|
HC CHEMO EA ADDL SEQUENTIAL INFUSION
|
Facility
|
IP
|
$369.00
|
|
|
Service Code
|
CPT 96417
|
| Hospital Charge Code |
911800809
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$313.65 |
| Rate for Payer: Adventist Health Commercial |
$73.80
|
| Rate for Payer: Cash Price |
$166.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$258.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.60
|
| Rate for Payer: EPIC Health Plan Senior |
$147.60
|
| Rate for Payer: Galaxy Health WC |
$313.65
|
| Rate for Payer: Global Benefits Group Commercial |
$221.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$234.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$217.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.56
|
| Rate for Payer: Multiplan Commercial |
$295.20
|
| Rate for Payer: Networks By Design Commercial |
$239.85
|
| Rate for Payer: Prime Health Services Commercial |
$313.65
|
|
|
HC CHEMO INFUSION EA ADDL HOUR
|
Facility
|
IP
|
$493.00
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
911800807
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$98.60 |
| Max. Negotiated Rate |
$419.05 |
| Rate for Payer: Adventist Health Commercial |
$98.60
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$345.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$197.20
|
| Rate for Payer: EPIC Health Plan Senior |
$197.20
|
| Rate for Payer: Galaxy Health WC |
$419.05
|
| Rate for Payer: Global Benefits Group Commercial |
$295.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$313.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$290.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.32
|
| Rate for Payer: Multiplan Commercial |
$394.40
|
| Rate for Payer: Networks By Design Commercial |
$320.45
|
| Rate for Payer: Prime Health Services Commercial |
$419.05
|
|
|
HC CHEMO INFUSION EA ADDL HOUR
|
Facility
|
OP
|
$493.00
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
911800807
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$36.10 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$98.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$138.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,036.00
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cigna of CA HMO |
$315.52
|
| Rate for Payer: Cigna of CA PPO |
$364.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$138.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$101.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$92.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$345.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.79
|
| Rate for Payer: EPIC Health Plan Senior |
$101.86
|
| Rate for Payer: Galaxy Health WC |
$419.05
|
| Rate for Payer: Global Benefits Group Commercial |
$295.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$151.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$313.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$116.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$124.08
|
| Rate for Payer: Multiplan Commercial |
$394.40
|
| Rate for Payer: Networks By Design Commercial |
$320.45
|
| Rate for Payer: Prime Health Services Commercial |
$419.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$295.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$295.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$92.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$138.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.86
|
| Rate for Payer: Vantage Medical Group Senior |
$92.60
|
|
|
HC CHEMO INFUSION EA ADDL HR
|
Facility
|
OP
|
$493.00
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
901200112
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$36.10 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$98.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$138.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,036.00
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cigna of CA HMO |
$315.52
|
| Rate for Payer: Cigna of CA PPO |
$364.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$138.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$101.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$92.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$345.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.79
|
| Rate for Payer: EPIC Health Plan Senior |
$101.86
|
| Rate for Payer: Galaxy Health WC |
$419.05
|
| Rate for Payer: Global Benefits Group Commercial |
$295.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$151.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$313.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$116.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$124.08
|
| Rate for Payer: Multiplan Commercial |
$394.40
|
| Rate for Payer: Networks By Design Commercial |
$320.45
|
| Rate for Payer: Prime Health Services Commercial |
$419.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$295.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$295.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$92.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$138.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.86
|
| Rate for Payer: Vantage Medical Group Senior |
$92.60
|
|
|
HC CHEMO INFUSION EA ADDL HR
|
Facility
|
IP
|
$493.00
|
|
|
Service Code
|
CPT 96415
|
| Hospital Charge Code |
901200112
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$98.60 |
| Max. Negotiated Rate |
$419.05 |
| Rate for Payer: Adventist Health Commercial |
$98.60
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$345.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$197.20
|
| Rate for Payer: EPIC Health Plan Senior |
$197.20
|
| Rate for Payer: Galaxy Health WC |
$419.05
|
| Rate for Payer: Global Benefits Group Commercial |
$295.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$313.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$290.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.32
|
| Rate for Payer: Multiplan Commercial |
$394.40
|
| Rate for Payer: Networks By Design Commercial |
$320.45
|
| Rate for Payer: Prime Health Services Commercial |
$419.05
|
|
|
HC CHEMO INFUSION INITIAL
|
Facility
|
IP
|
$1,381.00
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
901200111
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$276.20 |
| Max. Negotiated Rate |
$1,173.85 |
| Rate for Payer: Networks By Design Commercial |
$897.65
|
| Rate for Payer: Adventist Health Commercial |
$276.20
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$966.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$552.40
|
| Rate for Payer: Galaxy Health WC |
$1,173.85
|
| Rate for Payer: Global Benefits Group Commercial |
