|
HC BEHAVIORAL & QUALITATIVE ANALYSIS VOICE & RESONANCE
|
Facility
|
OP
|
$802.00
|
|
|
Service Code
|
CPT 92524
|
| Hospital Charge Code |
900100021
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$90.45 |
| Max. Negotiated Rate |
$681.70 |
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: Adventist Health Commercial |
$328.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$633.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$681.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$441.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$601.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$478.00
|
| Rate for Payer: Blue Shield of California Commercial |
$291.00
|
| Rate for Payer: Blue Shield of California Commercial |
$439.00
|
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Cigna of CA HMO |
$513.28
|
| Rate for Payer: Cigna of CA PPO |
$593.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$681.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$681.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$681.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$561.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.80
|
| Rate for Payer: EPIC Health Plan Senior |
$320.80
|
| Rate for Payer: Galaxy Health WC |
$681.70
|
| Rate for Payer: Global Benefits Group Commercial |
$481.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$90.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$509.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$473.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$561.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$561.40
|
| Rate for Payer: Multiplan Commercial |
$641.60
|
| Rate for Payer: Networks By Design Commercial |
$521.30
|
| Rate for Payer: Prime Health Services Commercial |
$681.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$481.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$481.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$681.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$681.70
|
| Rate for Payer: Vantage Medical Group Senior |
$681.70
|
|
|
HC BELOW/ABOVE ELBOW LOCK MECH
|
Facility
|
IP
|
$1,542.13
|
|
|
Service Code
|
CPT L6698
|
| Hospital Charge Code |
905356698
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$308.43 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$308.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$693.96
|
| Rate for Payer: Cash Price |
$693.96
|
| Rate for Payer: Cigna of CA HMO |
$1,079.49
|
| Rate for Payer: Cigna of CA PPO |
$1,079.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,079.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.85
|
| Rate for Payer: EPIC Health Plan Senior |
$616.85
|
| Rate for Payer: Galaxy Health WC |
$1,310.81
|
| Rate for Payer: Global Benefits Group Commercial |
$925.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$979.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$909.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.11
|
| Rate for Payer: Multiplan Commercial |
$1,233.70
|
| Rate for Payer: Networks By Design Commercial |
$1,002.38
|
| Rate for Payer: Prime Health Services Commercial |
$1,310.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$578.76
|
| Rate for Payer: United Healthcare All Other HMO |
$563.34
|
| Rate for Payer: United Healthcare HMO Rider |
$551.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$505.05
|
|
|
HC BELOW/ABOVE ELBOW LOCK MECH
|
Facility
|
IP
|
$1,542.13
|
|
|
Service Code
|
CPT L6698
|
| Hospital Charge Code |
915356698
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$308.43 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$308.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$693.96
|
| Rate for Payer: Cash Price |
$693.96
|
| Rate for Payer: Cigna of CA HMO |
$1,079.49
|
| Rate for Payer: Cigna of CA PPO |
$1,079.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,079.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.85
|
| Rate for Payer: EPIC Health Plan Senior |
$616.85
|
| Rate for Payer: Galaxy Health WC |
$1,310.81
|
| Rate for Payer: Global Benefits Group Commercial |
$925.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$979.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$909.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.11
|
| Rate for Payer: Multiplan Commercial |
$1,233.70
|
| Rate for Payer: Networks By Design Commercial |
$1,002.38
|
| Rate for Payer: Prime Health Services Commercial |
$1,310.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$578.76
|
| Rate for Payer: United Healthcare All Other HMO |
$563.34
|
| Rate for Payer: United Healthcare HMO Rider |
$551.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$505.05
|
|
|
HC BELOW/ABOVE ELBOW LOCK MECH
|
Facility
|
OP
|
$1,542.13
|
|
|
Service Code
|
CPT L6698
|
| Hospital Charge Code |
905356698
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$370.11 |
| Max. Negotiated Rate |
$1,310.81 |
| Rate for Payer: Adventist Health Commercial |
$632.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,310.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$848.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,156.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$933.45
|
| Rate for Payer: Blue Shield of California Commercial |
$781.86
|
| Rate for Payer: Blue Shield of California Commercial |
$1,185.90
|
| Rate for Payer: Cash Price |
$693.96
|
| Rate for Payer: Cash Price |
$693.96
|
| Rate for Payer: Cigna of CA HMO |
$1,079.49
|
| Rate for Payer: Cigna of CA PPO |
$1,079.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,310.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,310.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,079.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.85
