|
HC CPAP/BIPAP/NIPPV - DAILY
|
Facility
|
IP
|
$5,035.00
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
900800110
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,208.40 |
| Max. Negotiated Rate |
$4,279.75 |
| Rate for Payer: Cash Price |
$2,265.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,014.00
|
| Rate for Payer: Galaxy Health WC |
$4,279.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,021.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,358.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,918.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.40
|
| Rate for Payer: Multiplan Commercial |
$4,028.00
|
| Rate for Payer: Networks By Design Commercial |
$3,272.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,279.75
|
|
|
HC CPAP/BIPAP/NIPPV - DAILY
|
Facility
|
OP
|
$5,035.00
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
900800110
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$77.52 |
| Max. Negotiated Rate |
$4,279.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$237.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$399.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$293.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$266.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,021.00
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$2,265.75
|
| Rate for Payer: Cash Price |
$2,265.75
|
| Rate for Payer: Cash Price |
$2,265.75
|
| Rate for Payer: Cash Price |
$2,265.75
|
| Rate for Payer: Cigna of CA HMO |
$3,222.40
|
| Rate for Payer: Cigna of CA PPO |
$3,725.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$399.74
|
| Rate for Payer: Dignity Health Media |
$266.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$293.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$266.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$266.49
|
| Rate for Payer: Galaxy Health WC |
$4,279.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,021.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,776.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$437.04
|
| Rate for Payer: Heritage Provider Network Transplant |
$437.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$431.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$431.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$266.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,358.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$266.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$357.10
|
| Rate for Payer: Multiplan Commercial |
$4,028.00
|
| Rate for Payer: Networks By Design Commercial |
$3,272.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,279.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,021.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,021.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$399.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$293.14
|
| Rate for Payer: Vantage Medical Group Senior |
$266.49
|
|
|
HC C-REACTIVE PROTEIN
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
900910887
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$47.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.17
|
| Rate for Payer: Blue Distinction Transplant |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$11.63
|
| Rate for Payer: Blue Shield of California EPN |
$9.22
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Media |
$5.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC C-REACTIVE PROTEIN HI SENSITIVITY
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
900912102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.64 |
| Max. Negotiated Rate |
$118.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.06
|
| Rate for Payer: Blue Distinction Transplant |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$23.26
|
| Rate for Payer: Blue Shield of California EPN |
$18.43
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna of CA HMO |
$23.04
|
| Rate for Payer: Cigna of CA PPO |
$26.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.42
|
| Rate for Payer: Dignity Health Media |
$12.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.95
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$21.24
|
| Rate for Payer: Heritage Provider Network Transplant |
$21.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$20.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.35
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.49
|
| Rate for Payer: United Healthcare All Other HMO |
$10.49
|
| Rate for Payer: United Healthcare HMO Rider |
$10.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Senior |
$12.95
|
|
|
HC CREATINE KINASE
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
900910222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.27 |
| Max. Negotiated Rate |
$59.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.83
|
| Rate for Payer: Blue Distinction Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$15.50
|
| Rate for Payer: Blue Shield of California EPN |
$12.29
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.76
|
| Rate for Payer: Dignity Health Media |
$6.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.51
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.68
|
| Rate for Payer: Heritage Provider Network Transplant |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$10.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.72
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.27
|
| Rate for Payer: United Healthcare All Other HMO |
$5.27
|
| Rate for Payer: United Healthcare HMO Rider |
$5.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Vantage Medical Group Senior |
$6.51
|
|
|
HC CREATININE
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$46.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.68
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.69
|
| Rate for Payer: Blue Shield of California EPN |
$7.68
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Media |
$5.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.12
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.40
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CREATININE BODY FLUID
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
900910377
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$47.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.17
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.69
|
| Rate for Payer: Blue Shield of California EPN |
$7.68
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Media |
$5.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.18
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.94
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC CREATININE CLEARAN
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
900910260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$86.06 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.06
|
| Rate for Payer: Blue Distinction Transplant |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$23.26
