|
HC IDENT OF ARTHROPOD
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
900912431
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$38.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.94
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.98
|
| Rate for Payer: Blue Shield of California EPN |
$8.70
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.40
|
| Rate for Payer: Dignity Health Media |
$4.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.27
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.00
|
| Rate for Payer: Heritage Provider Network Transplant |
$7.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.72
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.46
|
| Rate for Payer: United Healthcare HMO Rider |
$3.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4.27
|
|
|
HC IDENT OF PARASITES
|
Facility
|
OP
|
$17.00
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
900911657
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$38.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$35.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.94
|
| Rate for Payer: Blue Distinction Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.98
|
| Rate for Payer: Blue Shield of California EPN |
$8.70
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.46
|
| Rate for Payer: Dignity Health Media |
$4.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.31
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.07
|
| Rate for Payer: Heritage Provider Network Transplant |
$7.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.78
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.49
|
| Rate for Payer: United Healthcare All Other HMO |
$3.49
|
| Rate for Payer: United Healthcare HMO Rider |
$3.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.74
|
| Rate for Payer: Vantage Medical Group Senior |
$4.31
|
|
|
HC I & D EXTERNAL AUDITORY CANAL
|
Facility
|
IP
|
$1,044.00
|
|
|
Service Code
|
CPT 69020
|
| Hospital Charge Code |
900501255
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$250.56 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Cash Price |
$469.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$417.60
|
| Rate for Payer: Galaxy Health WC |
$887.40
|
| Rate for Payer: Global Benefits Group Commercial |
$626.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$696.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$397.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.56
|
| Rate for Payer: Multiplan Commercial |
$835.20
|
| Rate for Payer: Networks By Design Commercial |
$678.60
|
| Rate for Payer: Prime Health Services Commercial |
$887.40
|
|
|
HC I & D EXTERNAL AUDITORY CANAL
|
Facility
|
OP
|
$1,044.00
|
|
|
Service Code
|
CPT 69020
|
| Hospital Charge Code |
900501255
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.76 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$626.40
|
| Rate for Payer: Cash Price |
$469.80
|
| Rate for Payer: Cash Price |
$469.80
|
| Rate for Payer: Cash Price |
$469.80
|
| Rate for Payer: Cigna of CA PPO |
$772.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$887.40
|
| Rate for Payer: Global Benefits Group Commercial |
$626.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$783.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,441.67
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$696.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$835.20
|
| Rate for Payer: Networks By Design Commercial |
$678.60
|
| Rate for Payer: Prime Health Services Commercial |
$887.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$626.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$522.00
|
| Rate for Payer: United Healthcare All Other HMO |
$522.00
|
| Rate for Payer: United Healthcare HMO Rider |
$522.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$522.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC I & D HEM SEROMA FL COLL
|
Facility
|
OP
|
$6,072.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
900501005
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$5,161.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,643.20
|
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: Cigna of CA PPO |
$4,493.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$5,161.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,643.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,554.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,322.13
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,050.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,457.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$4,857.60
|
| Rate for Payer: Networks By Design Commercial |
$3,946.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,161.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,643.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,036.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,036.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,036.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC I & D HEM SEROMA FL COLL
|
Facility
|
IP
|
$6,072.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
900501005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,457.28 |
| Max. Negotiated Rate |
$5,161.20 |
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,428.80
|
| Rate for Payer: Galaxy Health WC |
$5,161.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,643.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,050.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,313.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,457.28
|
| Rate for Payer: Multiplan Commercial |
$4,857.60
|
| Rate for Payer: Networks By Design Commercial |
$3,946.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,161.20
|
|
|
HC I & D HEM SEROMA FL COLL
|
Facility
|
IP
|
$6,072.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
900501005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,457.28 |
| Max. Negotiated Rate |
$5,161.20 |
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,428.80
|
| Rate for Payer: Galaxy Health WC |
$5,161.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,643.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,050.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,313.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,457.28
|
| Rate for Payer: Multiplan Commercial |
$4,857.60
|
| Rate for Payer: Networks By Design Commercial |
$3,946.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,161.20
|
|
|
HC I & D HEM SEROMA FL COLL
|
Facility
|
OP
|
$6,072.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
900501005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,643.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: Cigna of CA PPO |
$4,493.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$5,161.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,643.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,554.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,322.13
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,281.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,281.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,050.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,457.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$4,857.60
|
| Rate for Payer: Networks By Design Commercial |
$3,946.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,161.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,643.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC I & D HEM SEROMA FL COLL
|
Facility
|
OP
|
$6,072.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
900501005
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$5,161.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,643.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,475.06
|
| Rate for Payer: Blue Shield of California EPN |
$3,546.05
|
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: Cigna of CA HMO |
$3,886.08
|
| Rate for Payer: Cigna of CA PPO |
$4,493.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$5,161.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,643.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,554.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,322.13
