|
HC BONE BIOPSY DEEP, PERCUTAN
|
Facility
|
IP
|
$5,824.00
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
909000107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,164.80 |
| Max. Negotiated Rate |
$4,950.40 |
| Rate for Payer: Adventist Health Commercial |
$1,164.80
|
| Rate for Payer: Cash Price |
$2,620.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,076.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,329.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,329.60
|
| Rate for Payer: Galaxy Health WC |
$4,950.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,494.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,698.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,436.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.76
|
| Rate for Payer: Multiplan Commercial |
$4,659.20
|
| Rate for Payer: Networks By Design Commercial |
$3,785.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,950.40
|
|
|
HC BONE BIOPSY SUPFCL, PERCUT
|
Facility
|
OP
|
$2,693.00
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
909000106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$143.24 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$538.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,211.85
|
| Rate for Payer: Cash Price |
$1,211.85
|
| Rate for Payer: Cash Price |
$1,211.85
|
| Rate for Payer: Cigna of CA HMO |
$1,723.52
|
| Rate for Payer: Cigna of CA PPO |
$1,992.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,885.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$2,289.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,615.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$143.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,710.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$161.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$646.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$2,154.40
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,750.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,289.05
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,615.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,346.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BONE BIOPSY SUPFCL, PERCUT
|
Facility
|
IP
|
$2,693.00
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
909000106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$538.60 |
| Max. Negotiated Rate |
$2,289.05 |
| Rate for Payer: Adventist Health Commercial |
$538.60
|
| Rate for Payer: Cash Price |
$1,211.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,885.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,077.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,077.20
|
| Rate for Payer: Galaxy Health WC |
$2,289.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,615.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,710.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,588.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$646.32
|
| Rate for Payer: Multiplan Commercial |
$2,154.40
|
| Rate for Payer: Networks By Design Commercial |
$1,750.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,289.05
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$805.00
|
|
| Hospital Charge Code |
909081735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$684.25 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$603.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$487.27
|
| Rate for Payer: Blue Shield of California Commercial |
$408.13
|
| Rate for Payer: Blue Shield of California Commercial |
$619.04
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$684.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$511.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$292.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$474.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$563.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$563.50
|
| Rate for Payer: Multiplan Commercial |
$644.00
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$805.00
|
|
| Hospital Charge Code |
909081735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$511.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$474.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Multiplan Commercial |
$644.00
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
|
|
HC BONE, FINE NEEDLE ASPIRATION
|
Facility
|
OP
|
$1,664.00
|
|
|
Service Code
|
CPT 20615
|
| Hospital Charge Code |
909020019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$283.33 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$332.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cigna of CA HMO |
$1,064.96
|
| Rate for Payer: Cigna of CA PPO |
$1,231.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,164.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$1,414.40
|
| Rate for Payer: Global Benefits Group Commercial |
$998.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$283.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,056.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$1,331.20
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$1,081.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,414.40
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$998.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$832.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC BONE, FINE NEEDLE ASPIRATION
|
Facility
|
IP
|
$1,664.00
|
|
|
Service Code
|
CPT 20615
|
| Hospital Charge Code |
909020019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.80 |
| Max. Negotiated Rate |
$1,414.40 |
| Rate for Payer: Adventist Health Commercial |
$332.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,164.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$665.60
|
| Rate for Payer: EPIC Health Plan Senior |
$665.60
|
| Rate for Payer: Galaxy Health WC |
$1,414.40
|
| Rate for Payer: Global Benefits Group Commercial |
$998.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,056.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$981.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.36
|
| Rate for Payer: Multiplan Commercial |
$1,331.20
|
| Rate for Payer: Networks By Design Commercial |
$1,081.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,414.40
|
|
|
HC BONE LENGTH
|
Facility
|
IP
|
$969.00
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
909001603
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$193.80 |
| Max. Negotiated Rate |
$823.65 |
| Rate for Payer: Adventist Health Commercial |
$193.80
|
| Rate for Payer: Cash Price |
$436.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$678.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$387.60
|
| Rate for Payer: EPIC Health Plan Senior |
$387.60
|
| Rate for Payer: Galaxy Health WC |
$823.65
|
| Rate for Payer: Global Benefits Group Commercial |
$581.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$615.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$571.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.56
|
| Rate for Payer: Multiplan Commercial |
$775.20
|
| Rate for Payer: Networks By Design Commercial |
$629.85
|
| Rate for Payer: Prime Health Services Commercial |
$823.65
|
|
|
HC BONE LENGTH
|
Facility
|
OP
|
$969.00
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
909001603
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.84 |
