|
HC ADMIN BEBTELOVIMAB INJ
|
Facility
|
IP
|
$635.00
|
|
|
Service Code
|
CPT M0222
|
| Hospital Charge Code |
949001336
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$127.00 |
| Max. Negotiated Rate |
$539.75 |
| Rate for Payer: Adventist Health Commercial |
$127.00
|
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.00
|
| Rate for Payer: EPIC Health Plan Senior |
$254.00
|
| Rate for Payer: Galaxy Health WC |
$539.75
|
| Rate for Payer: Global Benefits Group Commercial |
$381.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$393.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.40
|
| Rate for Payer: Multiplan Commercial |
$508.00
|
| Rate for Payer: Networks By Design Commercial |
$412.75
|
| Rate for Payer: Prime Health Services Commercial |
$539.75
|
|
|
HC ADMIN BEBTELOVIMAB INJ
|
Facility
|
OP
|
$635.00
|
|
|
Service Code
|
CPT M0222
|
| Hospital Charge Code |
949001336
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$127.00 |
| Max. Negotiated Rate |
$539.75 |
| Rate for Payer: Adventist Health Commercial |
$127.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$416.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$476.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$389.95
|
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: Cigna of CA HMO |
$406.40
|
| Rate for Payer: Cigna of CA PPO |
$469.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$539.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$539.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.00
|
| Rate for Payer: EPIC Health Plan Senior |
$254.00
|
| Rate for Payer: Galaxy Health WC |
$539.75
|
| Rate for Payer: Global Benefits Group Commercial |
$381.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$393.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$444.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$444.50
|
| Rate for Payer: Multiplan Commercial |
$508.00
|
| Rate for Payer: Networks By Design Commercial |
$412.75
|
| Rate for Payer: Prime Health Services Commercial |
$539.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$381.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$381.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.50
|
| Rate for Payer: United Healthcare All Other HMO |
$317.50
|
| Rate for Payer: United Healthcare HMO Rider |
$317.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$317.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$539.75
|
| Rate for Payer: Vantage Medical Group Senior |
$539.75
|
|
|
HC ADMIN FEE
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 99999
|
| Hospital Charge Code |
910400999
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC ADMIN FEE
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 99999
|
| Hospital Charge Code |
910400999
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.85
|
| Rate for Payer: Blue Shield of California Commercial |
$40.14
|
| Rate for Payer: Blue Shield of California EPN |
$26.52
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.00
|
| Rate for Payer: United Healthcare All Other HMO |
$30.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.00
|
| Rate for Payer: Vantage Medical Group Senior |
$51.00
|
|
|
HC ADMINISTRATION OF XOFIGO
|
Facility
|
IP
|
$2,769.00
|
|
|
Service Code
|
CPT 79101
|
| Hospital Charge Code |
909301549
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$553.80 |
| Max. Negotiated Rate |
$2,353.65 |
| Rate for Payer: Adventist Health Commercial |
$553.80
|
| Rate for Payer: Cash Price |
$1,246.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,107.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,107.60
|
| Rate for Payer: Galaxy Health WC |
$2,353.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,661.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,846.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,054.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,714.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$664.56
|
| Rate for Payer: Multiplan Commercial |
$2,215.20
|
| Rate for Payer: Networks By Design Commercial |
$1,799.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,353.65
|
|
|
HC ADMINISTRATION OF XOFIGO
|
Facility
|
OP
|
$2,769.00
|
|
|
Service Code
|
CPT 79101
|
| Hospital Charge Code |
909301549
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$211.92 |
| Max. Negotiated Rate |
$2,353.65 |
| Rate for Payer: Adventist Health Commercial |
$553.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,816.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$427.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$313.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$284.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,700.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,694.63
|
| Rate for Payer: Blue Shield of California EPN |
$1,118.68
|
| Rate for Payer: Cash Price |
$1,246.05
|
| Rate for Payer: Cash Price |
$1,246.05
|
| Rate for Payer: Cigna of CA HMO |
$1,772.16
|
| Rate for Payer: Cigna of CA PPO |
$2,049.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$427.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$313.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$284.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.45
|
| Rate for Payer: EPIC Health Plan Senior |
$284.78
|
| Rate for Payer: Galaxy Health WC |
$2,353.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,661.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$467.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$211.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$284.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,846.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$284.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$664.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$381.61
|
| Rate for Payer: Multiplan Commercial |
$2,215.20
|
| Rate for Payer: Networks By Design Commercial |
$1,799.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,353.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,661.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,661.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$589.62
|
| Rate for Payer: United Healthcare All Other HMO |
$589.62
|
| Rate for Payer: United Healthcare HMO Rider |
$589.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$589.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$284.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$427.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$313.26
