|
HC AVULSION EA ADD'L NAIL PLATE
|
Facility
|
OP
|
$413.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
900501224
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$82.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$351.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$227.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cigna of CA HMO |
$264.32
|
| Rate for Payer: Cigna of CA PPO |
$305.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$351.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$351.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$351.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.20
|
| Rate for Payer: EPIC Health Plan Senior |
$165.20
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$243.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$289.10
|
| Rate for Payer: Multiplan Commercial |
$330.40
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$247.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.50
|
| Rate for Payer: United Healthcare All Other HMO |
$206.50
|
| Rate for Payer: United Healthcare HMO Rider |
$206.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$351.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$351.05
|
| Rate for Payer: Vantage Medical Group Senior |
$351.05
|
|
|
HC AVULSION EA ADD'L NAIL PLATE
|
Facility
|
OP
|
$413.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
900501224
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$58.42 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Adventist Health Commercial |
$169.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$167.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$351.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$227.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$309.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cigna of CA HMO |
$264.32
|
| Rate for Payer: Cigna of CA PPO |
$305.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$351.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$351.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$351.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.20
|
| Rate for Payer: EPIC Health Plan Senior |
$165.20
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$243.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$289.10
|
| Rate for Payer: Multiplan Commercial |
$330.40
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$247.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$247.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$351.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$351.05
|
| Rate for Payer: Vantage Medical Group Senior |
$351.05
|
|
|
HC AVULSION EA ADD'L NAIL PLATE
|
Facility
|
IP
|
$413.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
900501224
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$351.05 |
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Adventist Health Commercial |
$82.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.20
|
| Rate for Payer: EPIC Health Plan Senior |
$165.20
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$243.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.12
|
| Rate for Payer: Multiplan Commercial |
$330.40
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
|
|
HC AVULSION EA ADD'L NAIL PLATE
|
Facility
|
IP
|
$413.00
|
|
|
Service Code
|
CPT 11732
|
| Hospital Charge Code |
900501224
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$351.05 |
| Rate for Payer: Adventist Health Commercial |
$82.60
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.20
|
| Rate for Payer: EPIC Health Plan Senior |
$165.20
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$243.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.12
|
| Rate for Payer: Multiplan Commercial |
$330.40
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
|
|
HC AVX ANGIOJET, CATH
|
Facility
|
IP
|
$1,620.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909080036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$324.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$729.00
|
| Rate for Payer: Cash Price |
$729.00
|
| Rate for Payer: Cigna of CA HMO |
$1,134.00
|
| Rate for Payer: Cigna of CA PPO |
$1,134.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,134.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Senior |
$648.00
|
| Rate for Payer: Galaxy Health WC |
$1,377.00
|
| Rate for Payer: Global Benefits Group Commercial |
$972.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,028.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$955.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$388.80
|
| Rate for Payer: Multiplan Commercial |
$1,296.00
|
| Rate for Payer: Networks By Design Commercial |
$810.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,377.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$607.99
|
| Rate for Payer: United Healthcare All Other HMO |
$591.79
|
| Rate for Payer: United Healthcare HMO Rider |
$578.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.55
|
|
|
HC AVX ANGIOJET, CATH
|
Facility
|
OP
|
$1,620.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909080036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$324.00 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Adventist Health Commercial |
$324.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$891.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,215.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$980.59
|
| Rate for Payer: Blue Shield of California Commercial |
$1,245.78
|
| Rate for Payer: Blue Shield of California Commercial |
$821.34
|
| Rate for Payer: Cash Price |
$729.00
|
| Rate for Payer: Cigna of CA HMO |
$1,134.00
|
| Rate for Payer: Cigna of CA PPO |
$1,134.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,377.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,377.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,134.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$648.00
|
| Rate for Payer: EPIC Health Plan Senior |
$648.00
|
| Rate for Payer: Galaxy Health WC |
$1,377.00
|
