|
HC CONF COORD NURSE SPECIALIST
|
Facility
OP
|
$289.00
|
|
| Hospital Charge Code |
912154300
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.36 |
| Max. Negotiated Rate |
$245.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$189.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$245.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$158.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$158.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$172.19
|
| Rate for Payer: BCBS Transplant Transplant |
$173.40
|
| Rate for Payer: Blue Shield of California Commercial |
$212.99
|
| Rate for Payer: Blue Shield of California EPN |
$168.78
|
| Rate for Payer: Cash Price |
$130.05
|
| Rate for Payer: Cigna of CA HMO |
$184.96
|
| Rate for Payer: Cigna of CA PPO |
$213.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.65
|
| Rate for Payer: Dignity Health Media |
$245.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$245.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$115.60
|
| Rate for Payer: Galaxy Health WC |
$245.65
|
| Rate for Payer: Global Benefits Group Commercial |
$173.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$216.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.36
|
| Rate for Payer: Multiplan Commercial |
$231.20
|
| Rate for Payer: Networks By Design Commercial |
$187.85
|
| Rate for Payer: Prime Health Services Commercial |
$245.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$173.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$173.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$173.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.50
|
| Rate for Payer: United Healthcare All Other HMO |
$144.50
|
| Rate for Payer: United Healthcare HMO Rider |
$144.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$245.65
|
| Rate for Payer: Vantage Medical Group Senior |
$245.65
|
|
|
HC CONF COORD NURSE SPECIALIST
|
Facility
IP
|
$289.00
|
|
| Hospital Charge Code |
912154300
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$69.36 |
| Max. Negotiated Rate |
$245.65 |
| Rate for Payer: Cash Price |
$130.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.60
|
| Rate for Payer: Galaxy Health WC |
$245.65
|
| Rate for Payer: Global Benefits Group Commercial |
$173.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.36
|
| Rate for Payer: Multiplan Commercial |
$231.20
|
| Rate for Payer: Networks By Design Commercial |
$187.85
|
| Rate for Payer: Prime Health Services Commercial |
$245.65
|
|
|
HC CONF COORD OTHER ALLIED HLTH
|
Facility
OP
|
$236.00
|
|
| Hospital Charge Code |
912164305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$56.64 |
| Max. Negotiated Rate |
$200.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$154.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$129.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$129.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.61
|
| Rate for Payer: BCBS Transplant Transplant |
$141.60
|
| Rate for Payer: Blue Shield of California Commercial |
$173.93
|
| Rate for Payer: Blue Shield of California EPN |
$137.82
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cigna of CA HMO |
$151.04
|
| Rate for Payer: Cigna of CA PPO |
$174.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$200.60
|
| Rate for Payer: Dignity Health Media |
$200.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$200.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$177.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$157.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.64
|
| Rate for Payer: Multiplan Commercial |
$188.80
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$141.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$118.00
|
| Rate for Payer: United Healthcare All Other HMO |
$118.00
|
| Rate for Payer: United Healthcare HMO Rider |
$118.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$200.60
|
| Rate for Payer: Vantage Medical Group Senior |
$200.60
|
|
|
HC CONF COORD OTHER ALLIED HLTH
|
Facility
IP
|
$236.00
|
|
| Hospital Charge Code |
912164305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$56.64 |
| Max. Negotiated Rate |
$200.60 |
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$157.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.64
|
| Rate for Payer: Multiplan Commercial |
$188.80
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906811595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,628.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Dignity Health Media |
$4,071.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,478.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,677.03
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,677.03
|
| Rate for Payer: IEHP Medi-Cal |
$6,595.60
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,595.60
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,129.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906811595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$5,978.90 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,679.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,628.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Dignity Health Media |
$4,071.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,478.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,677.03
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,677.03
|
| Rate for Payer: IEHP Medi-Cal |
$6,595.60
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,595.60
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,129.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$5,978.90 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,679.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$5,978.90 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,679.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,628.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Dignity Health Media |