$828.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$876.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$814.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.44
|
| Rate for Payer: Multiplan Commercial |
$1,104.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.85
|
|
|
HC CHEMO INFUSION INITIAL
|
Facility
|
IP
|
$1,381.00
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
911800806
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$276.20 |
| Max. Negotiated Rate |
$1,173.85 |
| Rate for Payer: Adventist Health Commercial |
$276.20
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$966.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$552.40
|
| Rate for Payer: Galaxy Health WC |
$1,173.85
|
| Rate for Payer: Global Benefits Group Commercial |
$828.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$876.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$814.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.44
|
| Rate for Payer: Multiplan Commercial |
$1,104.80
|
| Rate for Payer: Networks By Design Commercial |
$897.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.85
|
|
|
HC CHEMO INFUSION INITIAL
|
Facility
|
OP
|
$1,381.00
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
901200111
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$48.03 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$276.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,162.96
|
| 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 |
$1,036.00
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Cigna of CA HMO |
$883.84
|
| Rate for Payer: Cigna of CA PPO |
$1,021.94
|
| 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 |
$966.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,173.85
|
| Rate for Payer: Global Benefits Group Commercial |
$828.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$876.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.44
|
| 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 |
$1,104.80
|
| Rate for Payer: Networks By Design Commercial |
$897.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$828.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$828.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| 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 CHEMO INFUSION INITIAL
|
Facility
|
OP
|
$1,381.00
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
911800806
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$48.03 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$276.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,162.96
|
| 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 |
$1,036.00
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Cash Price |
$621.45
|
| Rate for Payer: Cigna of CA HMO |
$883.84
|
| Rate for Payer: Cigna of CA PPO |
$1,021.94
|
| 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 |
$966.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,173.85
|
| Rate for Payer: Global Benefits Group Commercial |
$828.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$876.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.44
|
| 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 |
$1,104.80
|
| Rate for Payer: Networks By Design Commercial |
$897.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$828.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$828.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| 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 CHEMO INJ SUB ARACH/VENT/SUBQ
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
911800817
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$357.00 |
| Rate for Payer: Adventist Health Commercial |
$84.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$294.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Senior |
$168.00
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$266.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$247.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.80
|
| Rate for Payer: Multiplan Commercial |
$336.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
|
|
HC CHEMO INJ SUB ARACH/VENT/SUBQ
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
911800817
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$84.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$318.20
|
| 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 |
$1,036.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cigna of CA HMO |
$268.80
|
| Rate for Payer: Cigna of CA PPO |
$310.80
|
| 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 |
$294.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$143.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$266.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$162.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.80
|
| 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 |
$336.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$252.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$252.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| 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 CHEMO PROLONGED INFUSION 8HR OR MORE
|
Facility
|
IP
|
$831.00
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
911800808
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$166.20 |
| Max. Negotiated Rate |
$706.35 |
| Rate for Payer: Adventist Health Commercial |
$166.20
|
| Rate for Payer: Cash Price |
$373.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$581.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.40
|
| Rate for Payer: EPIC Health Plan Senior |
$332.40
|
| Rate for Payer: Galaxy Health WC |
$706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$498.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$527.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$490.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.44
|
| Rate for Payer: Multiplan Commercial |
$664.80
|
| Rate for Payer: Networks By Design Commercial |
$540.15
|
| Rate for Payer: Prime Health Services Commercial |
$706.35
|
|
|
HC CHEMO PROLONGED INFUSION 8HR OR MORE
|
Facility
|
OP
|
$831.00
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
911800808
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$77.60 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$166.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,284.07
|
| 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 |
$1,036.00
|
| Rate for Payer: Cash Price |
$373.95
|
| Rate for Payer: Cash Price |
$373.95
|
| Rate for Payer: Cash Price |
$373.95
|
| Rate for Payer: Cash Price |
$373.95
|
| Rate for Payer: Cigna of CA HMO |
$531.84
|
| Rate for Payer: Cigna of CA PPO |
$614.94
|
| 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 |