|
| Rate for Payer: EPIC Health Plan Senior |
$616.85
|
| Rate for Payer: Galaxy Health WC |
$1,310.81
|
| Rate for Payer: Global Benefits Group Commercial |
$925.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$714.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$979.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$808.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$909.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,079.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,079.49
|
| Rate for Payer: Multiplan Commercial |
$1,233.70
|
| Rate for Payer: Networks By Design Commercial |
$771.07
|
| Rate for Payer: Prime Health Services Commercial |
$1,310.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$925.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$925.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$578.76
|
| Rate for Payer: United Healthcare All Other HMO |
$563.34
|
| Rate for Payer: United Healthcare HMO Rider |
$551.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$505.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,310.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.81
|
| Rate for Payer: Vantage Medical Group Senior |
$1,310.81
|
|
|
HC BELOW/ABOVE ELBOW LOCK MECH
|
Facility
|
OP
|
$1,542.13
|
|
|
Service Code
|
CPT L6698
|
| Hospital Charge Code |
915356698
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$370.11 |
| Max. Negotiated Rate |
$1,310.81 |
| Rate for Payer: Adventist Health Commercial |
$632.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,310.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$848.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,156.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$933.45
|
| Rate for Payer: Blue Shield of California Commercial |
$781.86
|
| Rate for Payer: Blue Shield of California Commercial |
$1,185.90
|
| Rate for Payer: Cash Price |
$693.96
|
| Rate for Payer: Cash Price |
$693.96
|
| Rate for Payer: Cigna of CA HMO |
$1,079.49
|
| Rate for Payer: Cigna of CA PPO |
$1,079.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,310.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,310.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,310.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,079.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$616.85
|
| Rate for Payer: EPIC Health Plan Senior |
$616.85
|
| Rate for Payer: Galaxy Health WC |
$1,310.81
|
| Rate for Payer: Global Benefits Group Commercial |
$925.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$714.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$979.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$808.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$909.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,079.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,079.49
|
| Rate for Payer: Multiplan Commercial |
$1,233.70
|
| Rate for Payer: Networks By Design Commercial |
$771.07
|
| Rate for Payer: Prime Health Services Commercial |
$1,310.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$925.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$925.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$578.76
|
| Rate for Payer: United Healthcare All Other HMO |
$563.34
|
| Rate for Payer: United Healthcare HMO Rider |
$551.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$505.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,310.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,310.81
|
| Rate for Payer: Vantage Medical Group Senior |
$1,310.81
|
|
|
HC BELOW KNEE SUS/SEAL SLEEVE
|
Facility
|
OP
|
$253.00
|
|
|
Service Code
|
CPT L5685
|
| Hospital Charge Code |
905355685
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.72 |
| Max. Negotiated Rate |
$215.05 |
| Rate for Payer: Adventist Health Commercial |
$103.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$139.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$189.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.14
|
| Rate for Payer: Blue Shield of California Commercial |
$194.56
|
| Rate for Payer: Blue Shield of California Commercial |
$128.27
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cigna of CA HMO |
$177.10
|
| Rate for Payer: Cigna of CA PPO |
$177.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$215.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.20
|
| Rate for Payer: EPIC Health Plan Senior |
$101.20
|
| Rate for Payer: Galaxy Health WC |
$215.05
|
| Rate for Payer: Global Benefits Group Commercial |
$151.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$135.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$160.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$177.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$177.10
|
| Rate for Payer: Multiplan Commercial |
$202.40
|
| Rate for Payer: Networks By Design Commercial |
$126.50
|
| Rate for Payer: Prime Health Services Commercial |
$215.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.95
|
| Rate for Payer: United Healthcare All Other HMO |
$92.42
|
| Rate for Payer: United Healthcare HMO Rider |
$90.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.05
|
| Rate for Payer: Vantage Medical Group Senior |
$215.05
|
|
|
HC BELOW KNEE SUS/SEAL SLEEVE
|
Facility
|
IP
|
$253.00
|
|
|
Service Code
|
CPT L5685
|
| Hospital Charge Code |
915355685
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$50.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cigna of CA HMO |
$177.10
|
| Rate for Payer: Cigna of CA PPO |
$177.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.20
|
| Rate for Payer: EPIC Health Plan Senior |
$101.20
|
| Rate for Payer: Galaxy Health WC |