|
| Rate for Payer: Vantage Medical Group Senior |
$284.78
|
|
|
HC ADMIN SOTROVIMAB INFUSION MA
|
Facility
|
IP
|
$815.00
|
|
|
Service Code
|
CPT M0247
|
| Hospital Charge Code |
949001325
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$163.00 |
| Max. Negotiated Rate |
$692.75 |
| Rate for Payer: Adventist Health Commercial |
$163.00
|
| Rate for Payer: Cash Price |
$366.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$326.00
|
| Rate for Payer: Galaxy Health WC |
$692.75
|
| Rate for Payer: Global Benefits Group Commercial |
$489.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$543.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$310.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$504.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.60
|
| Rate for Payer: Multiplan Commercial |
$652.00
|
| Rate for Payer: Networks By Design Commercial |
$529.75
|
| Rate for Payer: Prime Health Services Commercial |
$692.75
|
|
|
HC ADMIN SOTROVIMAB INFUSION MA
|
Facility
|
OP
|
$815.00
|
|
|
Service Code
|
CPT M0247
|
| Hospital Charge Code |
949001325
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$163.00 |
| Max. Negotiated Rate |
$692.75 |
| Rate for Payer: Adventist Health Commercial |
$163.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$534.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$692.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$448.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$611.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$500.49
|
| Rate for Payer: Cash Price |
$366.75
|
| Rate for Payer: Cigna of CA HMO |
$521.60
|
| Rate for Payer: Cigna of CA PPO |
$603.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$692.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$692.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$692.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$326.00
|
| Rate for Payer: Galaxy Health WC |
$692.75
|
| Rate for Payer: Global Benefits Group Commercial |
$489.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$543.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$310.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$504.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$570.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$570.50
|
| Rate for Payer: Multiplan Commercial |
$652.00
|
| Rate for Payer: Networks By Design Commercial |
$529.75
|
| Rate for Payer: Prime Health Services Commercial |
$692.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$489.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$489.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$407.50
|
| Rate for Payer: United Healthcare All Other HMO |
$407.50
|
| Rate for Payer: United Healthcare HMO Rider |
$407.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$407.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$692.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$692.75
|
| Rate for Payer: Vantage Medical Group Senior |
$692.75
|
|
|
HC ADMIN VACCINE EA ADDIT
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
908600205
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC ADMIN VACCINE EA ADDIT
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
908600205
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.85
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.00
|
| Rate for Payer: United Healthcare All Other HMO |
$30.00
|
| Rate for Payer: United Healthcare HMO Rider |
$30.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.00
|
| Rate for Payer: Vantage Medical Group Senior |
$51.00
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
941000151
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.00
|
| Rate for Payer: EPIC Health Plan Senior |
$40.00
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
942100151
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$96.15 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.41
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cigna of CA HMO |
$64.00
|
| Rate for Payer: Cigna of CA PPO |
$74.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.15
|
| Rate for Payer: EPIC Health Plan Senior |
$58.63
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$96.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.56
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50.00
|
| Rate for Payer: United Healthcare HMO Rider |
$50.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Vantage Medical Group Senior |
$58.63
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
908600208
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.00
|
| Rate for Payer: EPIC Health Plan Senior |
$40.00
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
908600208
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$96.15 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.41
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cigna of CA HMO |
$64.00
|
| Rate for Payer: Cigna of CA PPO |
$74.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.15
|
| Rate for Payer: EPIC Health Plan Senior |
$58.63
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$96.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.56
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50.00
|
| Rate for Payer: United Healthcare HMO Rider |
$50.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Vantage Medical Group Senior |
$58.63
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
942100151
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.00
|
| Rate for Payer: EPIC Health Plan Senior |
$40.00
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
941000151
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$96.15 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.41
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cigna of CA HMO |
$64.00
|
| Rate for Payer: Cigna of CA PPO |
$74.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.15
|
| Rate for Payer: EPIC Health Plan Senior |
$58.63
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$96.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.56
|
| Rate for Payer: Multiplan Commercial |
$80.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50.00
|
| Rate for Payer: United Healthcare HMO Rider |
$50.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Vantage Medical Group Senior |
$58.63
|
|
|
HC ADMIN VACCINE H1N1
|
Facility
|
OP