$581.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$498.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$77.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$527.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$199.44
|
| 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 |
$664.80
|
| Rate for Payer: Networks By Design Commercial |
$540.15
|
| Rate for Payer: Prime Health Services Commercial |
$706.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$498.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$498.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| 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 CHEMO PUSH EA ADD PUSH
|
Facility
|
IP
|
$706.00
|
|
|
Service Code
|
CPT 96411
|
| Hospital Charge Code |
911800805
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$141.20 |
| Max. Negotiated Rate |
$600.10 |
| Rate for Payer: Adventist Health Commercial |
$141.20
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$494.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.40
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$600.10
|
| Rate for Payer: Global Benefits Group Commercial |
$423.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$448.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$416.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.44
|
| Rate for Payer: Multiplan Commercial |
$564.80
|
| Rate for Payer: Networks By Design Commercial |
$458.90
|
| Rate for Payer: Prime Health Services Commercial |
$600.10
|
|
|
HC CHEMO PUSH EA ADD PUSH
|
Facility
|
OP
|
$706.00
|
|
|
Service Code
|
CPT 96411
|
| Hospital Charge Code |
911800805
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$141.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$497.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$138.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,036.00
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cigna of CA HMO |
$451.84
|
| Rate for Payer: Cigna of CA PPO |
$522.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$138.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$101.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$92.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$494.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.79
|
| Rate for Payer: EPIC Health Plan Senior |
$101.86
|
| Rate for Payer: Galaxy Health WC |
$600.10
|
| Rate for Payer: Global Benefits Group Commercial |
$423.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$151.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$448.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$116.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$124.08
|
| Rate for Payer: Multiplan Commercial |
$564.80
|
| Rate for Payer: Networks By Design Commercial |
$458.90
|
| Rate for Payer: Prime Health Services Commercial |
$600.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$423.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$423.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$92.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$138.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.86
|
| Rate for Payer: Vantage Medical Group Senior |
$92.60
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
IP
|
$744.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
911800804
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$472.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| Rate for Payer: Multiplan Commercial |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$483.60
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
IP
|
$744.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
901200110
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$472.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| Rate for Payer: Multiplan Commercial |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$483.60
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
OP
|
$744.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
911800804
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$893.57
|
| 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 |
$1,036.00
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cigna of CA HMO |
$476.16
|
| Rate for Payer: Cigna of CA PPO |
$550.56
|
| 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 |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$472.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| 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 |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$483.60
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$446.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$446.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| 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 CHEMO PUSH INITIAL
|
Facility
|
OP
|
$744.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
901200110
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$30.17 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$893.57
|
| 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 |
$1,036.00
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cigna of CA HMO |
$476.16
|
| Rate for Payer: Cigna of CA PPO |
$550.56
|
| 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 |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$472.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| 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 |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$483.60
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$446.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$446.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| 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 CHEST 2 VIEWS
|
Facility
|
OP
|
$708.00
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
909001407
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$46.15 |
| Max. Negotiated Rate |
$601.80 |
| Rate for Payer: Adventist Health Commercial |
$141.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.78
|
| Rate for Payer: Blue Shield of California Commercial |
$298.07
|
| Rate for Payer: Blue Shield of California Commercial |
$451.70
|
| Rate for Payer: Cash Price |
$318.60
|
| Rate for Payer: Cash Price |
$318.60
|
| Rate for Payer: Cigna of CA HMO |
$453.12
|
| Rate for Payer: Cigna of CA PPO |
$523.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$495.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$601.80
|
| Rate for Payer: Global Benefits Group Commercial |
$424.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$46.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$449.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$141.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$566.40
