|
HC COMPREHENSIVE METABOLIC PANEL
|
Facility
|
OP
|
$70.00
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
900910423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.55 |
| Max. Negotiated Rate |
$109.24 |
| Rate for Payer: Adventist Health Commercial |
$14.00
|
| Rate for Payer: Adventist Health Commercial |
$159.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$87.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$87.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.24
|
| Rate for Payer: Blue Shield of California Commercial |
$366.50
|
| Rate for Payer: Blue Shield of California Commercial |
$32.27
|
| Rate for Payer: Blue Shield of California Commercial |
$554.12
|
| Rate for Payer: Blue Shield of California Commercial |
$48.79
|
| Rate for Payer: Cash Price |
$357.75
|
| Rate for Payer: Cash Price |
$357.75
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: Cigna of CA HMO |
$508.80
|
| Rate for Payer: Cigna of CA HMO |
$44.80
|
| Rate for Payer: Cigna of CA PPO |
$51.80
|
| Rate for Payer: Cigna of CA PPO |
$588.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$556.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.42
|
| Rate for Payer: EPIC Health Plan Senior |
$11.62
|
| Rate for Payer: EPIC Health Plan Senior |
$11.62
|
| Rate for Payer: Galaxy Health WC |
$59.50
|
| Rate for Payer: Galaxy Health WC |
$675.75
|
| Rate for Payer: Global Benefits Group Commercial |
$42.00
|
| Rate for Payer: Global Benefits Group Commercial |
$477.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.32
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$15.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$504.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.15
|
| Rate for Payer: Multiplan Commercial |
$636.00
|
| Rate for Payer: Multiplan Commercial |
$56.00
|
| Rate for Payer: Networks By Design Commercial |
$516.75
|
| Rate for Payer: Networks By Design Commercial |
$45.50
|
| Rate for Payer: Prime Health Services Commercial |
$59.50
|
| Rate for Payer: Prime Health Services Commercial |
$675.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$477.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$477.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.55
|
| Rate for Payer: United Healthcare All Other HMO |
$8.55
|
| Rate for Payer: United Healthcare All Other HMO |
$8.55
|
| Rate for Payer: United Healthcare HMO Rider |
$8.55
|
| Rate for Payer: United Healthcare HMO Rider |
$8.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.55
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.62
|
| Rate for Payer: Vantage Medical Group Senior |
$10.56
|
| Rate for Payer: Vantage Medical Group Senior |
$10.56
|
|
|
HC COMPREHENSIVE METABOLIC PANEL
|
Facility
|
IP
|
$795.00
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
900910423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$159.00 |
| Max. Negotiated Rate |
$675.75 |
| Rate for Payer: Adventist Health Commercial |
$159.00
|
| Rate for Payer: Cash Price |
$357.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$556.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.00
|
| Rate for Payer: EPIC Health Plan Senior |
$318.00
|
| Rate for Payer: Galaxy Health WC |
$675.75
|
| Rate for Payer: Global Benefits Group Commercial |
$477.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$504.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$469.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.80
|
| Rate for Payer: Multiplan Commercial |
$636.00
|
| Rate for Payer: Networks By Design Commercial |
$516.75
|
| Rate for Payer: Prime Health Services Commercial |
$675.75
|
|
|
HC COMPRESSION BRA
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cigna of CA HMO |
$227.50
|
| Rate for Payer: Cigna of CA PPO |
$227.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.97
|
| Rate for Payer: United Healthcare All Other HMO |
$118.72
|
| Rate for Payer: United Healthcare HMO Rider |
$116.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.44
|
|
|
HC COMPRESSION BRA
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: Adventist Health Commercial |
$133.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$276.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$178.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$243.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$196.72
|
| Rate for Payer: Blue Shield of California Commercial |
$164.78
|
| Rate for Payer: Blue Shield of California Commercial |
$249.93
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cigna of CA HMO |
$227.50
|
| Rate for Payer: Cigna of CA PPO |
$227.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$276.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$276.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$276.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$117.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$227.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$227.50
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.97
|
| Rate for Payer: United Healthcare All Other HMO |
$118.72
|
| Rate for Payer: United Healthcare HMO Rider |
$116.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$276.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$276.25
|
| Rate for Payer: Vantage Medical Group Senior |
$276.25
|
|
|
HC COMPRESSION BRA
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cigna of CA HMO |
$227.50
|
| Rate for Payer: Cigna of CA PPO |
$227.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Networks By Design Commercial |
$211.25
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.97
|
| Rate for Payer: United Healthcare All Other HMO |
$118.72
|
| Rate for Payer: United Healthcare HMO Rider |
$116.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.44
|
|
|
HC COMPRESSION BRA
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$276.25 |
| Rate for Payer: Adventist Health Commercial |
$133.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$276.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$178.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$243.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$196.72
|
| Rate for Payer: Blue Shield of California Commercial |
$164.78
|
| Rate for Payer: Blue Shield of California Commercial |
$249.93
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cigna of CA HMO |
$227.50
|
| Rate for Payer: Cigna of CA PPO |
$227.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$276.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$276.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$276.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$117.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$227.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$227.50