| Max. Negotiated Rate |
$823.65 |
| Rate for Payer: Adventist Health Commercial |
$193.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$175.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.27
|
| Rate for Payer: Blue Shield of California Commercial |
$407.95
|
| Rate for Payer: Blue Shield of California Commercial |
$618.22
|
| Rate for Payer: Cash Price |
$436.05
|
| Rate for Payer: Cash Price |
$436.05
|
| Rate for Payer: Cigna of CA HMO |
$620.16
|
| Rate for Payer: Cigna of CA PPO |
$717.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$678.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$823.65
|
| Rate for Payer: Global Benefits Group Commercial |
$581.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$53.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$615.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$775.20
|
| Rate for Payer: Networks By Design Commercial |
$629.85
|
| Rate for Payer: Prime Health Services Commercial |
$823.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$581.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$581.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC BONE MARROW ASP/AT TIME OF BX
|
Facility
|
OP
|
$3,588.00
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
911800314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$258.94 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$717.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$1,614.60
|
| Rate for Payer: Cash Price |
$1,614.60
|
| Rate for Payer: Cash Price |
$1,614.60
|
| Rate for Payer: Cigna of CA HMO |
$2,296.32
|
| Rate for Payer: Cigna of CA PPO |
$2,655.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,511.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$3,049.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,152.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$258.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,278.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$292.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$861.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$2,870.40
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$2,332.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,049.80
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,152.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,794.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC BONE MARROW ASP/AT TIME OF BX
|
Facility
|
IP
|
$3,588.00
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
911800314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$717.60 |
| Max. Negotiated Rate |
$3,049.80 |
| Rate for Payer: Adventist Health Commercial |
$717.60
|
| Rate for Payer: Cash Price |
$1,614.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,511.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,435.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,435.20
|
| Rate for Payer: Galaxy Health WC |
$3,049.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,152.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,278.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,116.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$861.12
|
| Rate for Payer: Multiplan Commercial |
$2,870.40
|
| Rate for Payer: Networks By Design Commercial |
$2,332.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,049.80
|
|
|
HC BONE MARROW ASP ONLY
|
Facility
|
OP
|
$2,227.00
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
911800312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$308.35 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$445.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$1,002.15
|
| Rate for Payer: Cash Price |
$1,002.15
|
| Rate for Payer: Cash Price |
$1,002.15
|
| Rate for Payer: Cigna of CA HMO |
$1,425.28
|
| Rate for Payer: Cigna of CA PPO |
$1,647.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,558.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$1,892.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,336.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$308.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,414.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$348.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$534.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$1,781.60
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,447.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,892.95
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,336.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BONE MARROW ASP ONLY
|
Facility
|
IP
|
$2,227.00
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
911800312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$445.40 |
| Max. Negotiated Rate |
$1,892.95 |
| Rate for Payer: Adventist Health Commercial |
$445.40
|
| Rate for Payer: Cash Price |
$1,002.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,558.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$890.80
|
| Rate for Payer: EPIC Health Plan Senior |
$890.80
|
| Rate for Payer: Galaxy Health WC |
$1,892.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,336.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,414.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,313.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$534.48
|
| Rate for Payer: Multiplan Commercial |
$1,781.60
|
| Rate for Payer: Networks By Design Commercial |
$1,447.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,892.95
|
|
|
HC BONE MARROW BX ONLY
|
Facility
|
OP
|
$3,588.00
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
909020057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$328.99 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$717.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$1,614.60
|
| Rate for Payer: Cash Price |
$1,614.60
|
| Rate for Payer: Cash Price |
$1,614.60
|
| Rate for Payer: Cigna of CA HMO |
$2,296.32
|
| Rate for Payer: Cigna of CA PPO |
$2,655.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,511.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$3,049.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,152.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$328.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,278.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$372.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$861.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$2,870.40
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$2,332.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,049.80
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,152.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,794.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BONE MARROW BX ONLY
|
Facility
|
IP
|
$3,588.00
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
909020057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$717.60 |
| Max. Negotiated Rate |
$3,049.80 |
| Rate for Payer: Adventist Health Commercial |
$717.60
|
| Rate for Payer: Cash Price |
$1,614.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,511.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,435.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,435.20
|
| Rate for Payer: Galaxy Health WC |