|
| Rate for Payer: Networks By Design Commercial |
$460.20
|
| Rate for Payer: Prime Health Services Commercial |
$601.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$424.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$424.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.01
|
| Rate for Payer: United Healthcare All Other HMO |
$159.01
|
| Rate for Payer: United Healthcare HMO Rider |
$159.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC CHEST 2 VIEWS
|
Facility
|
IP
|
$708.00
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
909001407
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$141.60 |
| Max. Negotiated Rate |
$601.80 |
| Rate for Payer: Adventist Health Commercial |
$141.60
|
| Rate for Payer: Cash Price |
$318.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$495.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$283.20
|
| Rate for Payer: EPIC Health Plan Senior |
$283.20
|
| Rate for Payer: Galaxy Health WC |
$601.80
|
| Rate for Payer: Global Benefits Group Commercial |
$424.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$449.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$417.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.92
|
| Rate for Payer: Multiplan Commercial |
$566.40
|
| Rate for Payer: Networks By Design Commercial |
$460.20
|
| Rate for Payer: Prime Health Services Commercial |
$601.80
|
|
|
HC CHEST COMP 4 VIEWS
|
Facility
|
OP
|
$852.00
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
909001402
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$63.47 |
| Max. Negotiated Rate |
$724.20 |
| Rate for Payer: Adventist Health Commercial |
$170.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$179.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$315.76
|
| Rate for Payer: Blue Shield of California Commercial |
$358.69
|
| Rate for Payer: Blue Shield of California Commercial |
$543.58
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Cigna of CA HMO |
$545.28
|
| Rate for Payer: Cigna of CA PPO |
$630.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$596.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$724.20
|
| Rate for Payer: Global Benefits Group Commercial |
$511.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$63.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$71.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$681.60
|
| Rate for Payer: Networks By Design Commercial |
$553.80
|
| Rate for Payer: Prime Health Services Commercial |
$724.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$511.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$511.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$303.97
|
| Rate for Payer: United Healthcare All Other HMO |
$303.97
|
| Rate for Payer: United Healthcare HMO Rider |
$303.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$303.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC CHEST COMP 4 VIEWS
|
Facility
|
IP
|
$852.00
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
909001402
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$170.40 |
| Max. Negotiated Rate |
$724.20 |
| Rate for Payer: Adventist Health Commercial |
$170.40
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$596.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.80
|
| Rate for Payer: EPIC Health Plan Senior |
$340.80
|
| Rate for Payer: Galaxy Health WC |
$724.20
|
| Rate for Payer: Global Benefits Group Commercial |
$511.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$502.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.48
|
| Rate for Payer: Multiplan Commercial |
$681.60
|
| Rate for Payer: Networks By Design Commercial |
$553.80
|
| Rate for Payer: Prime Health Services Commercial |
$724.20
|
|
|
HC CHEST FLUORO/PACEMKR
|
Facility
|
OP
|
$822.00
|
|
| Hospital Charge Code |
909001469
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$164.40 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$164.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$698.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$452.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$616.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$527.48
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Cigna of CA HMO |
$526.08
|
| Rate for Payer: Cigna of CA PPO |
$608.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$698.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$698.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$698.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$575.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.80
|
| Rate for Payer: EPIC Health Plan Senior |
$328.80
|
| Rate for Payer: Galaxy Health WC |
$698.70
|
| Rate for Payer: Global Benefits Group Commercial |
$493.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$521.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$298.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$484.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$575.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$575.40
|
| Rate for Payer: Multiplan Commercial |
$657.60
|
| Rate for Payer: Networks By Design Commercial |
$534.30
|
| Rate for Payer: Prime Health Services Commercial |
$698.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$493.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$411.00
|
| Rate for Payer: United Healthcare All Other HMO |
$411.00
|
| Rate for Payer: United Healthcare HMO Rider |
$411.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$411.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$698.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$698.70
|
| Rate for Payer: Vantage Medical Group Senior |
$698.70
|
|
|
HC CHEST FLUORO/PACEMKR
|
Facility
|
IP
|
$822.00
|
|
| Hospital Charge Code |
909001469
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$164.40 |
| Max. Negotiated Rate |
$698.70 |
| Rate for Payer: Adventist Health Commercial |
$164.40
|
| Rate for Payer: Cash Price |
$369.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$575.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.80
|
| Rate for Payer: EPIC Health Plan Senior |
$328.80
|
| Rate for Payer: Galaxy Health WC |
$698.70
|
| Rate for Payer: Global Benefits Group Commercial |
$493.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$521.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$484.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.28
|
| Rate for Payer: Multiplan Commercial |
$657.60
|
| Rate for Payer: Networks By Design Commercial |
$534.30
|
| Rate for Payer: Prime Health Services Commercial |
$698.70
|
|