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,281.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,281.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,050.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,457.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,552.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$4,857.60
|
| Rate for Payer: Networks By Design Commercial |
$3,946.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,161.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,643.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,643.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC I & D HEM SEROMA FL COLL
|
Facility
|
IP
|
$6,072.00
|
|
|
Service Code
|
CPT 10140
|
| Hospital Charge Code |
900501005
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,457.28 |
| Max. Negotiated Rate |
$5,161.20 |
| Rate for Payer: Cash Price |
$2,732.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,428.80
|
| Rate for Payer: Galaxy Health WC |
$5,161.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,643.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,050.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,313.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,457.28
|
| Rate for Payer: Multiplan Commercial |
$4,857.60
|
| Rate for Payer: Networks By Design Commercial |
$3,946.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,161.20
|
|
|
HC I&D OF MTH LSN;MSTCTR SPACE
|
Facility
|
OP
|
$4,736.00
|
|
|
Service Code
|
CPT 41018
|
| Hospital Charge Code |
900541018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$582.88 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,841.60
|
| Rate for Payer: Cash Price |
$2,131.20
|
| Rate for Payer: Cash Price |
$2,131.20
|
| Rate for Payer: Cash Price |
$2,131.20
|
| Rate for Payer: Cigna of CA PPO |
$3,504.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Dignity Health Media |
$1,905.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,095.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,572.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,905.44
|
| Rate for Payer: Galaxy Health WC |
$4,025.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,841.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,552.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,124.92
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,124.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,905.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,158.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$582.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,905.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,400.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,553.29
|
| Rate for Payer: Multiplan Commercial |
$3,788.80
|
| Rate for Payer: Networks By Design Commercial |
$3,078.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,025.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,841.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,368.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,368.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,368.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,368.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
HC I&D OF MTH LSN;MSTCTR SPACE
|
Facility
|
IP
|
$4,736.00
|
|
|
Service Code
|
CPT 41018
|
| Hospital Charge Code |
900541018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,136.64 |
| Max. Negotiated Rate |
$4,025.60 |
| Rate for Payer: Cash Price |
$2,131.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,894.40
|
| Rate for Payer: Galaxy Health WC |
$4,025.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,841.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,158.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,804.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.64
|
| Rate for Payer: Multiplan Commercial |
$3,788.80
|
| Rate for Payer: Networks By Design Commercial |
$3,078.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,025.60
|
|
|
HC I & D OF SCROTUM
|
Facility
|
IP
|
$10,364.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
900501592
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,487.36 |
| Max. Negotiated Rate |
$8,809.40 |
| Rate for Payer: Cash Price |
$4,663.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,145.60
|
| Rate for Payer: Galaxy Health WC |
$8,809.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,218.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,912.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,948.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,487.36
|
| Rate for Payer: Multiplan Commercial |
$8,291.20
|
| Rate for Payer: Networks By Design Commercial |
$6,736.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,809.40
|
|
|
HC I & D OF SCROTUM
|
Facility
|
OP
|
$10,364.00
|
|
|
Service Code
|
CPT 54700
|
| Hospital Charge Code |
900501592
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$377.04 |
| Max. Negotiated Rate |
$8,809.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,218.40
|
| Rate for Payer: Cash Price |
$4,663.80
|
| Rate for Payer: Cash Price |
$4,663.80
|
| Rate for Payer: Cash Price |
$4,663.80
|
| Rate for Payer: Cigna of CA PPO |
$7,669.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Dignity Health Media |
$2,544.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,799.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$8,809.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,218.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,773.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,173.59
|
| Rate for Payer: Heritage Provider Network Transplant |
$4,173.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,544.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,912.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,487.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,206.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$8,291.20
|
| Rate for Payer: Networks By Design Commercial |
$6,736.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,809.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,218.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,182.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,182.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,182.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC I&D OF VULVA OR PERI ABSC
|
Facility
|
IP
|
$1,674.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
900501168
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$401.76 |
| Max. Negotiated Rate |
$1,422.90 |
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.60
|
| Rate for Payer: Galaxy Health WC |
$1,422.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,116.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$637.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.76
|
| Rate for Payer: Multiplan Commercial |
$1,339.20
|
| Rate for Payer: Networks By Design Commercial |
$1,088.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.90
|
|
|
HC I&D OF VULVA OR PERI ABSC
|
Facility
|
OP
|
$1,674.00
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
900501168
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$172.33 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,004.40
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: Cash Price |
$753.30
|
| Rate for Payer: Cigna of CA PPO |
$1,238.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$1,422.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,004.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,255.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$657.34
|
| Rate for Payer: Heritage Provider Network Transplant |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,116.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$1,339.20
|
| Rate for Payer: Networks By Design Commercial |
$1,088.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,004.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$837.00
|
| Rate for Payer: United Healthcare All Other HMO |
$837.00
|
| Rate for Payer: United Healthcare HMO Rider |
$837.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$837.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
OP
|
$2,831.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
900501156
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.37 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,698.60
|
| Rate for Payer: Cash Price |
$1,273.95
|
| Rate for Payer: Cash Price |
$1,273.95
|
| Rate for Payer: Cash Price |
$1,273.95
|