| Rate for Payer: Global Benefits Group Commercial |
$972.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,028.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$588.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$955.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$388.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,134.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,134.00
|
| Rate for Payer: Multiplan Commercial |
$1,296.00
|
| Rate for Payer: Networks By Design Commercial |
$810.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,377.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$972.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$972.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$607.99
|
| Rate for Payer: United Healthcare All Other HMO |
$591.79
|
| Rate for Payer: United Healthcare HMO Rider |
$578.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,377.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,377.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,377.00
|
|
|
HC AXILLARY CRUTCH EXTENSION
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT L0978
|
| Hospital Charge Code |
915350978
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$96.00 |
| Max. Negotiated Rate |
$340.00 |
| Rate for Payer: Adventist Health Commercial |
$164.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$300.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$242.12
|
| Rate for Payer: Blue Shield of California Commercial |
$307.60
|
| Rate for Payer: Blue Shield of California Commercial |
$202.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$340.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$340.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$259.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$293.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$280.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$280.00
|
| Rate for Payer: Multiplan Commercial |
$320.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
|
HC AXILLARY CRUTCH EXTENSION
|
Facility
|
IP
|
$400.00
|
|
|
Service Code
|
CPT L0978
|
| Hospital Charge Code |
905350978
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.00
|
| Rate for Payer: Multiplan Commercial |
$320.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
|
|
HC AXILLARY CRUTCH EXTENSION
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT L0978
|
| Hospital Charge Code |
905350978
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$96.00 |
| Max. Negotiated Rate |
$340.00 |
| Rate for Payer: Adventist Health Commercial |
$164.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$300.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$242.12
|
| Rate for Payer: Blue Shield of California Commercial |
$307.60
|
| Rate for Payer: Blue Shield of California Commercial |
$202.80
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$340.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$340.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$259.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$293.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$280.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$280.00
|
| Rate for Payer: Multiplan Commercial |
$320.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
|
HC AXILLARY CRUTCH EXTENSION
|
Facility
|
IP
|
$400.00
|
|
|
Service Code
|
CPT L0978
|
| Hospital Charge Code |
915350978
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.00
|
| Rate for Payer: Multiplan Commercial |
$320.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
|
|
HC AZUR HYRDOCOIL
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909020139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC AZUR HYRDOCOIL
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909020139
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,558.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,502.63
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,415.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC B ABORTUS AB
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 86000
|
| Hospital Charge Code |
900911585
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$141.10 |
| Rate for Payer: Adventist Health Commercial |
$33.20
|
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.04
|
| Rate for Payer: Blue Shield of California Commercial |
$11.99
|
| Rate for Payer: Blue Shield of California Commercial |
$115.70
|
| Rate for Payer: Blue Shield of California Commercial |
$18.12
|
| Rate for Payer: Blue Shield of California Commercial |
$76.53
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$11.70
|
| Rate for Payer: Cash Price |
$74.70
|
| Rate for Payer: Cash Price |
$74.70
|
| Rate for Payer: Cigna of CA HMO |
$16.64
|
| Rate for Payer: Cigna of CA HMO |
$106.24
|
| Rate for Payer: Cigna of CA PPO |
$122.84
|
| Rate for Payer: Cigna of CA PPO |
$19.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$116.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.52
|
| Rate for Payer: EPIC Health Plan Senior |
$7.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7.68
|
| Rate for Payer: Galaxy Health WC |
$141.10
|
| Rate for Payer: Galaxy Health WC |
$22.10
|
| Rate for Payer: Global Benefits Group Commercial |
$99.60
|
| Rate for Payer: Global Benefits Group Commercial |
$15.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.45
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$105.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.35
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Multiplan Commercial |
$132.80
|
| Rate for Payer: Networks By Design Commercial |
$16.90
|
| Rate for Payer: Networks By Design Commercial |
$107.90
|
| Rate for Payer: Prime Health Services Commercial |
$141.10
|
| Rate for Payer: Prime Health Services Commercial |
$22.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.65
|
| Rate for Payer: United Healthcare All Other HMO |
$5.65
|
| Rate for Payer: United Healthcare All Other HMO |
$5.65
|
| Rate for Payer: United Healthcare HMO Rider |
$5.65
|
| Rate for Payer: United Healthcare HMO Rider |
