|
HC CARRY D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8986
|
| Hospital Charge Code |
900018308
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC CARRY D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8986
|
| Hospital Charge Code |
900018308
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC CARRY GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018307
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC CARRY GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018307
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$478.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| 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: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| 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 HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC CAR SEAT/BED TSTNG AIRWAY INTEGRITY 60 MIN
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
900801780
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC CAR SEAT/BED TSTNG AIRWAY INTEGRITY 60 MIN
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
900801780
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$48.04 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$149.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$224.59
|
| Rate for Payer: Blue Shield of California Commercial |
$147.35
|
| Rate for Payer: Blue Shield of California Commercial |
$223.30
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.27
|
| Rate for Payer: EPIC Health Plan Senior |
$52.84
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$78.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.37
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$48.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
|
|
HC CAR SEAT/BED TSTNG AIRWAY INTEGRITY EA ADD 30 MIN
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
900801781
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$148.75 |
| Rate for Payer: Adventist Health Commercial |
$35.00
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$122.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.00
|
| Rate for Payer: EPIC Health Plan Senior |
$70.00
|
| Rate for Payer: Galaxy Health WC |
$148.75
|
| Rate for Payer: Global Benefits Group Commercial |
$105.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$111.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$103.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$140.00
|
| Rate for Payer: Networks By Design Commercial |
$113.75
|
| Rate for Payer: Prime Health Services Commercial |
$148.75
|
|
|
HC CAR SEAT/BED TSTNG AIRWAY INTEGRITY EA ADD 30 MIN
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
900801781
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$35.00 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$35.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$148.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$96.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$131.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.30
|
| Rate for Payer: Blue Shield of California Commercial |
$73.67
|
| Rate for Payer: Blue Shield of California Commercial |
$111.65
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Cigna of CA HMO |
$112.00
|
| Rate for Payer: Cigna of CA PPO |
$129.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$148.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$148.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$122.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.00
|
| Rate for Payer: EPIC Health Plan Senior |
$70.00
|
| Rate for Payer: Galaxy Health WC |
$148.75
|
| Rate for Payer: Global Benefits Group Commercial |
$105.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$111.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$103.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$122.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$122.50
|
| Rate for Payer: Multiplan Commercial |
$140.00
|
| Rate for Payer: Networks By Design Commercial |
$113.75
|
| Rate for Payer: Prime Health Services Commercial |
$148.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$105.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$105.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$148.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.75
|
| Rate for Payer: Vantage Medical Group Senior |
$148.75
|
|
|
HC CAR-T ADMIN AUTOLOGOUS
|
Facility
|
OP
|
$2,125.00
|
|
|
Service Code
|
CPT 38228
|
| Hospital Charge Code |
947000540
|
|
Hospital Revenue Code
|
874
|
| Min. Negotiated Rate |
$396.55 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$425.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,109.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$956.25
|
| Rate for Payer: Cash Price |
$956.25
|
| Rate for Payer: Cash Price |
$956.25
|
| Rate for Payer: Cigna of CA HMO |
$1,360.00
|
| Rate for Payer: Cigna of CA PPO |
$1,572.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,487.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,806.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$396.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,349.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$448.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$510.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$535.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,700.00
|
| Rate for Payer: Networks By Design Commercial |
$1,381.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,806.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,275.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,062.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,062.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,062.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,062.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC CAR-T ADMIN AUTOLOGOUS
|
Facility
|
IP
|
$2,125.00
|
|
|
Service Code
|
CPT 38228
|
| Hospital Charge Code |
947000540
|
|
Hospital Revenue Code
|
874
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$1,806.25 |
| Rate for Payer: Adventist Health Commercial |
$425.00
|
| Rate for Payer: Cash Price |
$956.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,487.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.00
|
| Rate for Payer: EPIC Health Plan Senior |
$850.00
|
| Rate for Payer: Galaxy Health WC |
$1,806.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,349.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,253.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$510.00
|
| Rate for Payer: Multiplan Commercial |
$1,700.00
|
| Rate for Payer: Networks By Design Commercial |
$1,381.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,806.25
|
|
|
HC CAR-T CRYOPRESERVATION STORAGE
|
Facility
|
OP
|
$3,315.00
|
|
|
Service Code
|
CPT 38226
|
| Hospital Charge Code |
947000538
|
|
Hospital Revenue Code
|
872
|
| Min. Negotiated Rate |
$240.13 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$663.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$240.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,817.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,823.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,486.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Cigna of CA HMO |
$2,121.60
|
| Rate for Payer: Cigna of CA PPO |