$215.05
|
| Rate for Payer: Global Benefits Group Commercial |
$151.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$160.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.72
|
| Rate for Payer: Multiplan Commercial |
$202.40
|
| Rate for Payer: Networks By Design Commercial |
$164.45
|
| Rate for Payer: Prime Health Services Commercial |
$215.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.95
|
| Rate for Payer: United Healthcare All Other HMO |
$92.42
|
| Rate for Payer: United Healthcare HMO Rider |
$90.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.86
|
|
|
HC BELOW KNEE SUS/SEAL SLEEVE
|
Facility
|
OP
|
$253.00
|
|
|
Service Code
|
CPT L5685
|
| Hospital Charge Code |
915355685
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$60.72 |
| Max. Negotiated Rate |
$215.05 |
| Rate for Payer: Adventist Health Commercial |
$103.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$139.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$189.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.14
|
| Rate for Payer: Blue Shield of California Commercial |
$194.56
|
| Rate for Payer: Blue Shield of California Commercial |
$128.27
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cigna of CA HMO |
$177.10
|
| Rate for Payer: Cigna of CA PPO |
$177.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$215.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.20
|
| Rate for Payer: EPIC Health Plan Senior |
$101.20
|
| Rate for Payer: Galaxy Health WC |
$215.05
|
| Rate for Payer: Global Benefits Group Commercial |
$151.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$135.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$160.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$177.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$177.10
|
| Rate for Payer: Multiplan Commercial |
$202.40
|
| Rate for Payer: Networks By Design Commercial |
$126.50
|
| Rate for Payer: Prime Health Services Commercial |
$215.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.95
|
| Rate for Payer: United Healthcare All Other HMO |
$92.42
|
| Rate for Payer: United Healthcare HMO Rider |
$90.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.05
|
| Rate for Payer: Vantage Medical Group Senior |
$215.05
|
|
|
HC BELOW KNEE SUS/SEAL SLEEVE
|
Facility
|
IP
|
$253.00
|
|
|
Service Code
|
CPT L5685
|
| Hospital Charge Code |
905355685
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$50.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cash Price |
$113.85
|
| Rate for Payer: Cigna of CA HMO |
$177.10
|
| Rate for Payer: Cigna of CA PPO |
$177.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$177.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.20
|
| Rate for Payer: EPIC Health Plan Senior |
$101.20
|
| Rate for Payer: Galaxy Health WC |
$215.05
|
| Rate for Payer: Global Benefits Group Commercial |
$151.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$160.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$149.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.72
|
| Rate for Payer: Multiplan Commercial |
$202.40
|
| Rate for Payer: Networks By Design Commercial |
$164.45
|
| Rate for Payer: Prime Health Services Commercial |
$215.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.95
|
| Rate for Payer: United Healthcare All Other HMO |
$92.42
|
| Rate for Payer: United Healthcare HMO Rider |
$90.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$82.86
|
|
|
HC BELT BACK SUPPORT SMALL
|
Facility
|
IP
|
$88.62
|
|
|
Service Code
|
CPT L0625
|
| Hospital Charge Code |
901603587
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$17.72 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cigna of CA PPO |
$62.03
|
| Rate for Payer: Cash Price |
$39.88
|
| Rate for Payer: Cigna of CA HMO |
$62.03
|
| Rate for Payer: Adventist Health Commercial |
$17.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$39.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.45
|
| Rate for Payer: EPIC Health Plan Senior |
$35.45
|
| Rate for Payer: Galaxy Health WC |
$75.33
|
| Rate for Payer: Global Benefits Group Commercial |
$53.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$56.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.27
|
| Rate for Payer: Multiplan Commercial |
$70.90
|
| Rate for Payer: Networks By Design Commercial |
$57.60
|
| Rate for Payer: Prime Health Services Commercial |
$75.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.26
|
| Rate for Payer: United Healthcare All Other HMO |
$32.37
|
| Rate for Payer: United Healthcare HMO Rider |
$31.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.02
|
|
|
HC BELT BACK SUPPORT SMALL
|
Facility
|
OP
|
$88.62
|
|
|
Service Code
|
CPT L0625
|
| Hospital Charge Code |
901603587
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$21.27 |
| Max. Negotiated Rate |
$75.33 |
| Rate for Payer: Adventist Health Commercial |
$36.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$48.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.64
|
| Rate for Payer: Blue Shield of California Commercial |
$68.15
|
| Rate for Payer: Blue Shield of California Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$39.88
|
| Rate for Payer: Cash Price |
$39.88
|
| Rate for Payer: Cigna of CA HMO |
$62.03
|
| Rate for Payer: Cigna of CA PPO |
$62.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$62.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.45
|
| Rate for Payer: EPIC Health Plan Senior |
$35.45
|
| Rate for Payer: Galaxy Health WC |
$75.33
|
| Rate for Payer: Global Benefits Group Commercial |
$53.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$58.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$56.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$65.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62.03
