|
HC ARWY ORAL NEONATE SZ 1 LMA
|
Facility
|
IP
|
$49.69
|
|
| Hospital Charge Code |
901604968
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$42.24 |
| Rate for Payer: Adventist Health Commercial |
$9.94
|
| Rate for Payer: Cash Price |
$22.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$19.88
|
| Rate for Payer: Galaxy Health WC |
$42.24
|
| Rate for Payer: Global Benefits Group Commercial |
$29.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.93
|
| Rate for Payer: Multiplan Commercial |
$39.75
|
| Rate for Payer: Networks By Design Commercial |
$32.30
|
| Rate for Payer: Prime Health Services Commercial |
$42.24
|
|
|
HC ASPARAGUS IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913632
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Multiplan Commercial |
$52.80
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC ASPARAGUS IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913632
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$163.16 |
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$163.16
|
| Rate for Payer: Blue Shield of California Commercial |
$30.43
|
| Rate for Payer: Blue Shield of California Commercial |
$46.00
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$52.80
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
OP
|
$1,725.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.56 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$345.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$776.25
|
| Rate for Payer: Cash Price |
$776.25
|
| Rate for Payer: Cash Price |
$776.25
|
| Rate for Payer: Cigna of CA HMO |
$1,104.00
|
| Rate for Payer: Cigna of CA PPO |
$1,276.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$482.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$353.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$321.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,207.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$530.23
|
| Rate for Payer: EPIC Health Plan Senior |
$353.49
|
| Rate for Payer: Galaxy Health WC |
$1,466.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,035.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$527.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$87.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$321.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,095.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$449.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$404.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$430.61
|
| Rate for Payer: Multiplan Commercial |
$1,380.00
|
| Rate for Payer: Multiplan WC |
$492.37
|
| Rate for Payer: Networks By Design Commercial |
$1,121.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,466.25
|
| Rate for Payer: Prime Health Services WC |
$487.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,035.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$862.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$321.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Vantage Medical Group Senior |
$321.35
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
IP
|
$1,725.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$345.00 |
| Max. Negotiated Rate |
$1,466.25 |
| Rate for Payer: Adventist Health Commercial |
$345.00
|
| Rate for Payer: Cash Price |
$776.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,207.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$690.00
|
| Rate for Payer: EPIC Health Plan Senior |
$690.00
|
| Rate for Payer: Galaxy Health WC |
$1,466.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,035.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,095.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,017.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.00
|
| Rate for Payer: Multiplan Commercial |
$1,380.00
|
| Rate for Payer: Networks By Design Commercial |
$1,121.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,466.25
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
OP
|
$1,725.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$99.03 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Cigna of CA PPO |
$1,276.50
|
| Rate for Payer: Adventist Health Commercial |
$345.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$776.25
|
| Rate for Payer: Cash Price |
$776.25
|
| Rate for Payer: Cash Price |
$776.25
|
| Rate for Payer: Cigna of CA HMO |
$1,104.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$482.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$353.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$321.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,207.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$530.23
|
| Rate for Payer: EPIC Health Plan Senior |
$353.49
|
| Rate for Payer: Galaxy Health WC |
$1,466.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,035.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$527.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$321.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,095.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$345.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$404.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$430.61
|
| Rate for Payer: Multiplan Commercial |
$1,380.00
|
| Rate for Payer: Multiplan WC |
$492.37
|
| Rate for Payer: Networks By Design Commercial |
$1,121.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,466.25
|
| Rate for Payer: Prime Health Services WC |
$487.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,035.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$862.50
|
| Rate for Payer: United Healthcare All Other HMO |
$862.50
|
| Rate for Payer: United Healthcare HMO Rider |
$862.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$862.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$321.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Vantage Medical Group Senior |
$321.35
|
|
|
HC ASPIRATION/BLADDER BY NEEDLE
|
Facility
|
IP
|
$1,725.00
|
|
|
Service Code
|
CPT 51100
|
| Hospital Charge Code |
900501596
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$345.00 |
| Max. Negotiated Rate |
$1,466.25 |
| Rate for Payer: Adventist Health Commercial |
$345.00
|
| Rate for Payer: Cash Price |
$776.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,207.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$690.00
|
| Rate for Payer: EPIC Health Plan Senior |
$690.00
|
| Rate for Payer: Galaxy Health WC |
