|
| Rate for Payer: Blue Shield of California EPN |
$29.17
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$52.80
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC WATCHMAN B/S ACCESS SHEATH
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
906812701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC WATCHMAN B/S ACCESS SHEATH
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
906812701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,558.01
|
| 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 |
$2,394.99
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 WATCHMAN B/S CLOSURE DEVICE
|
Facility
|
OP
|
$35,250.00
|
|
| Hospital Charge Code |
906812700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,050.00 |
| Max. Negotiated Rate |
$29,962.50 |
| Rate for Payer: Adventist Health Commercial |
$7,050.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23,120.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29,962.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19,387.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26,437.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,647.03
|
| Rate for Payer: Cash Price |
$15,862.50
|
| Rate for Payer: Cigna of CA HMO |
$22,560.00
|
| Rate for Payer: Cigna of CA PPO |
$26,085.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29,962.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$29,962.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29,962.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14,100.00
|
| Rate for Payer: Galaxy Health WC |
$29,962.50
|
| Rate for Payer: Global Benefits Group Commercial |
$21,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,511.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,430.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,819.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,460.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,675.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,675.00
|
| Rate for Payer: Multiplan Commercial |
$28,200.00
|
| Rate for Payer: Networks By Design Commercial |
$22,912.50
|
| Rate for Payer: Prime Health Services Commercial |
$29,962.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21,150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,625.00
|
| Rate for Payer: United Healthcare All Other HMO |
$17,625.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,625.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,625.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29,962.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29,962.50
|
| Rate for Payer: Vantage Medical Group Senior |
$29,962.50
|
|
|
HC WATCHMAN B/S CLOSURE DEVICE
|
Facility
|
IP
|
$35,250.00
|
|
| Hospital Charge Code |
906812700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,050.00 |
| Max. Negotiated Rate |
$29,962.50 |
| Rate for Payer: Adventist Health Commercial |
$7,050.00
|
| Rate for Payer: Cash Price |
$15,862.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14,100.00
|
| Rate for Payer: Galaxy Health WC |
$29,962.50
|
| Rate for Payer: Global Benefits Group Commercial |
$21,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,511.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,430.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,819.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,460.00
|
| Rate for Payer: Multiplan Commercial |
$28,200.00
|
| Rate for Payer: Networks By Design Commercial |
$22,912.50
|
| Rate for Payer: Prime Health Services Commercial |
$29,962.50
|
|
|
HC WC ELECT STIM UNATTEND WOUND CARE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT G0282
|
| Hospital Charge Code |
900400045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.84 |
| Max. Negotiated Rate |
$457.00 |
| Rate for Payer: Adventist Health Commercial |
$27.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.50
|
| 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 |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.20
|
| Rate for Payer: Multiplan Commercial |
$52.80
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| 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 |
$56.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.10
|
| Rate for Payer: Vantage Medical Group Senior |
$56.10
|
|
|
HC WC ELECT STIM UNATTEND WOUND CARE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT G0282
|
| Hospital Charge Code |
900400045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Multiplan Commercial |
$52.80
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC WC EVAL RX SPEECH DVC 1ST HR
|
Facility
|
OP
|
$560.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000018
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$476.00 |
| Rate for Payer: Adventist Health Commercial |
$229.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$367.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$476.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$308.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$420.00
|
| 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 |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cigna of CA HMO |
$358.40
|
| Rate for Payer: Cigna of CA PPO |
$414.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$476.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$476.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$476.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.00
|
| Rate for Payer: EPIC Health Plan Senior |
$224.00
|
| Rate for Payer: Galaxy Health WC |
$476.00
|
| Rate for Payer: Global Benefits Group Commercial |
$336.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$161.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$373.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$346.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$392.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$392.00
|
| Rate for Payer: Multiplan Commercial |
$448.00
|
| Rate for Payer: Networks By Design Commercial |
$364.00
|
| Rate for Payer: Prime Health Services Commercial |
$476.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$336.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$336.00
|
| 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 |
$476.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$476.00
|
| Rate for Payer: Vantage Medical Group Senior |
$476.00
|
|
|
HC WC EVAL RX SPEECH DVC 1ST HR
|
Facility
|
IP
|
$560.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000018
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$476.00 |
| Rate for Payer: Adventist Health Commercial |