|
| Rate for Payer: Multiplan Commercial |
$70.90
|
| Rate for Payer: Networks By Design Commercial |
$44.31
|
| Rate for Payer: Prime Health Services Commercial |
$75.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.26
|
| Rate for Payer: United Healthcare All Other HMO |
$32.37
|
| Rate for Payer: United Healthcare HMO Rider |
$31.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.33
|
| Rate for Payer: Vantage Medical Group Senior |
$75.33
|
|
|
HC BE MOLD SKT FLEX HNG TRICP PAD
|
Facility
|
OP
|
$2,120.00
|
|
|
Service Code
|
CPT L6100
|
| Hospital Charge Code |
915356100
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$508.80 |
| Max. Negotiated Rate |
$1,802.00 |
| Rate for Payer: Adventist Health Commercial |
$869.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,166.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,590.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,283.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,630.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,074.84
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cigna of CA HMO |
$1,484.00
|
| Rate for Payer: Cigna of CA PPO |
$1,484.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,802.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,802.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,484.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.00
|
| Rate for Payer: EPIC Health Plan Senior |
$848.00
|
| Rate for Payer: Galaxy Health WC |
$1,802.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,272.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,369.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,346.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,548.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,250.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$508.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,484.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,484.00
|
| Rate for Payer: Multiplan Commercial |
$1,696.00
|
| Rate for Payer: Networks By Design Commercial |
$1,060.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,802.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,272.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,272.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$795.64
|
| Rate for Payer: United Healthcare All Other HMO |
$774.44
|
| Rate for Payer: United Healthcare HMO Rider |
$757.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$694.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,802.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,802.00
|
|
|
HC BE MOLD SKT FLEX HNG TRICP PAD
|
Facility
|
IP
|
$2,120.00
|
|
|
Service Code
|
CPT L6100
|
| Hospital Charge Code |
915356100
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$424.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$424.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cigna of CA HMO |
$1,484.00
|
| Rate for Payer: Cigna of CA PPO |
$1,484.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,484.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.00
|
| Rate for Payer: EPIC Health Plan Senior |
$848.00
|
| Rate for Payer: Galaxy Health WC |
$1,802.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,272.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,346.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,250.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$508.80
|
| Rate for Payer: Multiplan Commercial |
$1,696.00
|
| Rate for Payer: Networks By Design Commercial |
$1,378.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,802.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$795.64
|
| Rate for Payer: United Healthcare All Other HMO |
$774.44
|
| Rate for Payer: United Healthcare HMO Rider |
$757.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$694.30
|
|
|
HC BE MOLD SKT FLEX HNG TRICP PAD
|
Facility
|
IP
|
$2,120.00
|
|
|
Service Code
|
CPT L6100
|
| Hospital Charge Code |
905356100
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$424.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$424.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cigna of CA HMO |
$1,484.00
|
| Rate for Payer: Cigna of CA PPO |
$1,484.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,484.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.00
|
| Rate for Payer: EPIC Health Plan Senior |
$848.00
|
| Rate for Payer: Galaxy Health WC |
$1,802.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,272.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,346.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,250.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$508.80
|
| Rate for Payer: Multiplan Commercial |
$1,696.00
|
| Rate for Payer: Networks By Design Commercial |
$1,378.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,802.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$795.64
|
| Rate for Payer: United Healthcare All Other HMO |
$774.44
|
| Rate for Payer: United Healthcare HMO Rider |
$757.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$694.30
|
|
|
HC BE MOLD SKT FLEX HNG TRICP PAD
|
Facility
|
OP
|
$2,120.00
|
|
|
Service Code
|
CPT L6100
|
| Hospital Charge Code |
905356100
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$508.80 |
| Max. Negotiated Rate |
$1,802.00 |
| Rate for Payer: Adventist Health Commercial |
$869.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,166.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,590.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,283.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,630.28
|
| Rate for Payer: Blue Shield of California Commercial |