|
| Rate for Payer: Multiplan Commercial |
$260.00
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.97
|
| Rate for Payer: United Healthcare All Other HMO |
$118.72
|
| Rate for Payer: United Healthcare HMO Rider |
$116.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$276.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$276.25
|
| Rate for Payer: Vantage Medical Group Senior |
$276.25
|
|
|
HC COMPRESSIVE BELT
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380017
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$147.00
|
| Rate for Payer: Cigna of CA PPO |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.81
|
| Rate for Payer: United Healthcare All Other HMO |
$76.71
|
| Rate for Payer: United Healthcare HMO Rider |
$75.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.78
|
|
|
HC COMPRESSIVE BELT
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380017
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$86.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$157.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.11
|
| Rate for Payer: Blue Shield of California Commercial |
$106.47
|
| Rate for Payer: Blue Shield of California Commercial |
$161.49
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$147.00
|
| Rate for Payer: Cigna of CA PPO |
$147.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$178.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$178.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$76.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$147.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.00
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$105.00
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.81
|
| Rate for Payer: United Healthcare All Other HMO |
$76.71
|
| Rate for Payer: United Healthcare HMO Rider |
$75.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC COMPRESSIVE BELT
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380017
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$86.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$157.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.11
|
| Rate for Payer: Blue Shield of California Commercial |
$106.47
|
| Rate for Payer: Blue Shield of California Commercial |
$161.49
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$147.00
|
| Rate for Payer: Cigna of CA PPO |
$147.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$178.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$178.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$76.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$147.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.00
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$105.00
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.81
|
| Rate for Payer: United Healthcare All Other HMO |
$76.71
|
| Rate for Payer: United Healthcare HMO Rider |
$75.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC COMPRESSIVE BELT
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380017
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$147.00
|
| Rate for Payer: Cigna of CA PPO |
$147.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.81
|
| Rate for Payer: United Healthcare All Other HMO |
$76.71
|
| Rate for Payer: United Healthcare HMO Rider |
$75.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.78
|
|
|
HC COMVAX ADMINISTRATION
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890226
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$2,601.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC COMVAX ADMINISTRATION
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890226
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$19.20
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC CONF COORD DIETICIAN
|
Facility
|
IP
|
$258.00
|
|
| Hospital Charge Code |
912164300
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$219.30 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$103.20
|
| Rate for Payer: Galaxy Health WC |
$219.30
|
| Rate for Payer: Global Benefits Group Commercial |
$154.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$163.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.92
|
| Rate for Payer: Multiplan Commercial |
$206.40
|
| Rate for Payer: Networks By Design Commercial |
$167.70
|
| Rate for Payer: Prime Health Services Commercial |
$219.30
|
|
|
HC CONF COORD DIETICIAN
|
Facility
|
OP
|
$258.00
|
|
| Hospital Charge Code |
912164300
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$219.30 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$169.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$219.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$141.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$193.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$165.56
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Cigna of CA HMO |
$165.12
|
| Rate for Payer: Cigna of CA PPO |
$190.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$219.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$103.20
|
| Rate for Payer: Galaxy Health WC |
$219.30
|
| Rate for Payer: Global Benefits Group Commercial |
$154.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$163.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$93.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$180.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.60
|
| Rate for Payer: Multiplan Commercial |
$206.40
|
| Rate for Payer: Networks By Design Commercial |
$167.70
|
| Rate for Payer: Prime Health Services Commercial |
$219.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$154.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$154.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$129.00
|
| Rate for Payer: United Healthcare All Other HMO |
$129.00
|
| Rate for Payer: United Healthcare HMO Rider |
$129.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$129.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$219.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.30
|
| Rate for Payer: Vantage Medical Group Senior |
$219.30
|
|
|
HC CONF COORD NURSE SPECIALIST
|
Facility
|
OP
|
$297.00
|
|
| Hospital Charge Code |
912154300
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$59.40 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Adventist Health Commercial |
$59.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$194.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$252.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$222.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.58
|
| Rate for Payer: Cash Price |
$133.65
|
| Rate for Payer: Cigna of CA HMO |
$190.08
|
| Rate for Payer: Cigna of CA PPO |
