|
HC APHERESIS WBC
|
Facility
|
OP
|
$13,218.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
946100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,641.85 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,643.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$5,948.10
|
| Rate for Payer: Cash Price |
$5,948.10
|
| Rate for Payer: Cash Price |
$5,948.10
|
| Rate for Payer: Cigna of CA HMO |
$8,459.52
|
| Rate for Payer: Cigna of CA PPO |
$9,781.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$11,235.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,930.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,641.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,393.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,172.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,523.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$10,574.40
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,591.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,235.30
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,930.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,609.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$13,218.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,643.60 |
| Max. Negotiated Rate |
$11,235.30 |
| Rate for Payer: Adventist Health Commercial |
$2,643.60
|
| Rate for Payer: Cash Price |
$5,948.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,287.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,287.20
|
| Rate for Payer: Galaxy Health WC |
$11,235.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,930.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,393.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,798.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,172.32
|
| Rate for Payer: Multiplan Commercial |
$10,574.40
|
| Rate for Payer: Networks By Design Commercial |
$8,591.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,235.30
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$13,218.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
946100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,643.60 |
| Max. Negotiated Rate |
$11,235.30 |
| Rate for Payer: Adventist Health Commercial |
$2,643.60
|
| Rate for Payer: Cash Price |
$5,948.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,287.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,287.20
|
| Rate for Payer: Galaxy Health WC |
$11,235.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,930.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,393.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,798.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,172.32
|
| Rate for Payer: Multiplan Commercial |
$10,574.40
|
| Rate for Payer: Networks By Design Commercial |
$8,591.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,235.30
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$13,218.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,641.85 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,643.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$5,948.10
|
| Rate for Payer: Cash Price |
$5,948.10
|
| Rate for Payer: Cash Price |
$5,948.10
|
| Rate for Payer: Cigna of CA HMO |
$8,459.52
|
| Rate for Payer: Cigna of CA PPO |
$9,781.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$11,235.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,930.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,641.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,393.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,172.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,523.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$10,574.40
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,591.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,235.30
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,930.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,609.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC API M 10 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913746
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$16.71 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Senior |
$7.86
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
|
|
HC API M 10 (HONEY BEE), IGE
|
Facility
|
OP
|
$16.38
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913746
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$170.73 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Blue Shield of California Commercial |
$13.70
|
| Rate for Payer: Blue Shield of California Commercial |
$11.42
|
| Rate for Payer: Blue Shield of California Commercial |
$9.06
|
| Rate for Payer: Blue Shield of California Commercial |
$7.55
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$10.48
|
| Rate for Payer: Cigna of CA PPO |
$12.12
|
| Rate for Payer: Cigna of CA PPO |
$14.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$13.92
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$9.83
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Networks By Design Commercial |
$10.65
|
| Rate for Payer: Prime Health Services Commercial |
$13.92
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
|
|
HC API M 1 (HONEY BEE), IGE
|
Facility
|
OP
|
$16.38
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913742
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$170.73 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Blue Shield of California Commercial |
$13.70
|
| Rate for Payer: Blue Shield of California Commercial |
$11.42
|
| Rate for Payer: Blue Shield of California Commercial |
$9.06
|
| Rate for Payer: Blue Shield of California Commercial |
$7.55
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$10.48
|
| Rate for Payer: Cigna of CA PPO |
$12.12
|
| Rate for Payer: Cigna of CA PPO |
$14.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$13.92
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$9.83
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Networks By Design Commercial |
$10.65
|
| Rate for Payer: Prime Health Services Commercial |
$13.92
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
|
|
HC API M 1 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913742
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$16.71 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Senior |
$7.86
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
|
|
HC API M 2 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913743
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$16.71 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Senior |
$7.86
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
|
|
HC API M 2 (HONEY BEE), IGE
|
Facility
|
OP
|
$16.38
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913743
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$170.73 |
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Blue Shield of California Commercial |
$13.70
|