$5.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6.98
|
| Rate for Payer: Vantage Medical Group Senior |
$6.98
|
|
|
HC B ABORTUS AB
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
CPT 86000
|
| Hospital Charge Code |
900911585
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$141.10 |
| Rate for Payer: Adventist Health Commercial |
$33.20
|
| Rate for Payer: Cash Price |
$74.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$116.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.40
|
| Rate for Payer: EPIC Health Plan Senior |
$66.40
|
| Rate for Payer: Galaxy Health WC |
$141.10
|
| Rate for Payer: Global Benefits Group Commercial |
$99.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$105.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$97.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.84
|
| Rate for Payer: Multiplan Commercial |
$132.80
|
| Rate for Payer: Networks By Design Commercial |
$107.90
|
| Rate for Payer: Prime Health Services Commercial |
$141.10
|
|
|
HC BACTERIAL ANTIGEN
|
Facility
|
OP
|
$112.00
|
|
|
Service Code
|
CPT 86403
|
| Hospital Charge Code |
900912496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$102.15 |
| Rate for Payer: Adventist Health Commercial |
$22.40
|
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$84.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$84.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.15
|
| Rate for Payer: Blue Shield of California Commercial |
$106.64
|
| Rate for Payer: Blue Shield of California Commercial |
$51.63
|
| Rate for Payer: Blue Shield of California Commercial |
$70.53
|
| Rate for Payer: Blue Shield of California Commercial |
$78.06
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cigna of CA HMO |
$97.92
|
| Rate for Payer: Cigna of CA HMO |
$71.68
|
| Rate for Payer: Cigna of CA PPO |
$82.88
|
| Rate for Payer: Cigna of CA PPO |
$113.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.69
|
| Rate for Payer: EPIC Health Plan Senior |
$12.69
|
| Rate for Payer: Galaxy Health WC |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$67.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.93
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.46
|
| Rate for Payer: Multiplan Commercial |
$122.40
|
| Rate for Payer: Multiplan Commercial |
$89.60
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Networks By Design Commercial |
$72.80
|
| Rate for Payer: Prime Health Services Commercial |
$95.20
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.35
|
| Rate for Payer: United Healthcare All Other HMO |
$9.35
|
| Rate for Payer: United Healthcare All Other HMO |
$9.35
|
| Rate for Payer: United Healthcare HMO Rider |
$9.35
|
| Rate for Payer: United Healthcare HMO Rider |
$9.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.69
|
| Rate for Payer: Vantage Medical Group Senior |
$11.54
|
| Rate for Payer: Vantage Medical Group Senior |
$11.54
|
|
|
HC BACTERIAL ANTIGEN
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 86403
|
| Hospital Charge Code |
900912496
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$130.05 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.72
|
| Rate for Payer: Multiplan Commercial |
$122.40
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC BACTERIAL ANTIGEN DETECTION LLUH
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900913679
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$48.29 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.81
|
| 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 |
$48.29
|
| Rate for Payer: Blue Shield of California Commercial |
$23.05
|
| Rate for Payer: Blue Shield of California Commercial |
$34.85
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$5.70
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| 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 |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| 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: Upland Medical Group Pediatric |
$5.18
|
| 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 BACTERIAL ANTIGEN DETECTION LLUH
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900913679
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$42.50 |
| Rate for Payer: Adventist Health Commercial |
$10.00
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Senior |
$20.00
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$40.00
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
|
|
HC BAG ACCUDRAIN CSF 700ML
|
Facility
|
OP
|
$741.24
|
|
| Hospital Charge Code |
901605661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$148.25 |
| Max. Negotiated Rate |
$630.05 |
| Rate for Payer: Adventist Health Commercial |
$148.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$486.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$630.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$555.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$475.65
|
| Rate for Payer: Cash Price |
$333.56
|
| Rate for Payer: Cigna of CA HMO |
$474.39
|
| Rate for Payer: Cigna of CA PPO |
$548.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$630.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$630.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$630.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$518.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.50
|
| Rate for Payer: EPIC Health Plan Senior |
$296.50
|
| Rate for Payer: Galaxy Health WC |
$630.05
|
| Rate for Payer: Global Benefits Group Commercial |
$444.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$470.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$269.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$437.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$518.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$518.87
|
| Rate for Payer: Multiplan Commercial |
$592.99
|
| Rate for Payer: Networks By Design Commercial |
$481.81
|
| Rate for Payer: Prime Health Services Commercial |