$112.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.00
|
| Rate for Payer: EPIC Health Plan Senior |
$224.00
|
| Rate for Payer: Galaxy Health WC |
$476.00
|
| Rate for Payer: Global Benefits Group Commercial |
$336.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$373.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$213.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$346.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.40
|
| Rate for Payer: Multiplan Commercial |
$448.00
|
| Rate for Payer: Networks By Design Commercial |
$364.00
|
| Rate for Payer: Prime Health Services Commercial |
$476.00
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
IP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
905356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,594.80 |
| Max. Negotiated Rate |
$15,277.90 |
| Rate for Payer: Adventist Health Commercial |
$3,594.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,988.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,848.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,125.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,313.76
|
| Rate for Payer: Multiplan Commercial |
$14,379.20
|
| Rate for Payer: Networks By Design Commercial |
$8,987.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
OP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
915356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,313.76 |
| Max. Negotiated Rate |
$15,277.90 |
| Rate for Payer: Adventist Health Commercial |
$7,369.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,885.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,480.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,410.54
|
| Rate for Payer: Blue Shield of California Commercial |
$13,264.81
|
| Rate for Payer: Blue Shield of California EPN |
$8,735.36
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,277.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,277.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5,646.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,988.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,385.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,125.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,313.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,581.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,581.80
|
| Rate for Payer: Multiplan Commercial |
$14,379.20
|
| Rate for Payer: Networks By Design Commercial |
$8,987.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,784.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Senior |
$15,277.90
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
IP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
915356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,594.80 |
| Max. Negotiated Rate |
$15,277.90 |
| Rate for Payer: Adventist Health Commercial |
$3,594.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,988.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,848.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,125.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,313.76
|
| Rate for Payer: Multiplan Commercial |
$14,379.20
|
| Rate for Payer: Networks By Design Commercial |
$8,987.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
OP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
905356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,313.76 |
| Max. Negotiated Rate |
$15,277.90 |
| Rate for Payer: Adventist Health Commercial |
$7,369.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,885.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,480.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,410.54
|
| Rate for Payer: Blue Shield of California Commercial |
$13,264.81
|
| Rate for Payer: Blue Shield of California EPN |
$8,735.36
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,277.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,277.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5,646.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,988.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,385.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,125.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,313.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,581.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,581.80
|
| Rate for Payer: Multiplan Commercial |
$14,379.20
|
| Rate for Payer: Networks By Design Commercial |
$8,987.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,784.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Senior |
$15,277.90
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
IP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
905356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,069.40 |
| Max. Negotiated Rate |
$17,294.95 |
| Rate for Payer: Adventist Health Commercial |
$4,069.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,571.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,752.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,594.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,883.28
|
| Rate for Payer: Multiplan Commercial |
$16,277.60
|
| Rate for Payer: Networks By Design Commercial |
$10,173.50
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
OP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
915356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,883.28 |
| Max. Negotiated Rate |
$17,294.95 |
| Rate for Payer: Adventist Health Commercial |
$8,342.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,190.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,260.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,784.98
|
| Rate for Payer: Blue Shield of California Commercial |
$15,016.09
|
| Rate for Payer: Blue Shield of California EPN |
$9,888.64
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,294.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,294.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,435.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,571.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,278.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,594.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,883.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,242.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,242.90
|
| Rate for Payer: Multiplan Commercial |
$16,277.60
|
| Rate for Payer: Networks By Design Commercial |
$10,173.50
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,208.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,208.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Senior |
$17,294.95
|
|