$2,453.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,817.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,817.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,817.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,320.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.00
|
| Rate for Payer: Galaxy Health WC |
$2,817.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,105.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,203.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,955.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,320.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,320.50
|
| Rate for Payer: Multiplan Commercial |
$2,652.00
|
| Rate for Payer: Networks By Design Commercial |
$2,154.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,817.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,989.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,989.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,657.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,657.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,657.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,657.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,817.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,817.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,817.75
|
|
|
HC CAR-T CRYOPRESERVATION STORAGE
|
Facility
|
IP
|
$3,315.00
|
|
|
Service Code
|
CPT 38226
|
| Hospital Charge Code |
947000538
|
|
Hospital Revenue Code
|
872
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$2,817.75 |
| Rate for Payer: Adventist Health Commercial |
$663.00
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,320.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.00
|
| Rate for Payer: Galaxy Health WC |
$2,817.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,105.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,955.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.60
|
| Rate for Payer: Multiplan Commercial |
$2,652.00
|
| Rate for Payer: Networks By Design Commercial |
$2,154.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,817.75
|
|
|
HC CAR-T RECEIPT PREP FOR ADMIN
|
Facility
|
IP
|
$2,550.00
|
|
|
Service Code
|
CPT 38227
|
| Hospital Charge Code |
947000539
|
|
Hospital Revenue Code
|
873
|
| Min. Negotiated Rate |
$510.00 |
| Max. Negotiated Rate |
$2,167.50 |
| Rate for Payer: Adventist Health Commercial |
$510.00
|
| Rate for Payer: Cash Price |
$1,147.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,785.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,020.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,020.00
|
| Rate for Payer: Galaxy Health WC |
$2,167.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,530.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,619.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,504.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$612.00
|
| Rate for Payer: Multiplan Commercial |
$2,040.00
|
| Rate for Payer: Networks By Design Commercial |
$1,657.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,167.50
|
|
|
HC CAR-T RECEIPT PREP FOR ADMIN
|
Facility
|
OP
|
$2,550.00
|
|
|
Service Code
|
CPT 38227
|
| Hospital Charge Code |
947000539
|
|
Hospital Revenue Code
|
873
|
| Min. Negotiated Rate |
$242.15 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$510.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$242.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,167.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,402.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,912.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,147.50
|
| Rate for Payer: Cash Price |
$1,147.50
|
| Rate for Payer: Cash Price |
$1,147.50
|
| Rate for Payer: Cigna of CA HMO |
$1,632.00
|
| Rate for Payer: Cigna of CA PPO |
$1,887.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,167.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,167.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,167.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,785.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,020.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,020.00
|
| Rate for Payer: Galaxy Health WC |
$2,167.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,530.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,619.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$925.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,504.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$612.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,785.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,785.00
|
| Rate for Payer: Multiplan Commercial |
$2,040.00
|
| Rate for Payer: Networks By Design Commercial |
$1,657.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,167.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,530.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,530.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,275.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,275.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,275.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,275.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,167.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,167.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,167.50
|
|
|
HC CASE CONFERENCE GT 3 STAFF W/PT MCAL
|
Facility
|
OP
|
$742.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
907000005
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$178.08 |
| Max. Negotiated Rate |
$885.51 |
| Rate for Payer: Adventist Health Commercial |
$304.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$458.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.67
|
| 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 |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Cigna of CA HMO |
$474.88
|
| Rate for Payer: Cigna of CA PPO |
$549.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$805.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$590.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$536.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$519.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$885.51
|
| Rate for Payer: EPIC Health Plan Senior |
$590.34
|
| Rate for Payer: Galaxy Health WC |
$630.70
|
| Rate for Payer: Global Benefits Group Commercial |
$445.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$880.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$536.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$471.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$269.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$751.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$676.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$719.14
|
| Rate for Payer: Multiplan Commercial |
$593.60
|
| Rate for Payer: Networks By Design Commercial |
$482.30
|
| Rate for Payer: Prime Health Services Commercial |
$630.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$445.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$644.00
|
| 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 HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$536.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Vantage Medical Group Senior |
$536.67
|
|
|
HC CASE CONFERENCE GT 3 STAFF W/PT MCAL
|
Facility
