|
HC CONSULT COMP/MOD COMPLEX
|
Facility
|
IP
|
$897.00
|
|
| Hospital Charge Code |
912999244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.40 |
| Max. Negotiated Rate |
$762.45 |
| Rate for Payer: Adventist Health Commercial |
$179.40
|
| Rate for Payer: Cash Price |
$403.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.80
|
| Rate for Payer: EPIC Health Plan Senior |
$358.80
|
| Rate for Payer: Galaxy Health WC |
$762.45
|
| Rate for Payer: Global Benefits Group Commercial |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$598.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$555.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$215.28
|
| Rate for Payer: Multiplan Commercial |
$717.60
|
| Rate for Payer: Networks By Design Commercial |
$583.05
|
| Rate for Payer: Prime Health Services Commercial |
$762.45
|
|
|
HC CONSULT COMP/MOD COMPLEX
|
Facility
|
OP
|
$897.00
|
|
| Hospital Charge Code |
912999244
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.40 |
| Max. Negotiated Rate |
$762.45 |
| Rate for Payer: Adventist Health Commercial |
$179.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$588.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$762.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$672.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$550.85
|
| Rate for Payer: Cash Price |
$403.65
|
| Rate for Payer: Cigna of CA HMO |
$574.08
|
| Rate for Payer: Cigna of CA PPO |
$663.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$762.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$762.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$762.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.80
|
| Rate for Payer: EPIC Health Plan Senior |
$358.80
|
| Rate for Payer: Galaxy Health WC |
$762.45
|
| Rate for Payer: Global Benefits Group Commercial |
$538.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$598.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$555.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$215.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$627.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$627.90
|
| Rate for Payer: Multiplan Commercial |
$717.60
|
| Rate for Payer: Networks By Design Commercial |
$583.05
|
| Rate for Payer: Prime Health Services Commercial |
$762.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$538.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$538.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$448.50
|
| Rate for Payer: United Healthcare All Other HMO |
$448.50
|
| Rate for Payer: United Healthcare HMO Rider |
$448.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$448.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$762.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$762.45
|
| Rate for Payer: Vantage Medical Group Senior |
$762.45
|
|
|
HC CONSULT COMP/MOD COMPLEX
|
Facility
|
IP
|
$1,066.00
|
|
| Hospital Charge Code |
908600121
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$213.20 |
| Max. Negotiated Rate |
$906.10 |
| Rate for Payer: Adventist Health Commercial |
$213.20
|
| Rate for Payer: Cash Price |
$479.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$426.40
|
| Rate for Payer: EPIC Health Plan Senior |
$426.40
|
| Rate for Payer: Galaxy Health WC |
$906.10
|
| Rate for Payer: Global Benefits Group Commercial |
$639.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$711.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$406.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$659.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.84
|
| Rate for Payer: Multiplan Commercial |
$852.80
|
| Rate for Payer: Networks By Design Commercial |
$692.90
|
| Rate for Payer: Prime Health Services Commercial |
$906.10
|
|
|
HC CONSULT DETAILED
|
Facility
|
IP
|
$611.00
|
|
| Hospital Charge Code |
912999243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.20 |
| Max. Negotiated Rate |
$519.35 |
| Rate for Payer: Adventist Health Commercial |
$122.20
|
| Rate for Payer: Cash Price |
$274.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$244.40
|
| Rate for Payer: EPIC Health Plan Senior |
$244.40
|
| Rate for Payer: Galaxy Health WC |
$519.35
|
| Rate for Payer: Global Benefits Group Commercial |
$366.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$407.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$378.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.64
|
| Rate for Payer: Multiplan Commercial |
$488.80
|
| Rate for Payer: Networks By Design Commercial |
$397.15
|
| Rate for Payer: Prime Health Services Commercial |
$519.35
|
|
|
HC CONSULT DETAILED
|
Facility
|
OP
|
$873.00
|
|
| Hospital Charge Code |
908600120
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$174.60 |
| Max. Negotiated Rate |
$742.05 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$572.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$654.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$536.11
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Cigna of CA HMO |
$558.72
|
| Rate for Payer: Cigna of CA PPO |
$646.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$540.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$611.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$611.10
|
| Rate for Payer: Multiplan Commercial |
$698.40
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$523.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$523.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$436.50
|
| Rate for Payer: United Healthcare All Other HMO |
$436.50
|
| Rate for Payer: United Healthcare HMO Rider |