| Rate for Payer: Blue Shield of California Commercial |
$11.42
|
| Rate for Payer: Blue Shield of California Commercial |
$9.06
|
| Rate for Payer: Blue Shield of California Commercial |
$7.55
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$10.48
|
| Rate for Payer: Cigna of CA PPO |
$12.12
|
| Rate for Payer: Cigna of CA PPO |
$14.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$13.92
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$9.83
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Networks By Design Commercial |
$10.65
|
| Rate for Payer: Prime Health Services Commercial |
$13.92
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC API M 3 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913744
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$16.71 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Senior |
$7.86
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
|
|
HC API M 3 (HONEY BEE), IGE
|
Facility
|
OP
|
$16.38
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913744
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$170.73 |
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Blue Shield of California Commercial |
$13.70
|
| Rate for Payer: Blue Shield of California Commercial |
$11.42
|
| Rate for Payer: Blue Shield of California Commercial |
$9.06
|
| Rate for Payer: Blue Shield of California Commercial |
$7.55
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$10.48
|
| Rate for Payer: Cigna of CA PPO |
$12.12
|
| Rate for Payer: Cigna of CA PPO |
$14.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$13.92
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$9.83
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Networks By Design Commercial |
$10.65
|
| Rate for Payer: Prime Health Services Commercial |
$13.92
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC API M 5 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913745
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$16.71 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Senior |
$7.86
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
|
|
HC API M 5 (HONEY BEE), IGE
|
Facility
|
OP
|
$16.38
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913745
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$170.73 |
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Blue Shield of California Commercial |
$13.70
|
| Rate for Payer: Blue Shield of California Commercial |
$11.42
|
| Rate for Payer: Blue Shield of California Commercial |
$9.06
|
| Rate for Payer: Blue Shield of California Commercial |
$7.55
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$10.48
|
| Rate for Payer: Cigna of CA PPO |
$12.12
|
| Rate for Payer: Cigna of CA PPO |
$14.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$13.92
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$9.83
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$15.73
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Networks By Design Commercial |
$10.65
|
| Rate for Payer: Prime Health Services Commercial |
$13.92
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC APLS IGA
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900913647
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$166.77 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$166.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$166.77
|
| Rate for Payer: Blue Shield of California Commercial |
$35.50
|
| Rate for Payer: Blue Shield of California Commercial |
$23.97
|
| Rate for Payer: Blue Shield of California Commercial |
$53.67
|
| Rate for Payer: Blue Shield of California Commercial |
$36.24
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna of CA HMO |
$49.28
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Cigna of CA PPO |
$56.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.52
|
| Rate for Payer: EPIC Health Plan Senior |
$17.68
|
| Rate for Payer: EPIC Health Plan Senior |
$17.68
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.35
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.53
|
| Rate for Payer: Multiplan Commercial |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$41.60
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
|
|
HC APLS IGA
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900913647
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$65.45 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30.80
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.48
|
| Rate for Payer: Multiplan Commercial |
$61.60
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
|
|
HC APLS IGG
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913648
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$84.15 |
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Senior |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.76
|
| Rate for Payer: Multiplan Commercial |
$79.20
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
|
|
HC APLS IGG
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913648
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$211.56 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$211.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$211.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$149.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$149.05
|
| Rate for Payer: Blue Shield of California Commercial |
$45.64
|
| Rate for Payer: Blue Shield of California Commercial |
$45.18
|
| Rate for Payer: Blue Shield of California Commercial |
$69.00
|
| Rate for Payer: Blue Shield of California Commercial |
$68.31
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.99
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: EPIC Health Plan Senior |
$28.00
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$29.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.10
|
| Rate for Payer: Multiplan Commercial |
$79.20
|
| Rate for Payer: Multiplan Commercial |
$78.40
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.45
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
|
|
HC APLS IGM
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900913649
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$65.45 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30.80
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.48
|
| Rate for Payer: Multiplan Commercial |
$61.60
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
|
|
HC APLS IGM
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900913649
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$166.77 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$166.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$166.77
|
| Rate for Payer: Blue Shield of California Commercial |
$35.50
|
| Rate for Payer: Blue Shield of California Commercial |
$23.97
|
| Rate for Payer: Blue Shield of California Commercial |
$53.67
|
| Rate for Payer: Blue Shield of California Commercial |