$1,074.84
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cash Price |
$954.00
|
| Rate for Payer: Cigna of CA HMO |
$1,484.00
|
| Rate for Payer: Cigna of CA PPO |
$1,484.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,802.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,802.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,484.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.00
|
| Rate for Payer: EPIC Health Plan Senior |
$848.00
|
| Rate for Payer: Galaxy Health WC |
$1,802.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,272.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,369.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,346.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,548.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,250.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$508.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,484.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,484.00
|
| Rate for Payer: Multiplan Commercial |
$1,696.00
|
| Rate for Payer: Networks By Design Commercial |
$1,060.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,802.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,272.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,272.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$795.64
|
| Rate for Payer: United Healthcare All Other HMO |
$774.44
|
| Rate for Payer: United Healthcare HMO Rider |
$757.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$694.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,802.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,802.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,802.00
|
|
|
HC BE MOLD SKT MUENSTER SUSPENSN
|
Facility
|
IP
|
$4,675.00
|
|
|
Service Code
|
CPT L6110
|
| Hospital Charge Code |
905356110
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$935.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$935.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cigna of CA HMO |
$3,272.50
|
| Rate for Payer: Cigna of CA PPO |
$3,272.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,272.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,870.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,870.00
|
| Rate for Payer: Galaxy Health WC |
$3,973.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,805.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,968.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,758.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.00
|
| Rate for Payer: Multiplan Commercial |
$3,740.00
|
| Rate for Payer: Networks By Design Commercial |
$3,038.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,973.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,754.53
|
| Rate for Payer: United Healthcare All Other HMO |
$1,707.78
|
| Rate for Payer: United Healthcare HMO Rider |
$1,670.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,531.06
|
|
|
HC BE MOLD SKT MUENSTER SUSPENSN
|
Facility
|
OP
|
$4,675.00
|
|
|
Service Code
|
CPT L6110
|
| Hospital Charge Code |
905356110
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,122.00 |
| Max. Negotiated Rate |
$3,973.75 |
| Rate for Payer: Adventist Health Commercial |
$1,916.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,571.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,506.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,829.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,595.07
|
| Rate for Payer: Blue Shield of California Commercial |
$2,370.22
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cigna of CA HMO |
$3,272.50
|
| Rate for Payer: Cigna of CA PPO |
$3,272.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,973.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,973.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,272.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,870.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,870.00
|
| Rate for Payer: Galaxy Health WC |
$3,973.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,805.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,433.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,968.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,620.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,758.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,272.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,272.50
|
| Rate for Payer: Multiplan Commercial |
$3,740.00
|
| Rate for Payer: Networks By Design Commercial |
$2,337.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,973.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,805.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,805.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,754.53
|
| Rate for Payer: United Healthcare All Other HMO |
$1,707.78
|
| Rate for Payer: United Healthcare HMO Rider |
$1,670.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,531.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,973.75
|
| Rate for Payer: Vantage Medical Group Senior |
$3,973.75
|
|
|
HC BE MOLD SKT MUENSTER SUSPENSN
|
Facility
|
OP
|
$4,675.00
|
|
|
Service Code
|
CPT L6110
|
| Hospital Charge Code |
915356110
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,122.00 |
| Max. Negotiated Rate |
$3,973.75 |
| Rate for Payer: Adventist Health Commercial |
$1,916.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,571.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,506.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,829.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,595.07
|
| Rate for Payer: Blue Shield of California Commercial |
$2,370.22
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cigna of CA HMO |
$3,272.50
|
| Rate for Payer: Cigna of CA PPO |