$4,071.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,478.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,677.03
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,677.03
|
| Rate for Payer: IEHP Medi-Cal |
$6,595.60
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,595.60
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,129.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT HEART CATH ABNL NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,628.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Dignity Health Media |
$4,071.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,478.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,677.03
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,677.03
|
| Rate for Payer: IEHP Medi-Cal |
$6,595.60
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,595.60
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,129.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT HEART CATH ABNL NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$5,978.90 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,679.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$5,978.90 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,679.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,688.16 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,628.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Dignity Health Media |
$4,071.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,478.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,677.03
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,677.03
|
| Rate for Payer: IEHP Medi-Cal |
$6,595.60
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,595.60
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,688.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,129.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,627.20
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONSULT COMP/HIGH COMPLEX
|
Facility
IP
|
$990.00
|
|
| Hospital Charge Code |
912999245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$237.60 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Cash Price |
$445.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.00
|
| Rate for Payer: Galaxy Health WC |
$841.50
|
| Rate for Payer: Global Benefits Group Commercial |
$594.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$660.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.60
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
| Rate for Payer: Networks By Design Commercial |
$643.50
|
| Rate for Payer: Prime Health Services Commercial |
$841.50
|
|
|
HC CONSULT COMP/HIGH COMPLEX
|
Facility
IP
|
$1,177.00
|
|
| Hospital Charge Code |
908600122
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$282.48 |
| Max. Negotiated Rate |
$1,000.45 |
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$785.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.48
|
| Rate for Payer: Multiplan Commercial |
$941.60
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
|
|
HC CONSULT COMP/HIGH COMPLEX
|
Facility
OP
|
$990.00
|
|
| Hospital Charge Code |
912999245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$237.60 |
| Max. Negotiated Rate |
$841.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$649.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$841.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$544.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$544.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$589.84
|
| Rate for Payer: BCBS Transplant Transplant |
$594.00
|
| Rate for Payer: Blue Shield of California Commercial |
$729.63
|
| Rate for Payer: Blue Shield of California EPN |
$578.16
|
| Rate for Payer: Cash Price |
$445.50
|
| Rate for Payer: Cigna of CA HMO |
$633.60
|
| Rate for Payer: Cigna of CA PPO |
$732.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$841.50
|
| Rate for Payer: Dignity Health Media |
$841.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$841.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$396.00
|
| Rate for Payer: Galaxy Health WC |
$841.50
|
| Rate for Payer: Global Benefits Group Commercial |
$594.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$742.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$660.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.60
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
| Rate for Payer: Networks By Design Commercial |
$643.50
|
| Rate for Payer: Prime Health Services Commercial |
$841.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$594.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$594.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$594.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$495.00
|
| Rate for Payer: United Healthcare All Other HMO |
$495.00
|
| Rate for Payer: United Healthcare HMO Rider |
$495.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$495.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$841.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$841.50
|
| Rate for Payer: Vantage Medical Group Senior |
$841.50
|
|
|
HC CONSULT COMP/HIGH COMPLEX
|
Facility
OP
|
$1,177.00
|
|
| Hospital Charge Code |
908600122
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$282.48 |
| Max. Negotiated Rate |
$1,000.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$771.99
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,000.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$647.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$647.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$701.26
|
| Rate for Payer: BCBS Transplant Transplant |
$706.20
|
| Rate for Payer: Blue Shield of California Commercial |
$867.45
|
| Rate for Payer: Blue Shield of California EPN |
$687.37
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Cigna of CA HMO |
