|
HC BIOPSY SKIN EA ADDL LESION
|
Facility
|
OP
|
$512.00
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
902890012
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$102.40 |
| Max. Negotiated Rate |
$2,489.00 |
| Rate for Payer: Adventist Health Commercial |
$102.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$335.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$435.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$384.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,489.00
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$327.68
|
| Rate for Payer: Cigna of CA PPO |
$378.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$435.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$435.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$204.80
|
| Rate for Payer: EPIC Health Plan Senior |
$204.80
|
| Rate for Payer: Galaxy Health WC |
$435.20
|
| Rate for Payer: Global Benefits Group Commercial |
$307.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$341.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$316.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.40
|
| Rate for Payer: Multiplan Commercial |
$409.60
|
| Rate for Payer: Networks By Design Commercial |
$332.80
|
| Rate for Payer: Prime Health Services Commercial |
$435.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$307.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$307.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$256.00
|
| Rate for Payer: United Healthcare All Other HMO |
$256.00
|
| Rate for Payer: United Healthcare HMO Rider |
$256.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$256.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$435.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.20
|
| Rate for Payer: Vantage Medical Group Senior |
$435.20
|
|
|
HC BIOPSY SKIN EA ADDL LESION
|
Facility
|
IP
|
$512.00
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
902890012
|
|
Hospital Revenue Code
|
280
|
| Min. Negotiated Rate |
$102.40 |
| Max. Negotiated Rate |
$435.20 |
| Rate for Payer: Adventist Health Commercial |
$102.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$204.80
|
| Rate for Payer: EPIC Health Plan Senior |
$204.80
|
| Rate for Payer: Galaxy Health WC |
$435.20
|
| Rate for Payer: Global Benefits Group Commercial |
$307.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$341.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$316.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.88
|
| Rate for Payer: Multiplan Commercial |
$409.60
|
| Rate for Payer: Networks By Design Commercial |
$332.80
|
| Rate for Payer: Prime Health Services Commercial |
$435.20
|
|
|
HC BIOPSY SKIN EA ADDL LESION
|
Facility
|
OP
|
$512.00
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
902890012
|
|
Hospital Revenue Code
|
280
|
| Min. Negotiated Rate |
$102.40 |
| Max. Negotiated Rate |
$3,250.00 |
| Rate for Payer: Adventist Health Commercial |
$102.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$335.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$435.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$384.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$991.00
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$327.68
|
| Rate for Payer: Cigna of CA PPO |
$378.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$435.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$435.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$435.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$204.80
|
| Rate for Payer: EPIC Health Plan Senior |
$204.80
|
| Rate for Payer: Galaxy Health WC |
$435.20
|
| Rate for Payer: Global Benefits Group Commercial |
$307.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$341.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$316.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.40
|
| Rate for Payer: Multiplan Commercial |
$409.60
|
| Rate for Payer: Networks By Design Commercial |
$332.80
|
| Rate for Payer: Prime Health Services Commercial |
$435.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$307.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$307.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,183.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,250.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,912.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,668.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$435.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$435.20
|
| Rate for Payer: Vantage Medical Group Senior |
$435.20
|
|
|
HC BIOPSY SKIN EA ADDL LESION
|
Facility
|
IP
|
$512.00
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
902890012
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$102.40 |
| Max. Negotiated Rate |
$435.20 |
| Rate for Payer: Adventist Health Commercial |
$102.40
|
| Rate for Payer: Cash Price |
$230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$204.80
|
| Rate for Payer: EPIC Health Plan Senior |
$204.80
|
| Rate for Payer: Galaxy Health WC |
$435.20
|
| Rate for Payer: Global Benefits Group Commercial |
$307.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$341.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$316.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.88
|
| Rate for Payer: Multiplan Commercial |
$409.60
|
| Rate for Payer: Networks By Design Commercial |
$332.80
|
| Rate for Payer: Prime Health Services Commercial |
$435.20
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$949.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
900501451
|
|
Hospital Revenue Code
|
280
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$3,250.00 |
| Rate for Payer: Adventist Health Commercial |
$189.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$622.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$806.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$521.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$711.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$991.00