$436.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$436.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.05
|
| Rate for Payer: Vantage Medical Group Senior |
$742.05
|
|
|
HC CONSULT DETAILED
|
Facility
|
OP
|
$611.00
|
|
| Hospital Charge Code |
912999243
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.20 |
| Max. Negotiated Rate |
$519.35 |
| Rate for Payer: Adventist Health Commercial |
$122.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$400.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$519.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$458.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$375.22
|
| Rate for Payer: Cash Price |
$274.95
|
| Rate for Payer: Cigna of CA HMO |
$391.04
|
| Rate for Payer: Cigna of CA PPO |
$452.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$519.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$519.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$519.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$244.40
|
| Rate for Payer: EPIC Health Plan Senior |
$244.40
|
| Rate for Payer: Galaxy Health WC |
$519.35
|
| Rate for Payer: Global Benefits Group Commercial |
$366.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$407.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$378.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$427.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$427.70
|
| Rate for Payer: Multiplan Commercial |
$488.80
|
| Rate for Payer: Networks By Design Commercial |
$397.15
|
| Rate for Payer: Prime Health Services Commercial |
$519.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$366.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$366.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$305.50
|
| Rate for Payer: United Healthcare All Other HMO |
$305.50
|
| Rate for Payer: United Healthcare HMO Rider |
$305.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$305.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$519.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$519.35
|
| Rate for Payer: Vantage Medical Group Senior |
$519.35
|
|
|
HC CONSULT DETAILED
|
Facility
|
IP
|
$873.00
|
|
| Hospital Charge Code |
908600120
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$174.60 |
| Max. Negotiated Rate |
$742.05 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$540.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.52
|
| Rate for Payer: Multiplan Commercial |
$698.40
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
|
|
HC CONSULT EXPANDED
|
Facility
|
IP
|
$440.00
|
|
| Hospital Charge Code |
912999242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$374.00 |
| Rate for Payer: Adventist Health Commercial |
$88.00
|
| Rate for Payer: Cash Price |
$198.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.00
|
| Rate for Payer: EPIC Health Plan Senior |
$176.00
|
| Rate for Payer: Galaxy Health WC |
$374.00
|
| Rate for Payer: Global Benefits Group Commercial |
$264.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$293.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$272.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.60
|
| Rate for Payer: Multiplan Commercial |
$352.00
|
| Rate for Payer: Networks By Design Commercial |
$286.00
|
| Rate for Payer: Prime Health Services Commercial |
$374.00
|
|
|
HC CONSULT EXPANDED
|
Facility
|
OP
|
$631.00
|
|
| Hospital Charge Code |
908600119
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$126.20 |
| Max. Negotiated Rate |
$536.35 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$413.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$536.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$347.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$473.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$387.50
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: Cigna of CA HMO |
$403.84
|
| Rate for Payer: Cigna of CA PPO |
$466.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$536.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$536.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$536.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: EPIC Health Plan Senior |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$390.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$441.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$441.70
|
| Rate for Payer: Multiplan Commercial |
$504.80
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$315.50
|
| Rate for Payer: United Healthcare All Other HMO |
$315.50
|
| Rate for Payer: United Healthcare HMO Rider |
$315.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$315.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$536.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$536.35
|
| Rate for Payer: Vantage Medical Group Senior |
$536.35
|
|
|
HC CONSULT EXPANDED
|
Facility
|
IP
|
$631.00
|
|
| Hospital Charge Code |
908600119
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$126.20 |
| Max. Negotiated Rate |
$536.35 |
| Rate for Payer: Adventist Health Commercial |
$126.20
|
| Rate for Payer: Cash Price |
$283.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.40
|
| Rate for Payer: EPIC Health Plan Senior |
$252.40
|
| Rate for Payer: Galaxy Health WC |
$536.35
|
| Rate for Payer: Global Benefits Group Commercial |
$378.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$390.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.44
|
| Rate for Payer: Multiplan Commercial |
$504.80
|
| Rate for Payer: Networks By Design Commercial |
$410.15
|
| Rate for Payer: Prime Health Services Commercial |