$753.28
|
| Rate for Payer: Cigna of CA PPO |
$870.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Dignity Health Media |
$1,000.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,000.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$470.80
|
| Rate for Payer: Galaxy Health WC |
$1,000.45
|
| Rate for Payer: Global Benefits Group Commercial |
$706.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$882.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$785.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$448.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.48
|
| Rate for Payer: Multiplan Commercial |
$941.60
|
| Rate for Payer: Networks By Design Commercial |
$765.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,000.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$706.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$706.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$706.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$588.50
|
| Rate for Payer: United Healthcare All Other HMO |
$588.50
|
| Rate for Payer: United Healthcare HMO Rider |
$588.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$588.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,000.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,000.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,000.45
|
|
|
HC CONSULT COMP/MOD COMPLEX
|
Facility
IP
|
$871.00
|
|
| Hospital Charge Code |
912999244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.04 |
| Max. Negotiated Rate |
$740.35 |
| Rate for Payer: Cash Price |
$391.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.40
|
| Rate for Payer: Galaxy Health WC |
$740.35
|
| Rate for Payer: Global Benefits Group Commercial |
$522.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$580.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.04
|
| Rate for Payer: Multiplan Commercial |
$696.80
|
| Rate for Payer: Networks By Design Commercial |
$566.15
|
| Rate for Payer: Prime Health Services Commercial |
$740.35
|
|
|
HC CONSULT COMP/MOD COMPLEX
|
Facility
OP
|
$871.00
|
|
| Hospital Charge Code |
912999244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$209.04 |
| Max. Negotiated Rate |
$740.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$571.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$740.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$479.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$479.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$518.94
|
| Rate for Payer: BCBS Transplant Transplant |
$522.60
|
| Rate for Payer: Blue Shield of California Commercial |
$641.93
|
| Rate for Payer: Blue Shield of California EPN |
$508.66
|
| Rate for Payer: Cash Price |
$391.95
|
| Rate for Payer: Cigna of CA HMO |
$557.44
|
| Rate for Payer: Cigna of CA PPO |
$644.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$740.35
|
| Rate for Payer: Dignity Health Media |
$740.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$740.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$348.40
|
| Rate for Payer: Galaxy Health WC |
$740.35
|
| Rate for Payer: Global Benefits Group Commercial |
$522.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$653.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$580.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.04
|
| Rate for Payer: Multiplan Commercial |
$696.80
|
| Rate for Payer: Networks By Design Commercial |
$566.15
|
| Rate for Payer: Prime Health Services Commercial |
$740.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$522.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$522.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$522.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$435.50
|
| Rate for Payer: United Healthcare All Other HMO |
$435.50
|
| Rate for Payer: United Healthcare HMO Rider |
$435.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$435.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$740.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$740.35
|
| Rate for Payer: Vantage Medical Group Senior |
$740.35
|
|
|
HC CONSULT COMP/MOD COMPLEX
|
Facility
IP
|
$1,035.00
|
|
| Hospital Charge Code |
908600121
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$248.40 |
| Max. Negotiated Rate |
$879.75 |
| Rate for Payer: Cash Price |
$465.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.00
|
| Rate for Payer: Galaxy Health WC |
$879.75
|
| Rate for Payer: Global Benefits Group Commercial |
$621.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$690.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$394.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.40
|
| Rate for Payer: Multiplan Commercial |
$828.00
|
| Rate for Payer: Networks By Design Commercial |
$672.75
|
| Rate for Payer: Prime Health Services Commercial |
$879.75
|
|
|
HC CONSULT COMP/MOD COMPLEX
|
Facility
OP
|
$1,035.00
|
|
| Hospital Charge Code |
908600121
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$248.40 |
| Max. Negotiated Rate |
$879.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$678.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$879.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$569.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$569.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$616.65
|
| Rate for Payer: BCBS Transplant Transplant |
$621.00
|
| Rate for Payer: Blue Shield of California Commercial |
$762.80
|
| Rate for Payer: Blue Shield of California EPN |
$604.44
|
| Rate for Payer: Cash Price |
$465.75
|
| Rate for Payer: Cigna of CA HMO |
$662.40
|
| Rate for Payer: Cigna of CA PPO |
$765.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$879.75
|
| Rate for Payer: Dignity Health Media |
$879.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$879.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$414.00
|