|
$170.00
|
|
| Hospital Charge Code |
941009141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$111.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$127.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.40
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO |
$108.80
|
| Rate for Payer: Cigna of CA PPO |
$125.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$144.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$144.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$144.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$105.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$119.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$119.00
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$85.00
|
| Rate for Payer: United Healthcare All Other HMO |
$85.00
|
| Rate for Payer: United Healthcare HMO Rider |
$85.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$144.50
|
| Rate for Payer: Vantage Medical Group Senior |
$144.50
|
|
|
HC ADMIN VACCINE H1N1
|
Facility
|
IP
|
$170.00
|
|
| Hospital Charge Code |
941009141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$105.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
907200502
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$7.49 |
| Max. Negotiated Rate |
$148.31 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.04
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$135.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$90.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.08
|
| Rate for Payer: EPIC Health Plan Senior |
$90.43
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$148.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$90.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$113.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$121.18
|
| Rate for Payer: Multiplan Commercial |
$70.40
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.00
|
| Rate for Payer: United Healthcare All Other HMO |
$44.00
|
| Rate for Payer: United Healthcare HMO Rider |
$44.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$90.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Vantage Medical Group Senior |
$90.43
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
907200502
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$74.80 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.20
|
| Rate for Payer: EPIC Health Plan Senior |
$35.20
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.12
|
| Rate for Payer: Multiplan Commercial |
$70.40
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
CPT 90747
|
| Hospital Charge Code |
908600203
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$73.10 |
| Rate for Payer: Adventist Health Commercial |
$17.20
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.40
|
| Rate for Payer: EPIC Health Plan Senior |
$34.40
|
| Rate for Payer: Galaxy Health WC |
$73.10
|
| Rate for Payer: Global Benefits Group Commercial |
$51.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: Networks By Design Commercial |
$55.90
|
| Rate for Payer: Prime Health Services Commercial |
$73.10
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
CPT 90747
|
| Hospital Charge Code |
908600203
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$391.80 |
| Rate for Payer: Adventist Health Commercial |
$17.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$391.80
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cigna of CA HMO |
$55.04
|
| Rate for Payer: Cigna of CA PPO |
$63.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.40
|
| Rate for Payer: EPIC Health Plan Senior |
$34.40
|
| Rate for Payer: Galaxy Health WC |
$73.10
|
| Rate for Payer: Global Benefits Group Commercial |
$51.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$140.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: Networks By Design Commercial |
$55.90
|
| Rate for Payer: Prime Health Services Commercial |
$73.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.00
|
| Rate for Payer: United Healthcare All Other HMO |
$43.00
|
| Rate for Payer: United Healthcare HMO Rider |
$43.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.10
|
| Rate for Payer: Vantage Medical Group Senior |
$73.10
|
|
|
HC ADMIN VACCINE HEP B ADULT
|
Facility
|
IP
|
$38.00
|
|
| Hospital Charge Code |
908603024
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$32.30 |
| Rate for Payer: Adventist Health Commercial |
$7.60
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.20
|
| Rate for Payer: EPIC Health Plan Senior |
$15.20
|
| Rate for Payer: Galaxy Health WC |
$32.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.12
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: Networks By Design Commercial |
$24.70
|
| Rate for Payer: Prime Health Services Commercial |
$32.30
|
|
|
HC ADMIN VACCINE HEP B ADULT
|
Facility
|
OP
|
$38.00
|
|
| Hospital Charge Code |
908603024
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$32.30 |
| Rate for Payer: Adventist Health Commercial |
$7.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.34
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Cigna of CA HMO |
$24.32
|
| Rate for Payer: Cigna of CA PPO |
$28.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.20
|
| Rate for Payer: EPIC Health Plan Senior |
$15.20
|
| Rate for Payer: Galaxy Health WC |
$32.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.60
|
| Rate for Payer: Multiplan Commercial |
$30.40
|
| Rate for Payer: Networks By Design Commercial |
$24.70
|
| Rate for Payer: Prime Health Services Commercial |
$32.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19.00
|
| Rate for Payer: United Healthcare HMO Rider |
$19.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.30
|
| Rate for Payer: Vantage Medical Group Senior |
$32.30
|
|
|
HC ADMIN VACCINE INFLUENZA 6-35 MON
|
Facility
|
OP
|
$39.00
|
|
| Hospital Charge Code |
908600539
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.95
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.60
|
| Rate for Payer: EPIC Health Plan Senior |
$15.60
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.30
|
| Rate for Payer: Multiplan Commercial |
$31.20
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.50
|
| Rate for Payer: United Healthcare All Other HMO |
$19.50
|
| Rate for Payer: United Healthcare HMO Rider |
$19.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.15
|
| Rate for Payer: Vantage Medical Group Senior |
$33.15
|
|