|
IP
|
$742.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
907000005
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$148.40 |
| Max. Negotiated Rate |
$630.70 |
| Rate for Payer: Adventist Health Commercial |
$148.40
|
| Rate for Payer: Cash Price |
$333.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$519.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$296.80
|
| Rate for Payer: EPIC Health Plan Senior |
$296.80
|
| Rate for Payer: Galaxy Health WC |
$630.70
|
| Rate for Payer: Global Benefits Group Commercial |
$445.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$471.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$437.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.08
|
| Rate for Payer: Multiplan Commercial |
$593.60
|
| Rate for Payer: Networks By Design Commercial |
$482.30
|
| Rate for Payer: Prime Health Services Commercial |
$630.70
|
|
|
HC CASTING 3" TCC-EZ SINGLE APP
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698310
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$372.19
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CASTING 3" TCC-EZ SINGLE APP
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698310
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CASTING 4" TCC-EZ SINGLE APP
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CASTING 4" TCC-EZ SINGLE APP
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$372.19
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CAST OFF LOADER KIT
|
Facility
|
OP
|
$556.57
|
|
|
Service Code
|
CPT A6452
|
| Hospital Charge Code |
901698871
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$16.82 |
| Max. Negotiated Rate |
$473.08 |
| Rate for Payer: Adventist Health Commercial |
$111.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$473.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$306.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$417.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$357.15
|
| Rate for Payer: Cash Price |
$250.46
|
| Rate for Payer: Cash Price |
$250.46
|
| Rate for Payer: Cigna of CA HMO |
$356.20
|
| Rate for Payer: Cigna of CA PPO |
$411.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$473.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$473.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$473.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$389.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.63
|
| Rate for Payer: EPIC Health Plan Senior |
$222.63
|
| Rate for Payer: Galaxy Health WC |
$473.08
|
| Rate for Payer: Global Benefits Group Commercial |
$333.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$353.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$202.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$328.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$389.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$389.60
|
| Rate for Payer: Multiplan Commercial |
$445.26
|
| Rate for Payer: Networks By Design Commercial |
$361.77
|
| Rate for Payer: Prime Health Services Commercial |
$473.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$333.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$333.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$278.29
|
| Rate for Payer: United Healthcare All Other HMO |
$278.29
|
| Rate for Payer: United Healthcare HMO Rider |
$278.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$473.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$473.08
|
| Rate for Payer: Vantage Medical Group Senior |
$473.08
|
|
|
HC CAST OFF LOADER KIT
|
Facility
|
IP
|
$556.57
|
|
|
Service Code
|
CPT A6452
|
| Hospital Charge Code |
901698871
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$111.31 |
| Max. Negotiated Rate |
$473.08 |
| Rate for Payer: Adventist Health Commercial |
$111.31
|
| Rate for Payer: Cash Price |
$250.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$389.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.63
|
| Rate for Payer: EPIC Health Plan Senior |
$222.63
|
| Rate for Payer: Galaxy Health WC |
$473.08
|
| Rate for Payer: Global Benefits Group Commercial |
$333.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$353.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$328.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.58
|
| Rate for Payer: Multiplan Commercial |
$445.26
|
| Rate for Payer: Networks By Design Commercial |
$361.77
|
| Rate for Payer: Prime Health Services Commercial |
$473.08
|
|
|
HC CATECHOLAMINES UR FRACTIONATED
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900910455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$260.65 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$209.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$209.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$260.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$260.65
|
| Rate for Payer: Blue Shield of California Commercial |
$43.33
|
| Rate for Payer: Blue Shield of California Commercial |
$39.19
|
| Rate for Payer: Blue Shield of California Commercial |
$65.52
|
| Rate for Payer: Blue Shield of California Commercial |
$59.24
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cigna of CA HMO |
$60.16
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Cigna of CA PPO |
$69.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.66
|
| Rate for Payer: EPIC Health Plan Senior |
$27.77
|
| Rate for Payer: EPIC Health Plan Senior |
$27.77
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$37.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$37.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.84
|
| Rate for Payer: Multiplan Commercial |
$75.20
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.77
|
| Rate for Payer: Vantage Medical Group Senior |
$25.25
|
| Rate for Payer: Vantage Medical Group Senior |
$25.25
|
|
|
HC CATECHOLAMINES UR FRACTIONATED
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900910455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$79.90 |
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Senior |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$55.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$75.20
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
|
|
HC CATH 2 LUMEN 5.5FR 50CM PICC
|
Facility
|
IP
|
$940.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.05 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$188.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cigna of CA HMO |
$658.17
|
| Rate for Payer: Cigna of CA PPO |
$658.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.10
|
| Rate for Payer: EPIC Health Plan Senior |
$376.10
|
| Rate for Payer: Galaxy Health WC |
$799.20
|
| Rate for Payer: Global Benefits Group Commercial |
$564.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$597.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$554.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.66
|
| Rate for Payer: Multiplan Commercial |
$752.19
|
| Rate for Payer: Networks By Design Commercial |
$470.12
|
| Rate for Payer: Prime Health Services Commercial |
$799.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.87
|
| Rate for Payer: United Healthcare All Other HMO |
$343.47
|
| Rate for Payer: United Healthcare HMO Rider |
$336.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.93
|
|