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cigna of CA HMO |
$607.36
|
| Rate for Payer: Cigna of CA PPO |
$702.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$806.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$806.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.60
|
| Rate for Payer: EPIC Health Plan Senior |
$379.60
|
| Rate for Payer: Galaxy Health WC |
$806.65
|
| Rate for Payer: Global Benefits Group Commercial |
$569.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$664.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$664.30
|
| Rate for Payer: Multiplan Commercial |
$759.20
|
| Rate for Payer: Networks By Design Commercial |
$616.85
|
| Rate for Payer: Prime Health Services Commercial |
$806.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$569.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$569.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,183.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,250.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,912.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,668.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$806.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$806.65
|
| Rate for Payer: Vantage Medical Group Senior |
$806.65
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$949.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
900501451
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$189.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$806.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$521.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$711.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$582.78
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cigna of CA HMO |
$607.36
|
| Rate for Payer: Cigna of CA PPO |
$702.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$806.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$806.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.60
|
| Rate for Payer: EPIC Health Plan Senior |
$379.60
|
| Rate for Payer: Galaxy Health WC |
$806.65
|
| Rate for Payer: Global Benefits Group Commercial |
$569.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$664.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$664.30
|
| Rate for Payer: Multiplan Commercial |
$759.20
|
| Rate for Payer: Networks By Design Commercial |
$616.85
|
| Rate for Payer: Prime Health Services Commercial |
$806.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$569.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$569.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$474.50
|
| Rate for Payer: United Healthcare All Other HMO |
$474.50
|
| Rate for Payer: United Healthcare HMO Rider |
$474.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$474.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$806.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$806.65
|
| Rate for Payer: Vantage Medical Group Senior |
$806.65
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$949.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
900501451
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$806.65 |
| Rate for Payer: Adventist Health Commercial |
$189.80
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.60
|
| Rate for Payer: EPIC Health Plan Senior |
$379.60
|
| Rate for Payer: Galaxy Health WC |
$806.65
|
| Rate for Payer: Global Benefits Group Commercial |
$569.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.76
|
| Rate for Payer: Multiplan Commercial |
$759.20
|
| Rate for Payer: Networks By Design Commercial |
$616.85
|
| Rate for Payer: Prime Health Services Commercial |
$806.65
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$949.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
900501451
|
|
Hospital Revenue Code
|
280
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$806.65 |
| Rate for Payer: Adventist Health Commercial |
$189.80
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.60
|
| Rate for Payer: EPIC Health Plan Senior |
$379.60
|
| Rate for Payer: Galaxy Health WC |
$806.65
|
| Rate for Payer: Global Benefits Group Commercial |
$569.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.76
|
| Rate for Payer: Multiplan Commercial |
$759.20
|
| Rate for Payer: Networks By Design Commercial |
$616.85
|
| Rate for Payer: Prime Health Services Commercial |
$806.65
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$949.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
900501451
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$189.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$806.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$521.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$711.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$582.78
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cigna of CA HMO |
$607.36
|
| Rate for Payer: Cigna of CA PPO |
$702.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$806.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$806.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.60
|
| Rate for Payer: EPIC Health Plan Senior |
$379.60
|
| Rate for Payer: Galaxy Health WC |
$806.65
|
| Rate for Payer: Global Benefits Group Commercial |
$569.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$664.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$664.30
|
| Rate for Payer: Multiplan Commercial |
$759.20
|
| Rate for Payer: Networks By Design Commercial |
$616.85
|
| Rate for Payer: Prime Health Services Commercial |
$806.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$569.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$474.50
|
| Rate for Payer: United Healthcare All Other HMO |
$474.50
|
| Rate for Payer: United Healthcare HMO Rider |
$474.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$474.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$806.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$806.65