$3,049.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,152.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,278.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,116.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$861.12
|
| Rate for Payer: Multiplan Commercial |
$2,870.40
|
| Rate for Payer: Networks By Design Commercial |
$2,332.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,049.80
|
|
|
HC BONE MARROW IMAGING, LTD
|
Facility
|
IP
|
$1,437.00
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
909301330
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$287.40 |
| Max. Negotiated Rate |
$1,221.45 |
| Rate for Payer: Adventist Health Commercial |
$287.40
|
| Rate for Payer: Cash Price |
$646.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,005.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$574.80
|
| Rate for Payer: EPIC Health Plan Senior |
$574.80
|
| Rate for Payer: Galaxy Health WC |
$1,221.45
|
| Rate for Payer: Global Benefits Group Commercial |
$862.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$912.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$847.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.88
|
| Rate for Payer: Multiplan Commercial |
$1,149.60
|
| Rate for Payer: Networks By Design Commercial |
$934.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,221.45
|
|
|
HC BONE MARROW IMAGING, LTD
|
Facility
|
OP
|
$1,437.00
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
909301330
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$156.66 |
| Max. Negotiated Rate |
$1,221.45 |
| Rate for Payer: Adventist Health Commercial |
$287.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,003.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$922.12
|
| Rate for Payer: Blue Shield of California Commercial |
$916.81
|
| Rate for Payer: Blue Shield of California Commercial |
$604.98
|
| Rate for Payer: Cash Price |
$646.65
|
| Rate for Payer: Cash Price |
$646.65
|
| Rate for Payer: Cigna of CA HMO |
$919.68
|
| Rate for Payer: Cigna of CA PPO |
$1,063.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,005.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$1,221.45
|
| Rate for Payer: Global Benefits Group Commercial |
$862.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$156.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$912.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$177.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$647.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,149.60
|
| Rate for Payer: Networks By Design Commercial |
$934.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,221.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$862.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$862.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$654.98
|
| Rate for Payer: United Healthcare All Other HMO |
$654.98
|
| Rate for Payer: United Healthcare HMO Rider |
$654.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$654.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC BONE SCAN LIMITED
|
Facility
|
OP
|
$1,825.00
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
909301370
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$135.93 |
| Max. Negotiated Rate |
$1,551.25 |
| Rate for Payer: Adventist Health Commercial |
$365.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,045.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,171.10
|
| Rate for Payer: Blue Shield of California Commercial |
$768.33
|
| Rate for Payer: Blue Shield of California Commercial |
$1,164.35
|
| Rate for Payer: Cash Price |
$821.25
|
| Rate for Payer: Cash Price |
$821.25
|
| Rate for Payer: Cigna of CA HMO |
$1,168.00
|
| Rate for Payer: Cigna of CA PPO |
$1,350.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,277.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$1,551.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,095.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$135.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,158.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$647.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,460.00
|
| Rate for Payer: Networks By Design Commercial |
$1,186.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,551.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,095.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,095.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.16
|
| Rate for Payer: United Healthcare All Other HMO |
$632.16
|
| Rate for Payer: United Healthcare HMO Rider |
$632.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.16
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC BONE SCAN LIMITED
|
Facility
|
IP
|
$1,825.00
|
|
|
Service Code
|
CPT 78300
|
| Hospital Charge Code |
909301370
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$365.00 |
| Max. Negotiated Rate |
$1,551.25 |
| Rate for Payer: Adventist Health Commercial |
$365.00
|
| Rate for Payer: Cash Price |
$821.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,277.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.00
|
| Rate for Payer: EPIC Health Plan Senior |
$730.00
|
| Rate for Payer: Galaxy Health WC |
$1,551.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,095.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,158.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,076.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.00
|
| Rate for Payer: Multiplan Commercial |
$1,460.00
|
| Rate for Payer: Networks By Design Commercial |
$1,186.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,551.25
|
|
|
HC BONE SCAN WHOLE BODY
|
Facility
|
IP
|
$3,218.00
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
909301371
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$643.60 |
| Max. Negotiated Rate |
$2,735.30 |
| Rate for Payer: Adventist Health Commercial |
$643.60
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,287.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,287.20
|
| Rate for Payer: Galaxy Health WC |
$2,735.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,930.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,043.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,898.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.32
|
| Rate for Payer: Multiplan Commercial |
$2,574.40
|
| Rate for Payer: Networks By Design Commercial |
$2,091.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,735.30
|
|
|
HC BONE SCAN WHOLE BODY
|
Facility
|
OP
|
$3,218.00
|
|
|
Service Code
|
CPT 78306
|
| Hospital Charge Code |
909301371
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$236.93 |
| Max. Negotiated Rate |
$2,735.30 |
| Rate for Payer: Adventist Health Commercial |
$643.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,518.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,064.99
|
| Rate for Payer: Blue Shield of California Commercial |
$2,053.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,354.78
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Cigna of CA HMO |
$2,059.52
|
| Rate for Payer: Cigna of CA PPO |
$2,381.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$2,735.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,930.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$236.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,043.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$267.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$647.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$2,574.40