$3,272.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,973.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,973.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,272.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,870.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,870.00
|
| Rate for Payer: Galaxy Health WC |
$3,973.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,805.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,433.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,968.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,620.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,758.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,272.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,272.50
|
| Rate for Payer: Multiplan Commercial |
$3,740.00
|
| Rate for Payer: Networks By Design Commercial |
$2,337.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,973.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,805.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,805.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,754.53
|
| Rate for Payer: United Healthcare All Other HMO |
$1,707.78
|
| Rate for Payer: United Healthcare HMO Rider |
$1,670.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,531.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,973.75
|
| Rate for Payer: Vantage Medical Group Senior |
$3,973.75
|
|
|
HC BE MOLD SKT MUENSTER SUSPENSN
|
Facility
|
IP
|
$4,675.00
|
|
|
Service Code
|
CPT L6110
|
| Hospital Charge Code |
915356110
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$935.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$935.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cigna of CA HMO |
$3,272.50
|
| Rate for Payer: Cigna of CA PPO |
$3,272.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,272.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,870.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,870.00
|
| Rate for Payer: Galaxy Health WC |
$3,973.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,805.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,968.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,758.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.00
|
| Rate for Payer: Multiplan Commercial |
$3,740.00
|
| Rate for Payer: Networks By Design Commercial |
$3,038.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,973.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,754.53
|
| Rate for Payer: United Healthcare All Other HMO |
$1,707.78
|
| Rate for Payer: United Healthcare HMO Rider |
$1,670.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,531.06
|
|
|
HC BENZODIAZPINES CONF
|
Facility
|
OP
|
$312.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900910515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$265.20 |
| Rate for Payer: United Healthcare HMO Rider |
$156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$129.50
|
| Rate for Payer: Adventist Health Commercial |
$62.40
|
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$265.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$171.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$194.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$234.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$183.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$183.10
|
| Rate for Payer: Blue Shield of California Commercial |
$217.46
|
| Rate for Payer: Blue Shield of California Commercial |
$119.40
|
| Rate for Payer: Blue Shield of California Commercial |
$180.52
|
| Rate for Payer: Blue Shield of California Commercial |
$143.83
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cigna of CA HMO |
$165.76
|
| Rate for Payer: Cigna of CA HMO |
$199.68
|
| Rate for Payer: Cigna of CA PPO |
$191.66
|
| Rate for Payer: Cigna of CA PPO |
$230.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$265.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$220.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$265.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$265.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$220.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$218.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$181.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.80
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$124.80
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Galaxy Health WC |
$265.20
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Global Benefits Group Commercial |
$187.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$94.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$113.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$218.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$218.40
|
| Rate for Payer: Multiplan Commercial |
$249.60
|
| Rate for Payer: Multiplan Commercial |
$207.20
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: Networks By Design Commercial |
$202.80
|
| Rate for Payer: Prime Health Services Commercial |
$265.20
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$187.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$129.50
|
| Rate for Payer: United Healthcare All Other HMO |
$129.50
|
| Rate for Payer: United Healthcare All Other HMO |
$156.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$129.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$156.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$265.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$265.20
|
| Rate for Payer: Vantage Medical Group Senior |
$220.15
|
| Rate for Payer: Vantage Medical Group Senior |
$265.20
|
|
|
HC BENZODIAZPINES CONF
|
Facility
|
IP
|
$312.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900910515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$265.20 |