|
| Rate for Payer: Vantage Medical Group Senior |
$806.65
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$949.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
900501451
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$806.65 |
| Rate for Payer: Adventist Health Commercial |
$189.80
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.60
|
| Rate for Payer: EPIC Health Plan Senior |
$379.60
|
| Rate for Payer: Galaxy Health WC |
$806.65
|
| Rate for Payer: Global Benefits Group Commercial |
$569.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.76
|
| Rate for Payer: Multiplan Commercial |
$759.20
|
| Rate for Payer: Networks By Design Commercial |
$616.85
|
| Rate for Payer: Prime Health Services Commercial |
$806.65
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$949.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
900501451
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Adventist Health Commercial |
$189.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$806.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$521.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$711.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,489.00
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: Cigna of CA HMO |
$607.36
|
| Rate for Payer: Cigna of CA PPO |
$702.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$806.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$806.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.60
|
| Rate for Payer: EPIC Health Plan Senior |
$379.60
|
| Rate for Payer: Galaxy Health WC |
$806.65
|
| Rate for Payer: Global Benefits Group Commercial |
$569.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$664.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$664.30
|
| Rate for Payer: Multiplan Commercial |
$759.20
|
| Rate for Payer: Networks By Design Commercial |
$616.85
|
| Rate for Payer: Prime Health Services Commercial |
$806.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$569.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$474.50
|
| Rate for Payer: United Healthcare All Other HMO |
$474.50
|
| Rate for Payer: United Healthcare HMO Rider |
$474.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$474.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$806.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$806.65
|
| Rate for Payer: Vantage Medical Group Senior |
$806.65
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$1,091.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
909000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$218.20 |
| Max. Negotiated Rate |
$927.35 |
| Rate for Payer: Adventist Health Commercial |
$218.20
|
| Rate for Payer: Cash Price |
$490.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$436.40
|
| Rate for Payer: EPIC Health Plan Senior |
$436.40
|
| Rate for Payer: Galaxy Health WC |
$927.35
|
| Rate for Payer: Global Benefits Group Commercial |
$654.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$727.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$415.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$675.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$261.84
|
| Rate for Payer: Multiplan Commercial |
$872.80
|
| Rate for Payer: Networks By Design Commercial |
$709.15
|
| Rate for Payer: Prime Health Services Commercial |
$927.35
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$949.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
900501451
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$189.80 |
| Max. Negotiated Rate |
$806.65 |
| Rate for Payer: Adventist Health Commercial |
$189.80
|
| Rate for Payer: Cash Price |
$427.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.60
|
| Rate for Payer: EPIC Health Plan Senior |
$379.60
|
| Rate for Payer: Galaxy Health WC |
$806.65
|
| Rate for Payer: Global Benefits Group Commercial |
$569.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$587.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.76
|
| Rate for Payer: Multiplan Commercial |
$759.20
|
| Rate for Payer: Networks By Design Commercial |
$616.85
|
| Rate for Payer: Prime Health Services Commercial |
$806.65
|
|
|
HC BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$1,091.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
909000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$218.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$218.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$927.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$600.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$818.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$669.98
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$490.95
|
| Rate for Payer: Cash Price |
$490.95
|
| Rate for Payer: Cigna of CA HMO |
$698.24
|
| Rate for Payer: Cigna of CA PPO |
$807.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$927.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$927.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$927.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$436.40
|
| Rate for Payer: EPIC Health Plan Senior |
$436.40
|
| Rate for Payer: Galaxy Health WC |
$927.35
|
| Rate for Payer: Global Benefits Group Commercial |
$654.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$727.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$415.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$675.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$261.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$763.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$763.70
|
| Rate for Payer: Multiplan Commercial |
$872.80
|
| Rate for Payer: Networks By Design Commercial |
$709.15
|
| Rate for Payer: Prime Health Services Commercial |
$927.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$654.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$545.50
|
| Rate for Payer: United Healthcare All Other HMO |
$545.50
|