$1,466.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,035.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,095.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,017.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.00
|
| Rate for Payer: Multiplan Commercial |
$1,380.00
|
| Rate for Payer: Networks By Design Commercial |
$1,121.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,466.25
|
|
|
HC ASPIRATION INJECTION INTERM JONT W US GUID
|
Facility
|
IP
|
$1,100.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
906620606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$935.00 |
| Rate for Payer: Adventist Health Commercial |
$220.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$770.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.00
|
| Rate for Payer: EPIC Health Plan Senior |
$440.00
|
| Rate for Payer: Galaxy Health WC |
$935.00
|
| Rate for Payer: Global Benefits Group Commercial |
$660.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$698.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$649.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Multiplan Commercial |
$880.00
|
| Rate for Payer: Networks By Design Commercial |
$715.00
|
| Rate for Payer: Prime Health Services Commercial |
$935.00
|
|
|
HC ASPIRATION INJECTION INTERM JONT W US GUID
|
Facility
|
OP
|
$1,100.00
|
|
|
Service Code
|
CPT 20606
|
| Hospital Charge Code |
906620606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$137.63 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$220.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cigna of CA HMO |
$704.00
|
| Rate for Payer: Cigna of CA PPO |
$814.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$770.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Senior |
$998.67
|
| Rate for Payer: Galaxy Health WC |
$935.00
|
| Rate for Payer: Global Benefits Group Commercial |
$660.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,488.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$137.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$698.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$155.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,271.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,143.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$880.00
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$715.00
|
| Rate for Payer: Prime Health Services Commercial |
$935.00
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$660.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$550.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$907.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC ASPIRATION INJECTION MAJOR JONT W US GUID
|
Facility
|
OP
|
$1,100.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
906620611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$153.30 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$220.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cigna of CA HMO |
$704.00
|
| Rate for Payer: Cigna of CA PPO |
$814.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$770.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$935.00
|
| Rate for Payer: Global Benefits Group Commercial |
$660.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$153.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$698.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$173.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$497.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$880.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$715.00
|
| Rate for Payer: Prime Health Services Commercial |
$935.00
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$660.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$550.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ASPIRATION INJECTION MAJOR JONT W US GUID
|
Facility
|
IP
|
$1,100.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
906620611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$935.00 |
| Rate for Payer: Adventist Health Commercial |
$220.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$770.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.00
|
| Rate for Payer: EPIC Health Plan Senior |
$440.00
|
| Rate for Payer: Galaxy Health WC |
$935.00
|
| Rate for Payer: Global Benefits Group Commercial |
$660.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$698.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$649.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Multiplan Commercial |
$880.00
|
| Rate for Payer: Networks By Design Commercial |
$715.00
|
| Rate for Payer: Prime Health Services Commercial |
$935.00
|
|
|
HC ASPIRATION INJECTION SM JONT W US GUID
|
Facility
|
IP
|
$1,100.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
906620604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$935.00 |
| Rate for Payer: Adventist Health Commercial |
$220.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$770.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.00
|
| Rate for Payer: EPIC Health Plan Senior |
$440.00
|
| Rate for Payer: Galaxy Health WC |
$935.00
|
| Rate for Payer: Global Benefits Group Commercial |
$660.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$698.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$649.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Multiplan Commercial |
$880.00
|
| Rate for Payer: Networks By Design Commercial |
$715.00
|
| Rate for Payer: Prime Health Services Commercial |
$935.00
|
|
|
HC ASPIRATION INJECTION SM JONT W US GUID
|
Facility
|
OP
|
$1,100.00
|
|
|
Service Code
|
CPT 20604
|
| Hospital Charge Code |
906620604
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.16 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$220.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cash Price |
$495.00
|
| Rate for Payer: Cigna of CA HMO |
$704.00
|
| Rate for Payer: Cigna of CA PPO |
$814.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$770.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$935.00
|
| Rate for Payer: Global Benefits Group Commercial |
$660.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$127.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$698.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$497.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$880.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$715.00
|
| Rate for Payer: Prime Health Services Commercial |
$935.00
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$660.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$550.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