$219.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$252.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.80
|
| Rate for Payer: EPIC Health Plan Senior |
$118.80
|
| Rate for Payer: Galaxy Health WC |
$252.45
|
| Rate for Payer: Global Benefits Group Commercial |
$178.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$207.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$207.90
|
| Rate for Payer: Multiplan Commercial |
$237.60
|
| Rate for Payer: Networks By Design Commercial |
$193.05
|
| Rate for Payer: Prime Health Services Commercial |
$252.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$148.50
|
| Rate for Payer: United Healthcare All Other HMO |
$148.50
|
| Rate for Payer: United Healthcare HMO Rider |
$148.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$148.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$252.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.45
|
| Rate for Payer: Vantage Medical Group Senior |
$252.45
|
|
|
HC CONF COORD NURSE SPECIALIST
|
Facility
|
IP
|
$297.00
|
|
| Hospital Charge Code |
912154300
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$59.40 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Adventist Health Commercial |
$59.40
|
| Rate for Payer: Cash Price |
$133.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.80
|
| Rate for Payer: EPIC Health Plan Senior |
$118.80
|
| Rate for Payer: Galaxy Health WC |
$252.45
|
| Rate for Payer: Global Benefits Group Commercial |
$178.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$175.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.28
|
| Rate for Payer: Multiplan Commercial |
$237.60
|
| Rate for Payer: Networks By Design Commercial |
$193.05
|
| Rate for Payer: Prime Health Services Commercial |
$252.45
|
|
|
HC CONF COORD OTHER ALLIED HLTH
|
Facility
|
OP
|
$243.00
|
|
| Hospital Charge Code |
912164305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Adventist Health Commercial |
$48.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$159.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$182.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$155.93
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Cigna of CA HMO |
$155.52
|
| Rate for Payer: Cigna of CA PPO |
$179.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$206.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$206.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Senior |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$154.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$88.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$143.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$170.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$170.10
|
| Rate for Payer: Multiplan Commercial |
$194.40
|
| Rate for Payer: Networks By Design Commercial |
$157.95
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.50
|
| Rate for Payer: United Healthcare All Other HMO |
$121.50
|
| Rate for Payer: United Healthcare HMO Rider |
$121.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.55
|
| Rate for Payer: Vantage Medical Group Senior |
$206.55
|
|
|
HC CONF COORD OTHER ALLIED HLTH
|
Facility
|
IP
|
$243.00
|
|
| Hospital Charge Code |
912164305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$206.55 |
| Rate for Payer: Adventist Health Commercial |
$48.60
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Senior |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$154.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$143.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.32
|
| Rate for Payer: Multiplan Commercial |
$194.40
|
| Rate for Payer: Networks By Design Commercial |
$157.95
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
|
IP
|
$6,876.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906811595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,375.20 |
| Max. Negotiated Rate |
$5,844.60 |
| Rate for Payer: Adventist Health Commercial |
$1,375.20
|
| Rate for Payer: Cash Price |
$3,094.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,813.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,750.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,750.40
|
| Rate for Payer: Galaxy Health WC |
$5,844.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,125.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,366.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,056.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,650.24
|
| Rate for Payer: Multiplan Commercial |
$5,500.80
|
| Rate for Payer: Networks By Design Commercial |
$4,469.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,844.60
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
|
OP
|
$6,876.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906811595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,375.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,375.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,759.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Cash Price |
$3,094.20
|
| Rate for Payer: Cash Price |
$3,094.20
|
| Rate for Payer: Cash Price |
$3,094.20
|
| Rate for Payer: Cigna of CA HMO |
$4,469.40
|
| Rate for Payer: Cigna of CA PPO |
$5,088.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,813.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$5,844.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,125.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,366.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,650.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,253.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$5,500.80
|
| Rate for Payer: Networks By Design Commercial |
$4,469.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,844.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,125.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,125.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,438.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
|
HC CONG R & L HEART W SEPTAL
|
Facility
|
OP
|
$8,882.00
|
|
|
Service Code
|
CPT 93533
|
| Hospital Charge Code |
906811253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,776.40 |
| Max. Negotiated Rate |
$16,261.00 |
| Rate for Payer: Adventist Health Commercial |
$1,776.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,549.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,885.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,661.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Cash Price |
$3,996.90
|
| Rate for Payer: Cash Price |
$3,996.90
|
| Rate for Payer: Cigna of CA HMO |
$5,773.30
|
| Rate for Payer: Cigna of CA PPO |