| Rate for Payer: United Healthcare HMO Rider |
$545.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$545.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$927.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$927.35
|
| Rate for Payer: Vantage Medical Group Senior |
$927.35
|
|
|
HC BIOPTOME ARGON JAWZ
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906811728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$380.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$356.18
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC BIOPTOME ARGON JAWZ
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906811728
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC BIOPTOME ATC SPARROWHAWK
|
Facility
|
OP
|
$313.00
|
|
| Hospital Charge Code |
906812372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$266.05 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$205.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$266.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$172.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$234.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$192.21
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$266.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$266.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$266.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$193.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.10
|
| Rate for Payer: Multiplan Commercial |
$250.40
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$187.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.50
|
| Rate for Payer: United Healthcare All Other HMO |
$156.50
|
| Rate for Payer: United Healthcare HMO Rider |
$156.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$156.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$266.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$266.05
|
| Rate for Payer: Vantage Medical Group Senior |
$266.05
|
|
|
HC BIOPTOME ATC SPARROWHAWK
|
Facility
|
IP
|
$313.00
|
|
| Hospital Charge Code |
906812372
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$266.05 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$193.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.12
|
| Rate for Payer: Multiplan Commercial |
$250.40
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC BIVONA ADULT AIRE-CUF 5.0
|
Facility
|
OP
|
$422.87
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
900800818
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$359.44 |
| Rate for Payer: Adventist Health Commercial |
$84.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$359.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.68
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Cigna of CA HMO |
$270.64
|
| Rate for Payer: Cigna of CA PPO |
$312.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$359.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$359.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.15
|
| Rate for Payer: EPIC Health Plan Senior |
$169.15
|
| Rate for Payer: Galaxy Health WC |
$359.44
|
| Rate for Payer: Global Benefits Group Commercial |
$253.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$282.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$261.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$296.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$296.01
|
| Rate for Payer: Multiplan Commercial |
$338.30
|
| Rate for Payer: Networks By Design Commercial |
$274.87
|
| Rate for Payer: Prime Health Services Commercial |
$359.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.44
|
| Rate for Payer: United Healthcare All Other HMO |
$211.44
|
| Rate for Payer: United Healthcare HMO Rider |
$211.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$359.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$359.44
|
| Rate for Payer: Vantage Medical Group Senior |
$359.44
|
|
|
HC BIVONA ADULT AIRE-CUF 5.0
|
Facility
|
IP
|
$422.87
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
900800818
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$359.44 |
| Rate for Payer: Adventist Health Commercial |
$84.57
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.15
|
| Rate for Payer: EPIC Health Plan Senior |
$169.15
|
| Rate for Payer: Galaxy Health WC |
$359.44
|
| Rate for Payer: Global Benefits Group Commercial |
$253.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$282.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$261.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.49
|
| Rate for Payer: Multiplan Commercial |
$338.30
|
| Rate for Payer: Networks By Design Commercial |
$274.87
|
| Rate for Payer: Prime Health Services Commercial |
$359.44
|
|
|
HC BIVONA ADULT AIRE-CUF 6.0
|
Facility
|
OP
|
$422.87
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
900800819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$359.44 |
| Rate for Payer: Adventist Health Commercial |
$84.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$359.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.68
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: Cigna of CA HMO |
$270.64
|
| Rate for Payer: Cigna of CA PPO |
$312.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$359.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$359.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.15
|
| Rate for Payer: EPIC Health Plan Senior |
$169.15
|
| Rate for Payer: Galaxy Health WC |
$359.44
|
| Rate for Payer: Global Benefits Group Commercial |
$253.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$282.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$261.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$296.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$296.01
|
| Rate for Payer: Multiplan Commercial |
$338.30
|
| Rate for Payer: Networks By Design Commercial |
$274.87
|
| Rate for Payer: Prime Health Services Commercial |
$359.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.44
|