IP
|
$1,238.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$247.60 |
| Max. Negotiated Rate |
$1,052.30 |
| Rate for Payer: Adventist Health Commercial |
$247.60
|
| Rate for Payer: Cash Price |
$557.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$866.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$495.20
|
| Rate for Payer: EPIC Health Plan Senior |
$495.20
|
| Rate for Payer: Galaxy Health WC |
$1,052.30
|
| Rate for Payer: Global Benefits Group Commercial |
$742.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$786.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$730.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.12
|
| Rate for Payer: Multiplan Commercial |
$990.40
|
| Rate for Payer: Networks By Design Commercial |
$804.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,052.30
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
OP
|
$1,238.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.28 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$247.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$557.10
|
| Rate for Payer: Cash Price |
$557.10
|
| Rate for Payer: Cash Price |
$557.10
|
| Rate for Payer: Cigna of CA HMO |
$792.32
|
| Rate for Payer: Cigna of CA PPO |
$916.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$866.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,052.30
|
| Rate for Payer: Global Benefits Group Commercial |
$742.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$786.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$497.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$990.40
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$804.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,052.30
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$619.00
|
| Rate for Payer: United Healthcare All Other HMO |
$619.00
|
| Rate for Payer: United Healthcare HMO Rider |
$619.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$619.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
OP
|
$1,238.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$91.32 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$247.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$557.10
|
| Rate for Payer: Cash Price |
$557.10
|
| Rate for Payer: Cash Price |
$557.10
|
| Rate for Payer: Cigna of CA HMO |
$792.32
|
| Rate for Payer: Cigna of CA PPO |
$916.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$866.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,052.30
|
| Rate for Payer: Global Benefits Group Commercial |
$742.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$91.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$786.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$497.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$990.40
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$804.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,052.30
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$742.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$619.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ASPIRATION/INJ GANGLION CYSTS
|
Facility
|
IP
|
$1,238.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
909020036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$247.60 |
| Max. Negotiated Rate |
$1,052.30 |
| Rate for Payer: Adventist Health Commercial |
$247.60
|
| Rate for Payer: Cash Price |
$557.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$866.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$495.20
|
| Rate for Payer: EPIC Health Plan Senior |
$495.20
|
| Rate for Payer: Galaxy Health WC |
$1,052.30
|
| Rate for Payer: Global Benefits Group Commercial |
$742.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$786.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$730.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$297.12
|
| Rate for Payer: Multiplan Commercial |
$990.40
|
| Rate for Payer: Networks By Design Commercial |
$804.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,052.30
|
|
|
HC ASPIRATOR MECONIUM
|
Facility
|
IP
|
$717.60
|
|
| Hospital Charge Code |
901602312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.52 |
| Max. Negotiated Rate |
$609.96 |
| Rate for Payer: Adventist Health Commercial |
$143.52
|
| Rate for Payer: Cash Price |
$322.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$502.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$287.04
|
| Rate for Payer: EPIC Health Plan Senior |
$287.04
|
| Rate for Payer: Galaxy Health WC |
$609.96
|
| Rate for Payer: Global Benefits Group Commercial |
$430.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$455.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$423.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.22
|
| Rate for Payer: Multiplan Commercial |
$574.08
|
| Rate for Payer: Networks By Design Commercial |
$466.44
|
| Rate for Payer: Prime Health Services Commercial |
$609.96
|
|
|
HC ASPIRATOR MECONIUM
|
Facility
|
OP
|
$717.60
|
|
| Hospital Charge Code |
901602312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.52 |
| Max. Negotiated Rate |
$609.96 |
| Rate for Payer: Adventist Health Commercial |
$143.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$470.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$609.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$394.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$538.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$460.48
|
| Rate for Payer: Cash Price |
$322.92
|
| Rate for Payer: Cigna of CA HMO |
$459.26
|
| Rate for Payer: Cigna of CA PPO |
$531.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$609.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$609.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$609.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$502.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$287.04
|
| Rate for Payer: EPIC Health Plan Senior |
$287.04
|
| Rate for Payer: Galaxy Health WC |
$609.96
|
| Rate for Payer: Global Benefits Group Commercial |
$430.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$455.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$260.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$423.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$502.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$502.32
|
| Rate for Payer: Multiplan Commercial |
$574.08
|
| Rate for Payer: Networks By Design Commercial |
$466.44
|
| Rate for Payer: Prime Health Services Commercial |