|
| Rate for Payer: Networks By Design Commercial |
$2,091.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,735.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,930.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,930.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.16
|
| Rate for Payer: United Healthcare All Other HMO |
$632.16
|
| Rate for Payer: United Healthcare HMO Rider |
$632.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.16
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC BONE SPECT
|
Facility
|
OP
|
$3,422.00
|
|
|
Service Code
|
CPT 78320
|
| Hospital Charge Code |
909301369
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$684.40 |
| Max. Negotiated Rate |
$2,908.70 |
| Rate for Payer: Adventist Health Commercial |
$684.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,244.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,908.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,882.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,566.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,195.90
|
| Rate for Payer: Blue Shield of California Commercial |
$1,440.66
|
| Rate for Payer: Blue Shield of California Commercial |
$2,183.24
|
| Rate for Payer: Cash Price |
$1,539.90
|
| Rate for Payer: Cigna of CA HMO |
$2,190.08
|
| Rate for Payer: Cigna of CA PPO |
$2,532.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,908.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,908.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,908.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,395.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,368.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,368.80
|
| Rate for Payer: Galaxy Health WC |
$2,908.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,053.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,172.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,242.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,018.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$821.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,395.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,395.40
|
| Rate for Payer: Multiplan Commercial |
$2,737.60
|
| Rate for Payer: Networks By Design Commercial |
$2,224.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,908.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,053.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,053.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,711.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,711.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,711.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,711.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,908.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,908.70
|
| Rate for Payer: Vantage Medical Group Senior |
$2,908.70
|
|
|
HC BONE SPECT
|
Facility
|
IP
|
$3,422.00
|
|
|
Service Code
|
CPT 78320
|
| Hospital Charge Code |
909301369
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$684.40 |
| Max. Negotiated Rate |
$2,908.70 |
| Rate for Payer: Adventist Health Commercial |
$684.40
|
| Rate for Payer: Cash Price |
$1,539.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,395.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,368.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,368.80
|
| Rate for Payer: Galaxy Health WC |
$2,908.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,053.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,172.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,018.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$821.28
|
| Rate for Payer: Multiplan Commercial |
$2,737.60
|
| Rate for Payer: Networks By Design Commercial |
$2,224.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,908.70
|
|
|
HC BONE/STEM TRANS ALLOGENIC
|
Facility
|
IP
|
$6,498.00
|
|
|
Service Code
|
CPT 38240
|
| Hospital Charge Code |
907702201
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$1,299.60 |
| Max. Negotiated Rate |
$5,523.30 |
| Rate for Payer: Adventist Health Commercial |
$1,299.60
|
| Rate for Payer: Cash Price |
$2,924.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,548.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,599.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,599.20
|
| Rate for Payer: Galaxy Health WC |
$5,523.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,898.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,126.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,833.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,559.52
|
| Rate for Payer: Multiplan Commercial |
$5,198.40
|
| Rate for Payer: Networks By Design Commercial |
$4,223.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,523.30
|
|
|
HC BONE/STEM TRANS ALLOGENIC
|
Facility
|
OP
|
$6,498.00
|
|
|
Service Code
|
CPT 38240
|
| Hospital Charge Code |
907702201
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$175.12 |
| Max. Negotiated Rate |
$133,487.23 |
| Rate for Payer: Adventist Health Commercial |
$1,299.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$815.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$121,352.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$80,901.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$80,901.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,924.00
|
| Rate for Payer: Cash Price |
$2,924.10
|
| Rate for Payer: Cash Price |
$2,924.10
|
| Rate for Payer: Cash Price |
$2,924.10
|
| Rate for Payer: Cigna of CA HMO |
$4,158.72
|
| Rate for Payer: Cigna of CA PPO |
$4,808.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$121,352.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$80,901.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$80,901.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,548.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$133,487.23
|
| Rate for Payer: EPIC Health Plan Senior |
$88,991.49
|
| Rate for Payer: Galaxy Health WC |
$5,523.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,898.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$132,678.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$175.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$80,901.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,126.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$113,261.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,559.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101,935.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108,407.81
|
| Rate for Payer: Multiplan Commercial |
$5,198.40
|
| Rate for Payer: Multiplan WC |
$119,732.14
|
| Rate for Payer: Networks By Design Commercial |
$4,223.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,523.30
|
| Rate for Payer: Prime Health Services WC |
$118,510.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,898.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,898.80
|
| Rate for Payer: Upland Medical Group Pediatric |
$80,901.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$121,352.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80,901.35
|
| Rate for Payer: Vantage Medical Group Senior |
$80,901.35
|
|