$36.24
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$34.65
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna of CA HMO |
$49.28
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Cigna of CA PPO |
$56.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.52
|
| Rate for Payer: EPIC Health Plan Senior |
$17.68
|
| Rate for Payer: EPIC Health Plan Senior |
$17.68
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.35
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$23.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.53
|
| Rate for Payer: Multiplan Commercial |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$41.60
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.11
|
|
|
HC APP CAST FINGER
|
Facility
|
OP
|
$501.00
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
900509086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$100.20 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$100.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$209.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$225.45
|
| Rate for Payer: Cash Price |
$225.45
|
| Rate for Payer: Cash Price |
$225.45
|
| Rate for Payer: Cigna of CA HMO |
$320.64
|
| Rate for Payer: Cigna of CA PPO |
$370.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$313.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$209.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$350.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.85
|
| Rate for Payer: EPIC Health Plan Senior |
$229.90
|
| Rate for Payer: Galaxy Health WC |
$425.85
|
| Rate for Payer: Global Benefits Group Commercial |
$300.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$342.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$318.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$135.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$400.80
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$325.65
|
| Rate for Payer: Prime Health Services Commercial |
$425.85
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$300.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$250.50
|
| Rate for Payer: United Healthcare All Other HMO |
$250.50
|
| Rate for Payer: United Healthcare HMO Rider |
$250.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$250.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Vantage Medical Group Senior |
$209.00
|
|
|
HC APP CAST FINGER
|
Facility
|
IP
|
$501.00
|
|
|
Service Code
|
CPT 29086
|
| Hospital Charge Code |
900509086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$100.20 |
| Max. Negotiated Rate |
$425.85 |
| Rate for Payer: Adventist Health Commercial |
$100.20
|
| Rate for Payer: Cash Price |
$225.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$350.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$200.40
|
| Rate for Payer: EPIC Health Plan Senior |
$200.40
|
| Rate for Payer: Galaxy Health WC |
$425.85
|
| Rate for Payer: Global Benefits Group Commercial |
$300.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$318.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$295.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.24
|
| Rate for Payer: Multiplan Commercial |
$400.80
|
| Rate for Payer: Networks By Design Commercial |
$325.65
|
| Rate for Payer: Prime Health Services Commercial |
$425.85
|
|
|
HC APP HIP SPICA CASE-ONE LEG
|
Facility
|
IP
|
$1,020.00
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
900501680
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$867.00 |
| Rate for Payer: Adventist Health Commercial |
$204.00
|
| Rate for Payer: Cash Price |
$459.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$714.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$408.00
|
| Rate for Payer: EPIC Health Plan Senior |
$408.00
|
| Rate for Payer: Galaxy Health WC |
$867.00
|
| Rate for Payer: Global Benefits Group Commercial |
$612.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$647.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$244.80
|
| Rate for Payer: Multiplan Commercial |
$816.00
|
| Rate for Payer: Networks By Design Commercial |
$663.00
|
| Rate for Payer: Prime Health Services Commercial |
$867.00
|
|
|
HC APP HIP SPICA CASE-ONE LEG
|
Facility
|
OP
|
$1,020.00
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
900501680
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$204.00 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$204.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$459.00
|
| Rate for Payer: Cash Price |
$459.00
|
| Rate for Payer: Cash Price |
$459.00
|
| Rate for Payer: Cigna of CA HMO |
$652.80
|
| Rate for Payer: Cigna of CA PPO |
$754.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$395.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$714.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.55
|
| Rate for Payer: EPIC Health Plan Senior |
$395.70
|
| Rate for Payer: Galaxy Health WC |
$867.00
|
| Rate for Payer: Global Benefits Group Commercial |
$612.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$589.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$359.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$647.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$470.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$244.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$453.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$816.00
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$663.00
|
| Rate for Payer: Prime Health Services Commercial |
$867.00
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$612.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$510.00
|
| Rate for Payer: United Healthcare All Other HMO |
$510.00
|
| Rate for Payer: United Healthcare HMO Rider |
$510.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$510.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$359.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Vantage Medical Group Senior |
$359.73
|
|
|
HC APPLICATION HAND WRIST CAST
|
Facility
|
IP
|
$972.00
|
|
|
Service Code
|
CPT 29085
|
| Hospital Charge Code |
901301202
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$194.40 |
| Max. Negotiated Rate |
$826.20 |
| Rate for Payer: Adventist Health Commercial |
$194.40
|
| Rate for Payer: Cash Price |
$437.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$680.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$388.80
|
| Rate for Payer: EPIC Health Plan Senior |
$388.80
|
| Rate for Payer: Galaxy Health WC |
$826.20
|
| Rate for Payer: Global Benefits Group Commercial |
$583.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$617.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$573.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$233.28
|
| Rate for Payer: Multiplan Commercial |
$777.60
|
| Rate for Payer: Networks By Design Commercial |
$631.80
|
| Rate for Payer: Prime Health Services Commercial |
$826.20
|
|