$6,572.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,549.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,549.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,549.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,217.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,552.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,552.80
|
| Rate for Payer: Galaxy Health WC |
$7,549.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,329.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,640.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,224.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,240.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,131.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,217.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,217.40
|
| Rate for Payer: Multiplan Commercial |
$7,105.60
|
| Rate for Payer: Networks By Design Commercial |
$5,773.30
|
| Rate for Payer: Prime Health Services Commercial |
$7,549.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,329.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,329.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,441.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,441.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,441.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,441.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,549.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,549.70
|
| Rate for Payer: Vantage Medical Group Senior |
$7,549.70
|
|
|
HC CONG R & L HEART W SEPTAL
|
Facility
|
IP
|
$8,882.00
|
|
|
Service Code
|
CPT 93533
|
| Hospital Charge Code |
906811253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,776.40 |
| Max. Negotiated Rate |
$7,549.70 |
| Rate for Payer: Adventist Health Commercial |
$1,776.40
|
| Rate for Payer: Cash Price |
$3,996.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,217.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,552.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,552.80
|
| Rate for Payer: Galaxy Health WC |
$7,549.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,329.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,640.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,240.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,131.68
|
| Rate for Payer: Multiplan Commercial |
$7,105.60
|
| Rate for Payer: Networks By Design Commercial |
$5,773.30
|
| Rate for Payer: Prime Health Services Commercial |
$7,549.70
|
|
|
HC CONG R & L HEART W TRANSEPTAL
|
Facility
|
OP
|
$8,035.00
|
|
|
Service Code
|
CPT 93532
|
| Hospital Charge Code |
906811252
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,607.00 |
| Max. Negotiated Rate |
$16,261.00 |
| Rate for Payer: Adventist Health Commercial |
$1,607.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,829.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,419.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,026.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Cash Price |
$3,615.75
|
| Rate for Payer: Cash Price |
$3,615.75
|
| Rate for Payer: Cigna of CA HMO |
$5,222.75
|
| Rate for Payer: Cigna of CA PPO |
$5,945.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,829.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,829.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,829.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,624.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,214.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,214.00
|
| Rate for Payer: Galaxy Health WC |
$6,829.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,821.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,102.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,916.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,740.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,928.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,624.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,624.50
|
| Rate for Payer: Multiplan Commercial |
$6,428.00
|
| Rate for Payer: Networks By Design Commercial |
$5,222.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,829.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,821.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,821.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,017.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,017.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,017.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,017.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,829.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,829.75
|
| Rate for Payer: Vantage Medical Group Senior |
$6,829.75
|
|
|
HC CONG R & L HEART W TRANSEPTAL
|
Facility
|
IP
|
$8,035.00
|
|
|
Service Code
|
CPT 93532
|
| Hospital Charge Code |
906811252
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,607.00 |
| Max. Negotiated Rate |
$6,829.75 |
| Rate for Payer: Adventist Health Commercial |
$1,607.00
|
| Rate for Payer: Cash Price |
$3,615.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,624.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,214.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,214.00
|
| Rate for Payer: Galaxy Health WC |
$6,829.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,821.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,102.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,740.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,928.40
|
| Rate for Payer: Multiplan Commercial |
$6,428.00
|
| Rate for Payer: Networks By Design Commercial |
$5,222.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,829.75
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
OP
|
$6,876.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,375.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,375.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,759.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Cash Price |
$3,094.20
|
| Rate for Payer: Cash Price |
$3,094.20
|
| Rate for Payer: Cash Price |
$3,094.20
|
| Rate for Payer: Cigna of CA HMO |
$4,469.40
|
| Rate for Payer: Cigna of CA PPO |
$5,088.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,813.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$5,844.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,125.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,366.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,650.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,253.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$5,500.80
|
| Rate for Payer: Networks By Design Commercial |
$4,469.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,844.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,125.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,125.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,438.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