| Rate for Payer: Galaxy Health WC |
$879.75
|
| Rate for Payer: Global Benefits Group Commercial |
$621.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$776.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$690.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$394.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.40
|
| Rate for Payer: Multiplan Commercial |
$828.00
|
| Rate for Payer: Networks By Design Commercial |
$672.75
|
| Rate for Payer: Prime Health Services Commercial |
$879.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$621.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$621.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$621.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$517.50
|
| Rate for Payer: United Healthcare All Other HMO |
$517.50
|
| Rate for Payer: United Healthcare HMO Rider |
$517.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$517.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$879.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$879.75
|
| Rate for Payer: Vantage Medical Group Senior |
$879.75
|
|
|
HC CONSULT DETAILED
|
Facility
OP
|
$848.00
|
|
| Hospital Charge Code |
908600120
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$203.52 |
| Max. Negotiated Rate |
$720.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$556.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$720.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$466.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$466.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$505.24
|
| Rate for Payer: BCBS Transplant Transplant |
$508.80
|
| Rate for Payer: Blue Shield of California Commercial |
$624.98
|
| Rate for Payer: Blue Shield of California EPN |
$495.23
|
| Rate for Payer: Cash Price |
$381.60
|
| Rate for Payer: Cigna of CA HMO |
$542.72
|
| Rate for Payer: Cigna of CA PPO |
$627.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$720.80
|
| Rate for Payer: Dignity Health Media |
$720.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$720.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$339.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$339.20
|
| Rate for Payer: Galaxy Health WC |
$720.80
|
| Rate for Payer: Global Benefits Group Commercial |
$508.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$636.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$565.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$323.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.52
|
| Rate for Payer: Multiplan Commercial |
$678.40
|
| Rate for Payer: Networks By Design Commercial |
$551.20
|
| Rate for Payer: Prime Health Services Commercial |
$720.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$508.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$508.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$508.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$424.00
|
| Rate for Payer: United Healthcare All Other HMO |
$424.00
|
| Rate for Payer: United Healthcare HMO Rider |
$424.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$424.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$720.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$720.80
|
| Rate for Payer: Vantage Medical Group Senior |
$720.80
|
|
|
HC CONSULT DETAILED
|
Facility
IP
|
$594.00
|
|
| Hospital Charge Code |
912999243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.56 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Cash Price |
$267.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.60
|
| Rate for Payer: Galaxy Health WC |
$504.90
|
| Rate for Payer: Global Benefits Group Commercial |
$356.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$396.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.56
|
| Rate for Payer: Multiplan Commercial |
$475.20
|
| Rate for Payer: Networks By Design Commercial |
$386.10
|
| Rate for Payer: Prime Health Services Commercial |
$504.90
|
|
|
HC CONSULT DETAILED
|
Facility
OP
|
$594.00
|
|
| Hospital Charge Code |
912999243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.56 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$389.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$504.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$326.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$326.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$353.91
|
| Rate for Payer: BCBS Transplant Transplant |
$356.40
|
| Rate for Payer: Blue Shield of California Commercial |
$437.78
|
| Rate for Payer: Blue Shield of California EPN |
$346.90
|
| Rate for Payer: Cash Price |
$267.30
|
| Rate for Payer: Cigna of CA HMO |
$380.16
|
| Rate for Payer: Cigna of CA PPO |
$439.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$504.90
|
| Rate for Payer: Dignity Health Media |
$504.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$504.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$237.60
|
| Rate for Payer: Galaxy Health WC |
$504.90
|
| Rate for Payer: Global Benefits Group Commercial |
$356.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$445.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$396.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.56
|
| Rate for Payer: Multiplan Commercial |
$475.20
|
| Rate for Payer: Networks By Design Commercial |
$386.10
|
| Rate for Payer: Prime Health Services Commercial |
$504.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$356.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$356.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$356.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$297.00
|
| Rate for Payer: United Healthcare HMO Rider |
$297.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$297.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$504.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$504.90
|
| Rate for Payer: Vantage Medical Group Senior |
$504.90
|
|