$536.35
|
|
|
HC CONSULT EXPANDED
|
Facility
|
OP
|
$440.00
|
|
| Hospital Charge Code |
912999242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$374.00 |
| Rate for Payer: Adventist Health Commercial |
$88.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$288.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$374.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$242.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$330.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$270.20
|
| Rate for Payer: Cash Price |
$198.00
|
| Rate for Payer: Cigna of CA HMO |
$281.60
|
| Rate for Payer: Cigna of CA PPO |
$325.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$374.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$374.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$374.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.00
|
| Rate for Payer: EPIC Health Plan Senior |
$176.00
|
| Rate for Payer: Galaxy Health WC |
$374.00
|
| Rate for Payer: Global Benefits Group Commercial |
$264.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$293.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$272.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$308.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$308.00
|
| Rate for Payer: Multiplan Commercial |
$352.00
|
| Rate for Payer: Networks By Design Commercial |
$286.00
|
| Rate for Payer: Prime Health Services Commercial |
$374.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$220.00
|
| Rate for Payer: United Healthcare All Other HMO |
$220.00
|
| Rate for Payer: United Healthcare HMO Rider |
$220.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$374.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$374.00
|
| Rate for Payer: Vantage Medical Group Senior |
$374.00
|
|
|
HC CONSULT FOCUSED
|
Facility
|
IP
|
$339.00
|
|
| Hospital Charge Code |
908600118
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$288.15 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
|
|
HC CONSULT FOCUSED
|
Facility
|
OP
|
$339.00
|
|
| Hospital Charge Code |
908600118
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$67.80 |
| Max. Negotiated Rate |
$288.15 |
| Rate for Payer: Adventist Health Commercial |
$67.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$186.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$254.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$208.18
|
| Rate for Payer: Cash Price |
$152.55
|
| Rate for Payer: Cigna of CA HMO |
$216.96
|
| Rate for Payer: Cigna of CA PPO |
$250.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$288.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$288.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$288.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$135.60
|
| Rate for Payer: EPIC Health Plan Senior |
$135.60
|
| Rate for Payer: Galaxy Health WC |
$288.15
|
| Rate for Payer: Global Benefits Group Commercial |
$203.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$226.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$209.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$237.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$237.30
|
| Rate for Payer: Multiplan Commercial |
$271.20
|
| Rate for Payer: Networks By Design Commercial |
$220.35
|
| Rate for Payer: Prime Health Services Commercial |
$288.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$203.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$203.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$169.50
|
| Rate for Payer: United Healthcare All Other HMO |
$169.50
|
| Rate for Payer: United Healthcare HMO Rider |
$169.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$169.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$288.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$288.15
|
| Rate for Payer: Vantage Medical Group Senior |
$288.15
|
|
|
HC CONSULT FOCUSED
|
Facility
|
OP
|
$238.00
|
|
| Hospital Charge Code |
912999241
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$156.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$178.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.16
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna of CA HMO |
$152.32
|
| Rate for Payer: Cigna of CA PPO |
$176.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$202.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$202.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$166.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$166.60
|
| Rate for Payer: Multiplan Commercial |
$190.40
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$119.00
|
| Rate for Payer: United Healthcare All Other HMO |
$119.00
|
| Rate for Payer: United Healthcare HMO Rider |
$119.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$119.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$202.30
|
| Rate for Payer: Vantage Medical Group Senior |
$202.30
|
|
|
HC CONSULT FOCUSED
|
Facility
|
IP
|
$238.00
|
|
| Hospital Charge Code |
912999241
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$202.30 |
| Rate for Payer: Adventist Health Commercial |
$47.60
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.20
|
| Rate for Payer: EPIC Health Plan Senior |
$95.20
|
| Rate for Payer: Galaxy Health WC |
$202.30
|
| Rate for Payer: Global Benefits Group Commercial |
$142.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$90.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$147.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.12
|
| Rate for Payer: Multiplan Commercial |
$190.40
|
| Rate for Payer: Networks By Design Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$202.30