|
| Rate for Payer: Blue Shield of California EPN |
$18.43
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cigna of CA HMO |
$23.04
|
| Rate for Payer: Cigna of CA PPO |
$26.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.19
|
| Rate for Payer: Dignity Health Media |
$9.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.46
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.51
|
| Rate for Payer: Heritage Provider Network Transplant |
$15.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$15.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.68
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.66
|
| Rate for Payer: United Healthcare All Other HMO |
$7.66
|
| Rate for Payer: United Healthcare HMO Rider |
$7.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.41
|
| Rate for Payer: Vantage Medical Group Senior |
$9.46
|
|
|
HC CREATININE INDIVIDUAL
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
900910493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$46.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$42.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.68
|
| Rate for Payer: Blue Distinction Transplant |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.69
|
| Rate for Payer: Blue Shield of California EPN |
$7.68
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.68
|
| Rate for Payer: Dignity Health Media |
$5.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.12
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.40
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.15
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.63
|
| Rate for Payer: Vantage Medical Group Senior |
$5.12
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
IP
|
$6,354.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,524.96 |
| Max. Negotiated Rate |
$5,400.90 |
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,541.60
|
| Rate for Payer: Galaxy Health WC |
$5,400.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,812.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,238.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,420.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.96
|
| Rate for Payer: Multiplan Commercial |
$5,083.20
|
| Rate for Payer: Networks By Design Commercial |
$4,130.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,400.90
|
|
|
HC CRITICAL CARE ADDL 30 MIN
|
Facility
|
OP
|
$6,354.00
|
|
|
Service Code
|
CPT 99292
|
| Hospital Charge Code |
900501641
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.91 |
| Max. Negotiated Rate |
$5,400.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,494.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,494.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,812.40
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cash Price |
$2,859.30
|
| Rate for Payer: Cigna of CA PPO |
$4,701.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Dignity Health Media |
$5,400.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,400.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,541.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,541.60
|
| Rate for Payer: Galaxy Health WC |
$5,400.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,812.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,765.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,238.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.96
|
| Rate for Payer: Multiplan Commercial |
$5,083.20
|
| Rate for Payer: Networks By Design Commercial |
$4,130.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,400.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,812.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,177.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,177.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,177.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,177.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,400.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,400.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,400.90
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
OP
|
$12,719.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$231.04 |
| Max. Negotiated Rate |
$10,811.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,219.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,108.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,631.40
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: Cigna of CA PPO |
$9,412.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Dignity Health Media |
$1,108.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,219.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,496.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,108.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,108.71
|
| Rate for Payer: Galaxy Health WC |
$10,811.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,631.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,539.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,818.28
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,818.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,108.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,483.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,108.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,052.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,396.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,485.67
|
| Rate for Payer: Multiplan Commercial |
$10,175.20
|
| Rate for Payer: Networks By Design Commercial |
$8,267.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,811.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,631.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,631.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,690.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,039.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,435.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,663.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,219.58
|
| Rate for Payer: Vantage Medical Group Senior |
$1,108.71
|
|
|
HC CRITICAL CARE E&M 30-74 MIN
|
Facility
|
IP
|
$12,719.00
|
|
|
Service Code
|
CPT 99291
|
| Hospital Charge Code |
900509291
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,052.56 |
| Max. Negotiated Rate |
$10,811.15 |
| Rate for Payer: Cash Price |
$5,723.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,087.60
|
| Rate for Payer: Galaxy Health WC |
$10,811.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,631.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,483.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,845.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,052.56
|
| Rate for Payer: Multiplan Commercial |
$10,175.20
|
| Rate for Payer: Networks By Design Commercial |
$8,267.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,811.15
|
|
|
HC CRPRA CVRNSA-CRPS SPNGSM SHNT, UNI OR BI
|
Facility
|
IP
|
$9,452.00
|
|
|
Service Code
|