| Rate for Payer: Cigna of CA PPO |
$2,094.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,406.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,698.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,123.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,872.77
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,888.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$679.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,264.80
|
| Rate for Payer: Networks By Design Commercial |
$1,840.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,406.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,698.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,415.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,415.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,415.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,415.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC I&D PERIANAL ABSCESS SUPERFICIAL
|
Facility
|
IP
|
$2,831.00
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
900501156
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$679.44 |
| Max. Negotiated Rate |
$2,406.35 |
| Rate for Payer: Cash Price |
$1,273.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,132.40
|
| Rate for Payer: Galaxy Health WC |
$2,406.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,698.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,888.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,078.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$679.44
|
| Rate for Payer: Multiplan Commercial |
$2,264.80
|
| Rate for Payer: Networks By Design Commercial |
$1,840.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,406.35
|
|
|
HC I&D PERITONSILAR ABSCESS
|
Facility
|
IP
|
$1,351.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
900501151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$324.24 |
| Max. Negotiated Rate |
$1,148.35 |
| Rate for Payer: Cash Price |
$607.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$540.40
|
| Rate for Payer: Galaxy Health WC |
$1,148.35
|
| Rate for Payer: Global Benefits Group Commercial |
$810.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$901.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.24
|
| Rate for Payer: Multiplan Commercial |
$1,080.80
|
| Rate for Payer: Networks By Design Commercial |
$878.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,148.35
|
|
|
HC I&D PERITONSILAR ABSCESS
|
Facility
|
OP
|
$1,351.00
|
|
|
Service Code
|
CPT 42700
|
| Hospital Charge Code |
900501151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.64 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$810.60
|
| Rate for Payer: Cash Price |
$607.95
|
| Rate for Payer: Cash Price |
$607.95
|
| Rate for Payer: Cash Price |
$607.95
|
| Rate for Payer: Cigna of CA PPO |
$999.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$1,148.35
|
| Rate for Payer: Global Benefits Group Commercial |
$810.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,013.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$500.51
|
| Rate for Payer: Heritage Provider Network Transplant |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$901.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$324.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$1,080.80
|
| Rate for Payer: Networks By Design Commercial |
$878.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,148.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$810.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$675.50
|
| Rate for Payer: United Healthcare All Other HMO |
$675.50
|
| Rate for Payer: United Healthcare HMO Rider |
$675.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$675.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC I & D PILONIDAL CYST COMPLICAT
|
Facility
|
IP
|
$5,142.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
900501530
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,234.08 |
| Max. Negotiated Rate |
$4,370.70 |
| Rate for Payer: Cash Price |
$2,313.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,056.80
|
| Rate for Payer: Galaxy Health WC |
$4,370.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,085.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,429.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,959.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,234.08
|
| Rate for Payer: Multiplan Commercial |
$4,113.60
|
| Rate for Payer: Networks By Design Commercial |
$3,342.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,370.70
|
|
|
HC I & D PILONIDAL CYST COMPLICAT
|
Facility
|
OP
|
$5,142.00
|
|
|
Service Code
|
CPT 10081
|
| Hospital Charge Code |
900501530
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$219.51 |
| Max. Negotiated Rate |
$5,938.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,085.20
|
| Rate for Payer: Cash Price |
$2,313.90
|
| Rate for Payer: Cash Price |
$2,313.90
|
| Rate for Payer: Cash Price |
$2,313.90
|
| Rate for Payer: Cigna of CA PPO |
$3,805.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$4,370.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,085.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,856.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,441.67
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,429.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,234.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$4,113.60
|
| Rate for Payer: Networks By Design Commercial |
$3,342.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,370.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,085.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,571.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,571.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,571.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,571.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$1,096.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$263.04 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$657.60
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: Cigna of CA PPO |
$811.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$931.60
|
| Rate for Payer: Global Benefits Group Commercial |
$657.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$822.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,441.67
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$731.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,107.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$876.80
|
| Rate for Payer: Networks By Design Commercial |
$712.40
|
| Rate for Payer: Prime Health Services Commercial |
$931.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$657.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$548.00
|
| Rate for Payer: United Healthcare All Other HMO |
$548.00
|
| Rate for Payer: United Healthcare HMO Rider |
$548.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$548.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$1,096.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$263.04 |
| Max. Negotiated Rate |
$931.60 |
| Rate for Payer: Cash Price |
$493.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.40
|
| Rate for Payer: Galaxy Health WC |
$931.60
|
| Rate for Payer: Global Benefits Group Commercial |
$657.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$731.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$417.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.04
|
| Rate for Payer: Multiplan Commercial |
$876.80
|
| Rate for Payer: Networks By Design Commercial |
$712.40
|
| Rate for Payer: Prime Health Services Commercial |
$931.60
|
|
|
HC IDR CORDIS VISTA BRITE TIPN
|
Facility
|
IP
|
$5,293.00
|
|
|
Service Code
|
CPT 0220T
|
| Hospital Charge Code |
909010220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,270.32 |
| Max. Negotiated Rate |
$4,499.05 |
| Rate for Payer: Cash Price |
$2,381.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,117.20
|
| Rate for Payer: Galaxy Health WC |
$4,499.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,175.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,530.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,016.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,270.32
|
| Rate for Payer: Multiplan Commercial |
$4,234.40
|
| Rate for Payer: Networks By Design Commercial |
$3,440.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,499.05
|
|