| Rate for Payer: United Healthcare All Other HMO |
$211.44
|
| Rate for Payer: United Healthcare HMO Rider |
$211.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$359.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$359.44
|
| Rate for Payer: Vantage Medical Group Senior |
$359.44
|
|
|
HC BIVONA ADULT AIRE-CUF 6.0
|
Facility
|
IP
|
$422.87
|
|
|
Service Code
|
CPT A7521
|
| Hospital Charge Code |
900800819
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.57 |
| Max. Negotiated Rate |
$359.44 |
| Rate for Payer: Adventist Health Commercial |
$84.57
|
| Rate for Payer: Cash Price |
$190.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.15
|
| Rate for Payer: EPIC Health Plan Senior |
$169.15
|
| Rate for Payer: Galaxy Health WC |
$359.44
|
| Rate for Payer: Global Benefits Group Commercial |
$253.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$282.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$161.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$261.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.49
|
| Rate for Payer: Multiplan Commercial |
$338.30
|
| Rate for Payer: Networks By Design Commercial |
$274.87
|
| Rate for Payer: Prime Health Services Commercial |
$359.44
|
|
|
HC BIVONA CUSTOM TRACH TUBE
|
Facility
|
OP
|
$1,350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Adventist Health Commercial |
$270.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$885.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,147.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$742.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,012.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$829.03
|
| Rate for Payer: Cash Price |
$607.50
|
| Rate for Payer: Cigna of CA HMO |
$864.00
|
| Rate for Payer: Cigna of CA PPO |
$999.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,147.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,147.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,147.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$540.00
|
| Rate for Payer: EPIC Health Plan Senior |
$540.00
|
| Rate for Payer: Galaxy Health WC |
$1,147.50
|
| Rate for Payer: Global Benefits Group Commercial |
$810.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$900.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$835.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$945.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$945.00
|
| Rate for Payer: Multiplan Commercial |
$1,080.00
|
| Rate for Payer: Networks By Design Commercial |
$877.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,147.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$810.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$810.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$675.00
|
| Rate for Payer: United Healthcare All Other HMO |
$675.00
|
| Rate for Payer: United Healthcare HMO Rider |
$675.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$675.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,147.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,147.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,147.50
|
|
|
HC BIVONA CUSTOM TRACH TUBE
|
Facility
|
IP
|
$1,350.00
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$270.00 |
| Max. Negotiated Rate |
$1,147.50 |
| Rate for Payer: Adventist Health Commercial |
$270.00
|
| Rate for Payer: Cash Price |
$607.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$540.00
|
| Rate for Payer: EPIC Health Plan Senior |
$540.00
|
| Rate for Payer: Galaxy Health WC |
$1,147.50
|
| Rate for Payer: Global Benefits Group Commercial |
$810.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$900.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$835.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.00
|
| Rate for Payer: Multiplan Commercial |
$1,080.00
|
| Rate for Payer: Networks By Design Commercial |
$877.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,147.50
|
|
|
HC BIVONA HYPERFLEX ADJ TRACH 2.5
|
Facility
|
OP
|
$837.20
|
|
|
Service Code
|
CPT A7520
|
| Hospital Charge Code |
900800801
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$167.44 |
| Max. Negotiated Rate |
$711.62 |
| Rate for Payer: Adventist Health Commercial |
$167.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$549.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$460.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$627.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$514.12
|
| Rate for Payer: Cash Price |
$376.74
|
| Rate for Payer: Cigna of CA HMO |
$535.81
|
| Rate for Payer: Cigna of CA PPO |
$619.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$711.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$711.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$711.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.88
|
| Rate for Payer: EPIC Health Plan Senior |
$334.88
|
| Rate for Payer: Galaxy Health WC |
$711.62
|
| Rate for Payer: Global Benefits Group Commercial |
$502.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$558.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$318.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$518.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$586.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$586.04
|
| Rate for Payer: Multiplan Commercial |
$669.76
|
| Rate for Payer: Networks By Design Commercial |
$544.18
|
| Rate for Payer: Prime Health Services Commercial |
$711.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$502.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$502.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$418.60
|
| Rate for Payer: United Healthcare All Other HMO |
$418.60
|
| Rate for Payer: United Healthcare HMO Rider |
$418.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$418.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$711.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$711.62
|
| Rate for Payer: Vantage Medical Group Senior |
$711.62
|
|