$609.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$430.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$430.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$358.80
|
| Rate for Payer: United Healthcare All Other HMO |
$358.80
|
| Rate for Payer: United Healthcare HMO Rider |
$358.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$358.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$609.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$609.96
|
| Rate for Payer: Vantage Medical Group Senior |
$609.96
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
IP
|
$4,958.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$991.60 |
| Max. Negotiated Rate |
$4,214.30 |
| Rate for Payer: Adventist Health Commercial |
$991.60
|
| Rate for Payer: Cash Price |
$2,231.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,470.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,983.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,983.20
|
| Rate for Payer: Galaxy Health WC |
$4,214.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,974.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,148.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,925.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,189.92
|
| Rate for Payer: Multiplan Commercial |
$3,966.40
|
| Rate for Payer: Networks By Design Commercial |
$3,222.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,214.30
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
OP
|
$4,958.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$991.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$2,231.10
|
| Rate for Payer: Cash Price |
$2,231.10
|
| Rate for Payer: Cash Price |
$2,231.10
|
| Rate for Payer: Cigna of CA HMO |
$3,173.12
|
| Rate for Payer: Cigna of CA PPO |
$3,668.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,470.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$4,214.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,974.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,148.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,189.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$3,966.40
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,222.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,214.30
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,974.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,479.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,479.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,479.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,479.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
IP
|
$4,958.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$991.60 |
| Max. Negotiated Rate |
$4,214.30 |
| Rate for Payer: Adventist Health Commercial |
$991.60
|
| Rate for Payer: Cash Price |
$2,231.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,470.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,983.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,983.20
|
| Rate for Payer: Galaxy Health WC |
$4,214.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,974.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,148.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,925.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,189.92
|
| Rate for Payer: Multiplan Commercial |
$3,966.40
|
| Rate for Payer: Networks By Design Commercial |
$3,222.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,214.30
|
|
|
HC ASPIR INJECT THYROID CYST
|
Facility
|
OP
|
$4,958.00
|
|
|
Service Code
|
CPT 60300
|
| Hospital Charge Code |
909020010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.36 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$991.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$2,231.10
|
| Rate for Payer: Cash Price |
$2,231.10
|
| Rate for Payer: Cash Price |
$2,231.10
|
| Rate for Payer: Cigna of CA HMO |
$3,173.12
|
| Rate for Payer: Cigna of CA PPO |
$3,668.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,470.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$4,214.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,974.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$141.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,148.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,189.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$3,966.40
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,222.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,214.30
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,974.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,479.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC ASPIR/INJ MAJOR JOINT/BURSA
|
Facility
|
IP
|
$1,465.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
900501055
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$293.00 |
| Max. Negotiated Rate |
$1,245.25 |
| Rate for Payer: Adventist Health Commercial |
$293.00
|
| Rate for Payer: Cash Price |
$659.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,025.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$586.00
|
| Rate for Payer: EPIC Health Plan Senior |
$586.00
|
| Rate for Payer: Galaxy Health WC |
$1,245.25
|
| Rate for Payer: Global Benefits Group Commercial |
$879.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$930.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$864.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$351.60
|
| Rate for Payer: Multiplan Commercial |
$1,172.00
|
| Rate for Payer: Networks By Design Commercial |
$952.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,245.25
|
|
|
HC ASPIR/INJ MAJOR JOINT/BURSA
|
Facility
|
IP
|
$1,465.00
|
|
|
Service Code
|
CPT 20610
|
| Hospital Charge Code |
900501055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$293.00 |
| Max. Negotiated Rate |
$1,245.25 |
| Rate for Payer: Adventist Health Commercial |
$293.00
|
| Rate for Payer: Cash Price |
$659.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,025.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$586.00
|
| Rate for Payer: EPIC Health Plan Senior |
$586.00
|
| Rate for Payer: Galaxy Health WC |
$1,245.25
|
| Rate for Payer: Global Benefits Group Commercial |
$879.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$930.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$864.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$351.60
|
| Rate for Payer: Multiplan Commercial |
$1,172.00
|
| Rate for Payer: Networks By Design Commercial |
$952.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,245.25
|
|