CPT 54430
|
| Hospital Charge Code |
900504430
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,268.48 |
| Max. Negotiated Rate |
$8,034.20 |
| Rate for Payer: Cash Price |
$4,253.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,780.80
|
| Rate for Payer: Galaxy Health WC |
$8,034.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,671.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,304.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,601.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.48
|
| Rate for Payer: Multiplan Commercial |
$7,561.60
|
| Rate for Payer: Networks By Design Commercial |
$6,143.80
|
| Rate for Payer: Prime Health Services Commercial |
$8,034.20
|
|
|
HC CRPRA CVRNSA-CRPS SPNGSM SHNT, UNI OR BI
|
Facility
|
OP
|
$9,452.00
|
|
|
Service Code
|
CPT 54430
|
| Hospital Charge Code |
900504430
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$929.48 |
| Max. Negotiated Rate |
$8,034.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,034.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,198.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,198.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,671.20
|
| Rate for Payer: Cash Price |
$4,253.40
|
| Rate for Payer: Cash Price |
$4,253.40
|
| Rate for Payer: Cash Price |
$4,253.40
|
| Rate for Payer: Cigna of CA PPO |
$6,994.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,034.20
|
| Rate for Payer: Dignity Health Media |
$8,034.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,034.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,780.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,780.80
|
| Rate for Payer: Galaxy Health WC |
$8,034.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,671.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,089.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,304.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$929.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.48
|
| Rate for Payer: Multiplan Commercial |
$7,561.60
|
| Rate for Payer: Networks By Design Commercial |
$6,143.80
|
| Rate for Payer: Prime Health Services Commercial |
$8,034.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,671.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,726.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,726.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,726.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,034.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,034.20
|
| Rate for Payer: Vantage Medical Group Senior |
$8,034.20
|
|
|
HC CRYABLATION BONE
|
Facility
|
IP
|
$19,181.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,603.44 |
| Max. Negotiated Rate |
$16,303.85 |
| Rate for Payer: Cash Price |
$8,631.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,672.40
|
| Rate for Payer: Galaxy Health WC |
$16,303.85
|
| Rate for Payer: Global Benefits Group Commercial |
$11,508.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,793.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,307.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,603.44
|
| Rate for Payer: Multiplan Commercial |
$15,344.80
|
| Rate for Payer: Networks By Design Commercial |
$12,467.65
|
| Rate for Payer: Prime Health Services Commercial |
$16,303.85
|
|
|
HC CRYABLATION BONE
|
Facility
|
OP
|
$19,181.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$16,303.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,428.04
|
| Rate for Payer: Blue Distinction Transplant |
$11,508.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$8,631.45
|
| Rate for Payer: Cash Price |
$8,631.45
|
| Rate for Payer: Cigna of CA PPO |
$14,193.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$16,303.85
|
| Rate for Payer: Global Benefits Group Commercial |
$11,508.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14,385.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$483.21
|
| Rate for Payer: Heritage Provider Network Transplant |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$477.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$477.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,793.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,603.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$15,344.80
|
| Rate for Payer: Networks By Design Commercial |
$12,467.65
|
| Rate for Payer: Prime Health Services Commercial |
$16,303.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,508.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CRYABLATION BONE
|
Facility
|
IP
|
$19,181.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,603.44 |
| Max. Negotiated Rate |
$16,303.85 |
| Rate for Payer: Cash Price |
$8,631.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,672.40
|
| Rate for Payer: Galaxy Health WC |
$16,303.85
|
| Rate for Payer: Global Benefits Group Commercial |
$11,508.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,793.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,307.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,603.44
|
| Rate for Payer: Multiplan Commercial |
$15,344.80
|
| Rate for Payer: Networks By Design Commercial |
$12,467.65
|
| Rate for Payer: Prime Health Services Commercial |
$16,303.85
|
|
|
HC CRYABLATION BONE
|
Facility
|
OP
|
$19,181.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$16,303.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$11,508.60
|
| Rate for Payer: Cash Price |
$8,631.45
|
| Rate for Payer: Cash Price |
$8,631.45
|
| Rate for Payer: Cash Price |
$8,631.45
|
| Rate for Payer: Cigna of CA PPO |
$14,193.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$16,303.85
|
| Rate for Payer: Global Benefits Group Commercial |
$11,508.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14,385.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$483.21
|
| Rate for Payer: Heritage Provider Network Transplant |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,793.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,603.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$15,344.80
|
| Rate for Payer: Networks By Design Commercial |
$12,467.65
|
| Rate for Payer: Prime Health Services Commercial |
$16,303.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,508.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,590.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,590.50
|
| Rate for Payer: United Healthcare HMO Rider |
$9,590.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,590.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CRYOABLATION-LUNG
|
Facility
|
IP
|
$10,099.00
|
|
|
Service Code
|
CPT 32994
|
| Hospital Charge Code |
909020150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,423.76 |
| Max. Negotiated Rate |
$8,584.15 |
| Rate for Payer: Cash Price |
$4,544.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,039.60
|
| Rate for Payer: Galaxy Health WC |