| Rate for Payer: Adventist Health Commercial |
$62.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$218.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.80
|
| Rate for Payer: EPIC Health Plan Senior |
$124.80
|
| Rate for Payer: Galaxy Health WC |
$265.20
|
| Rate for Payer: Global Benefits Group Commercial |
$187.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.88
|
| Rate for Payer: Multiplan Commercial |
$249.60
|
| Rate for Payer: Networks By Design Commercial |
$202.80
|
| Rate for Payer: Prime Health Services Commercial |
$265.20
|
|
|
HC BER E 1 (BRAZIL NUT), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913741
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$170.73 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.73
|
| Rate for Payer: Blue Shield of California Commercial |
$12.89
|
| Rate for Payer: Blue Shield of California Commercial |
$10.74
|
| Rate for Payer: Blue Shield of California Commercial |
$8.52
|
| Rate for Payer: Blue Shield of California Commercial |
$7.10
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$26.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$14.79
|
| Rate for Payer: Multiplan Commercial |
$12.33
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC BER E 1 (BRAZIL NUT), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913741
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$15.72 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.44
|
| Rate for Payer: Multiplan Commercial |
$14.79
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC BE SPLIT SKT STEPUP HNG 1/2 CF
|
Facility
|
OP
|
$3,516.00
|
|
|
Service Code
|
CPT L6120
|
| Hospital Charge Code |
905356120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$843.84 |
| Max. Negotiated Rate |
$2,988.60 |
| Rate for Payer: Adventist Health Commercial |
$1,441.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,933.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,637.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,128.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2,703.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,782.61
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Cigna of CA HMO |
$2,461.20
|
| Rate for Payer: Cigna of CA PPO |
$2,461.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,988.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,988.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,461.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,406.40
|
| Rate for Payer: Galaxy Health WC |
$2,988.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,109.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,658.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,232.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,875.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,074.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,461.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,461.20
|
| Rate for Payer: Multiplan Commercial |
$2,812.80
|
| Rate for Payer: Networks By Design Commercial |
$1,758.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,988.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,109.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,109.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,319.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,284.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,256.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,151.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,988.60
|
| Rate for Payer: Vantage Medical Group Senior |
$2,988.60
|
|
|
HC BE SPLIT SKT STEPUP HNG 1/2 CF
|
Facility
|
OP
|
$3,516.00
|
|
|
Service Code
|
CPT L6120
|
| Hospital Charge Code |
915356120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$843.84 |
| Max. Negotiated Rate |
$2,988.60 |
| Rate for Payer: Adventist Health Commercial |
$1,441.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,933.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,637.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,128.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2,703.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,782.61
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Cigna of CA HMO |
$2,461.20
|
| Rate for Payer: Cigna of CA PPO |
$2,461.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,988.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,988.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,461.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,406.40
|
| Rate for Payer: Galaxy Health WC |
$2,988.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,109.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,658.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,232.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,875.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,074.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$843.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,461.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,461.20
|
| Rate for Payer: Multiplan Commercial |
$2,812.80
|
| Rate for Payer: Networks By Design Commercial |
$1,758.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,988.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,109.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,109.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,319.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,284.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,256.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,151.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,988.60
|
| Rate for Payer: Vantage Medical Group Senior |
$2,988.60
|
|