|
|
|
HC CONSULT WITH SLIDE PREP
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
903800034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$167.98 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$125.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.25
|
| Rate for Payer: Blue Shield of California Commercial |
$128.45
|
| Rate for Payer: Blue Shield of California EPN |
$84.86
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cigna of CA HMO |
$122.88
|
| Rate for Payer: Cigna of CA PPO |
$142.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.65
|
| Rate for Payer: EPIC Health Plan Senior |
$67.89
|
| Rate for Payer: Galaxy Health WC |
$163.20
|
| Rate for Payer: Global Benefits Group Commercial |
$115.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$111.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$148.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90.97
|
| Rate for Payer: Multiplan Commercial |
$153.60
|
| Rate for Payer: Networks By Design Commercial |
$124.80
|
| Rate for Payer: Prime Health Services Commercial |
$163.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$67.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.68
|
| Rate for Payer: Vantage Medical Group Senior |
$67.89
|
|
|
HC CONSULT WITH SLIDE PREP
|
Facility
|
IP
|
$661.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
903800034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$132.20 |
| Max. Negotiated Rate |
$561.85 |
| Rate for Payer: Adventist Health Commercial |
$132.20
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.40
|
| Rate for Payer: EPIC Health Plan Senior |
$264.40
|
| Rate for Payer: Galaxy Health WC |
$561.85
|
| Rate for Payer: Global Benefits Group Commercial |
$396.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$440.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$251.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$409.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.64
|
| Rate for Payer: Multiplan Commercial |
$528.80
|
| Rate for Payer: Networks By Design Commercial |
$429.65
|
| Rate for Payer: Prime Health Services Commercial |
$561.85
|
|
|
HC CONT GLUC MNTR PT PROV EQP
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
900095249
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$411.40 |
| Rate for Payer: Adventist Health Commercial |
$96.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$193.60
|
| Rate for Payer: EPIC Health Plan Senior |
$193.60
|
| Rate for Payer: Galaxy Health WC |
$411.40
|
| Rate for Payer: Global Benefits Group Commercial |
$290.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$299.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.16
|
| Rate for Payer: Multiplan Commercial |
$387.20
|
| Rate for Payer: Networks By Design Commercial |
$314.60
|
| Rate for Payer: Prime Health Services Commercial |
$411.40
|
|
|
HC CONT GLUC MNTR PT PROV EQP
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
900095249
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$75.47 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Adventist Health Commercial |
$96.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$317.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$297.22
|
| Rate for Payer: Blue Shield of California Commercial |
$296.21
|
| Rate for Payer: Blue Shield of California EPN |
$195.54
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Cigna of CA HMO |
$309.76
|
| Rate for Payer: Cigna of CA PPO |
$358.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$411.40
|
| Rate for Payer: Global Benefits Group Commercial |
$290.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$387.20
|
| Rate for Payer: Networks By Design Commercial |
$314.60
|
| Rate for Payer: Prime Health Services Commercial |
$411.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$290.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$290.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC CONT INHAL TRT W/AERO 1ST HR
|
Facility
|
IP
|
$332.00
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
900800012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$282.20 |
| Rate for Payer: Adventist Health Commercial |
$66.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.80
|
| Rate for Payer: EPIC Health Plan Senior |
$132.80
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$205.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.68
|
| Rate for Payer: Multiplan Commercial |
$265.60
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
|
|
HC CONT INHAL TRT W/AERO 1ST HR
|
Facility
|
OP
|
$332.00
|
|
|
Service Code
|
CPT 94644
|
| Hospital Charge Code |
900800012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$28.56 |
| Max. Negotiated Rate |
$536.00 |
| Rate for Payer: Adventist Health Commercial |
$66.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$217.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cigna of CA HMO |
$212.48
|
| Rate for Payer: Cigna of CA PPO |
$245.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$265.60
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$199.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$199.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$536.00
|
| Rate for Payer: United Healthcare All Other HMO |
$502.00
|
| Rate for Payer: United Healthcare HMO Rider |
$449.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$441.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC CONT INHAL TRT W/AERO ADD HR
|
Facility
|
IP
|
$247.00
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
900800013