$630.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$444.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$444.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$370.62
|
| Rate for Payer: United Healthcare All Other HMO |
$370.62
|
| Rate for Payer: United Healthcare HMO Rider |
$370.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$370.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$630.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$630.05
|
| Rate for Payer: Vantage Medical Group Senior |
$630.05
|
|
|
HC BAG ACCUDRAIN CSF 700ML
|
Facility
|
IP
|
$741.24
|
|
| Hospital Charge Code |
901605661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$148.25 |
| Max. Negotiated Rate |
$630.05 |
| Rate for Payer: Adventist Health Commercial |
$148.25
|
| Rate for Payer: Cash Price |
$333.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$518.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.50
|
| Rate for Payer: EPIC Health Plan Senior |
$296.50
|
| Rate for Payer: Galaxy Health WC |
$630.05
|
| Rate for Payer: Global Benefits Group Commercial |
$444.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$470.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$437.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.90
|
| Rate for Payer: Multiplan Commercial |
$592.99
|
| Rate for Payer: Networks By Design Commercial |
$481.81
|
| Rate for Payer: Prime Health Services Commercial |
$630.05
|
|
|
HC BAG BILE DISP
|
Facility
|
OP
|
$65.68
|
|
| Hospital Charge Code |
901600101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.14 |
| Max. Negotiated Rate |
$55.83 |
| Rate for Payer: Adventist Health Commercial |
$13.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.15
|
| Rate for Payer: Cash Price |
$29.56
|
| Rate for Payer: Cigna of CA HMO |
$42.04
|
| Rate for Payer: Cigna of CA PPO |
$48.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.27
|
| Rate for Payer: EPIC Health Plan Senior |
$26.27
|
| Rate for Payer: Galaxy Health WC |
$55.83
|
| Rate for Payer: Global Benefits Group Commercial |
$39.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.98
|
| Rate for Payer: Multiplan Commercial |
$52.54
|
| Rate for Payer: Networks By Design Commercial |
$42.69
|
| Rate for Payer: Prime Health Services Commercial |
$55.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.84
|
| Rate for Payer: United Healthcare All Other HMO |
$32.84
|
| Rate for Payer: United Healthcare HMO Rider |
$32.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.83
|
| Rate for Payer: Vantage Medical Group Senior |
$55.83
|
|
|
HC BAG BILE DISP
|
Facility
|
IP
|
$65.68
|
|
| Hospital Charge Code |
901600101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.14 |
| Max. Negotiated Rate |
$55.83 |
| Rate for Payer: Adventist Health Commercial |
$13.14
|
| Rate for Payer: Cash Price |
$29.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.27
|
| Rate for Payer: EPIC Health Plan Senior |
$26.27
|
| Rate for Payer: Galaxy Health WC |
$55.83
|
| Rate for Payer: Global Benefits Group Commercial |
$39.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.76
|
| Rate for Payer: Multiplan Commercial |
$52.54
|
| Rate for Payer: Networks By Design Commercial |
$42.69
|
| Rate for Payer: Prime Health Services Commercial |
$55.83
|
|
|
HC BAG BILE DRAINAGE
|
Facility
|
OP
|
$10.60
|
|
| Hospital Charge Code |
909001075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.01 |
| Rate for Payer: Adventist Health Commercial |
$2.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.80
|
| Rate for Payer: Cash Price |
$4.77
|
| Rate for Payer: Cigna of CA HMO |
$6.78
|
| Rate for Payer: Cigna of CA PPO |
$7.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.24
|
| Rate for Payer: EPIC Health Plan Senior |
$4.24
|
| Rate for Payer: Galaxy Health WC |
$9.01
|
| Rate for Payer: Global Benefits Group Commercial |
$6.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.42
|
| Rate for Payer: Multiplan Commercial |
$8.48
|
| Rate for Payer: Networks By Design Commercial |
$6.89
|
| Rate for Payer: Prime Health Services Commercial |
$9.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.30
|
| Rate for Payer: United Healthcare All Other HMO |
$5.30
|
| Rate for Payer: United Healthcare HMO Rider |
$5.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.01
|
| Rate for Payer: Vantage Medical Group Senior |
$9.01
|
|
|
HC BAG BILE DRAINAGE
|
Facility
|
IP
|
$10.60
|
|
| Hospital Charge Code |
909001075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.01 |
| Rate for Payer: Adventist Health Commercial |
$2.12
|
| Rate for Payer: Cash Price |
$4.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.24
|
| Rate for Payer: EPIC Health Plan Senior |
$4.24
|
| Rate for Payer: Galaxy Health WC |
$9.01
|
| Rate for Payer: Global Benefits Group Commercial |
$6.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.54
|
| Rate for Payer: Multiplan Commercial |
$8.48
|
| Rate for Payer: Networks By Design Commercial |
$6.89
|
| Rate for Payer: Prime Health Services Commercial |
$9.01
|
|
|
HC BAG DRAINAGE 4L A/R TWR LL
|
Facility
|
OP
|
$25.34
|
|
| Hospital Charge Code |
901607520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Vantage Medical Group Senior |
$21.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.54
|
| Rate for Payer: Adventist Health Commercial |
$5.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.26
|
| Rate for Payer: Cash Price |
$11.40
|
| Rate for Payer: Cigna of CA HMO |
$16.22
|
| Rate for Payer: Cigna of CA PPO |
$18.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.14
|
| Rate for Payer: EPIC Health Plan Senior |
$10.14
|
| Rate for Payer: Galaxy Health WC |
$21.54
|
| Rate for Payer: Global Benefits Group Commercial |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$20.27
|
| Rate for Payer: Networks By Design Commercial |
$16.47
|
| Rate for Payer: Prime Health Services Commercial |
$21.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.67
|
| Rate for Payer: United Healthcare All Other HMO |
$12.67
|
| Rate for Payer: United Healthcare HMO Rider |
$12.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.54
|
|