$8,584.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,059.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,736.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,847.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,423.76
|
| Rate for Payer: Multiplan Commercial |
$8,079.20
|
| Rate for Payer: Networks By Design Commercial |
$6,564.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,584.15
|
|
|
HC CRYOABLATION-LUNG
|
Facility
|
OP
|
$10,099.00
|
|
|
Service Code
|
CPT 32994
|
| Hospital Charge Code |
909020150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,351.09 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,628.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,059.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$4,544.55
|
| Rate for Payer: Cash Price |
$4,544.55
|
| Rate for Payer: Cigna of CA PPO |
$7,473.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Dignity Health Media |
$12,861.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,147.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Galaxy Health WC |
$8,584.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,059.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,574.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,092.55
|
| Rate for Payer: Heritage Provider Network Transplant |
$21,092.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20,835.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$20,835.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,861.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,736.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,941.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,423.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,205.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan Commercial |
$8,079.20
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Networks By Design Commercial |
$6,564.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,584.15
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,059.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
HC CRYO ABLAT LIVER TUMOR
|
Facility
|
IP
|
$9,806.00
|
|
|
Service Code
|
CPT 47381
|
| Hospital Charge Code |
909000269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,353.44 |
| Max. Negotiated Rate |
$8,335.10 |
| Rate for Payer: Cash Price |
$4,412.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,922.40
|
| Rate for Payer: Galaxy Health WC |
$8,335.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,883.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,540.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,736.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,353.44
|
| Rate for Payer: Multiplan Commercial |
$7,844.80
|
| Rate for Payer: Networks By Design Commercial |
$6,373.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,335.10
|
|
|
HC CRYO ABLAT LIVER TUMOR
|
Facility
|
OP
|
$9,806.00
|
|
|
Service Code
|
CPT 47381
|
| Hospital Charge Code |
909000269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$350.15 |
| Max. Negotiated Rate |
$13,086.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,086.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,335.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,393.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,393.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,883.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$4,412.70
|
| Rate for Payer: Cash Price |
$4,412.70
|
| Rate for Payer: Cigna of CA PPO |
$7,256.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,335.10
|
| Rate for Payer: Dignity Health Media |
$8,335.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,335.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,922.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,922.40
|
| Rate for Payer: Galaxy Health WC |
$8,335.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,883.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,354.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,540.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,353.44
|
| Rate for Payer: Multiplan Commercial |
$7,844.80
|
| Rate for Payer: Networks By Design Commercial |
$6,373.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,335.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,883.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,335.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,335.10
|
| Rate for Payer: Vantage Medical Group Senior |
$8,335.10
|
|
|
HC CRYO ABLAT RENAL TUMOR
|
Facility
|
IP
|
$20,105.00
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
909000268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,825.20 |
| Max. Negotiated Rate |
$17,089.25 |
| Rate for Payer: Cash Price |
$9,047.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,042.00
|
| Rate for Payer: Galaxy Health WC |
$17,089.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,063.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,410.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,660.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,825.20
|
| Rate for Payer: Multiplan Commercial |
$16,084.00
|
| Rate for Payer: Networks By Design Commercial |
$13,068.25
|
| Rate for Payer: Prime Health Services Commercial |
$17,089.25
|
|
|
HC CRYO ABLAT RENAL TUMOR
|
Facility
|
OP
|
$20,105.00
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
909000268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,686.96 |
| Max. Negotiated Rate |
$30,715.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,715.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: Blue Distinction Transplant |
$12,063.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$9,047.25
|
| Rate for Payer: Cash Price |
$9,047.25
|
| Rate for Payer: Cigna of CA PPO |
$14,877.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Dignity Health Media |
$12,861.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,147.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Galaxy Health WC |
$17,089.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,063.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15,078.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,092.55
|
| Rate for Payer: Heritage Provider Network Transplant |
$21,092.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20,835.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$20,835.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,861.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,410.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,401.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,825.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,205.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan Commercial |
$16,084.00
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Networks By Design Commercial |
$13,068.25
|
| Rate for Payer: Prime Health Services Commercial |
$17,089.25
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,063.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