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$49.40 |
| Max. Negotiated Rate |
$209.95 |
| Rate for Payer: Adventist Health Commercial |
$49.40
|
| Rate for Payer: Cash Price |
$111.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.80
|
| Rate for Payer: EPIC Health Plan Senior |
$98.80
|
| Rate for Payer: Galaxy Health WC |
$209.95
|
| Rate for Payer: Global Benefits Group Commercial |
$148.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$152.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.28
|
| Rate for Payer: Multiplan Commercial |
$197.60
|
| Rate for Payer: Networks By Design Commercial |
$160.55
|
| Rate for Payer: Prime Health Services Commercial |
$209.95
|
|
|
HC CONT INHAL TRT W/AERO ADD HR
|
Facility
|
OP
|
$247.00
|
|
|
Service Code
|
CPT 94645
|
| Hospital Charge Code |
900800013
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$20.83 |
| Max. Negotiated Rate |
$536.00 |
| Rate for Payer: Adventist Health Commercial |
$49.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$162.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$209.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$135.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$185.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$111.15
|
| Rate for Payer: Cash Price |
$111.15
|
| Rate for Payer: Cash Price |
$111.15
|
| Rate for Payer: Cash Price |
$111.15
|
| Rate for Payer: Cigna of CA HMO |
$158.08
|
| Rate for Payer: Cigna of CA PPO |
$182.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$209.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$209.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$209.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.80
|
| Rate for Payer: EPIC Health Plan Senior |
$98.80
|
| Rate for Payer: Galaxy Health WC |
$209.95
|
| Rate for Payer: Global Benefits Group Commercial |
$148.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$152.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$172.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$172.90
|
| Rate for Payer: Multiplan Commercial |
$197.60
|
| Rate for Payer: Networks By Design Commercial |
$160.55
|
| Rate for Payer: Prime Health Services Commercial |
$209.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$148.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$148.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$536.00
|
| Rate for Payer: United Healthcare All Other HMO |
$502.00
|
| Rate for Payer: United Healthcare HMO Rider |
$449.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$441.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$209.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$209.95
|
| Rate for Payer: Vantage Medical Group Senior |
$209.95
|
|
|
HC CONTINOUS RENAL REPLACE THERAPY
|
Facility
|
IP
|
$904.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
948000105
|
|
Hospital Revenue Code
|
880
|
| Min. Negotiated Rate |
$180.80 |
| Max. Negotiated Rate |
$768.40 |
| Rate for Payer: Adventist Health Commercial |
$180.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.60
|
| Rate for Payer: EPIC Health Plan Senior |
$361.60
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$559.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.96
|
| Rate for Payer: Multiplan Commercial |
$723.20
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
|
|
HC CONTINOUS RENAL REPLACE THERAPY
|
Facility
|
OP
|
$904.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
948000105
|
|
Hospital Revenue Code
|
880
|
| Min. Negotiated Rate |
$121.23 |
| Max. Negotiated Rate |
$887.32 |
| Rate for Payer: Adventist Health Commercial |
$180.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$592.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$811.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$595.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$541.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$555.15
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cash Price |
$406.80
|
| Rate for Payer: Cigna of CA HMO |
$578.56
|
| Rate for Payer: Cigna of CA PPO |
$668.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$811.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$595.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$541.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.42
|
| Rate for Payer: EPIC Health Plan Senior |
$541.05
|
| Rate for Payer: Galaxy Health WC |
$768.40
|
| Rate for Payer: Global Benefits Group Commercial |
$542.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$887.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$121.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$541.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$602.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$681.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$725.01
|
| Rate for Payer: Multiplan Commercial |
$723.20
|
| Rate for Payer: Networks By Design Commercial |
$587.60
|
| Rate for Payer: Prime Health Services Commercial |
$768.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$542.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$542.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.00
|
| Rate for Payer: United Healthcare All Other HMO |
$452.00
|
| Rate for Payer: United Healthcare HMO Rider |
$452.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$452.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$541.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$811.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$595.15
|
| Rate for Payer: Vantage Medical Group Senior |
$541.05
|
|
