|
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
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
|
IP
|
$6,876.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
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 RT AND LT HEART CATH NML NAT
|
Facility
|
OP
|
$6,876.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
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 RT HEART CATH ABNL NAT
|
Facility
|
IP
|
$6,876.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
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 RT HEART CATH ABNL NAT
|
Facility
|
OP
|
$6,876.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
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 RT HEART CONG NML NAT
|
Facility
|
OP
|
$6,876.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
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 RT HEART CONG NML NAT
|
Facility
|
IP
|
$6,876.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
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 CONSULT COMP/HIGH COMPLEX
|
Facility
|
OP
|
$1,019.00
|
|
| Hospital Charge Code |
912999245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$203.80 |
| Max. Negotiated Rate |
$866.15 |
| Rate for Payer: Adventist Health Commercial |
$203.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$668.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$866.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$560.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$764.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$653.89
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cigna of CA HMO |
$652.16
|
| Rate for Payer: Cigna of CA PPO |
$754.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$866.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$866.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$866.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$713.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$407.60
|
| Rate for Payer: EPIC Health Plan Senior |
$407.60
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$647.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$369.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$244.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$713.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$713.30
|
| Rate for Payer: Multiplan Commercial |
$815.20
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$611.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$611.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.50
|
| Rate for Payer: United Healthcare All Other HMO |
$509.50
|
| Rate for Payer: United Healthcare HMO Rider |
$509.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$509.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$866.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$866.15
|
| Rate for Payer: Vantage Medical Group Senior |
$866.15
|
|
|
HC CONSULT COMP/HIGH COMPLEX
|
Facility
|
IP
|
$1,212.00
|
|
| Hospital Charge Code |
908600122
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$242.40 |
| Max. Negotiated Rate |
$1,030.20 |
| Rate for Payer: Adventist Health Commercial |
$242.40
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$848.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$484.80
|
| Rate for Payer: EPIC Health Plan Senior |
$484.80
|
| Rate for Payer: Galaxy Health WC |
$1,030.20
|
| Rate for Payer: Global Benefits Group Commercial |
$727.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$769.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$715.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.88
|
| Rate for Payer: Multiplan Commercial |
$969.60
|
| Rate for Payer: Networks By Design Commercial |
$787.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,030.20
|
|
|
HC CONSULT COMP/HIGH COMPLEX
|
Facility
|
IP
|
$1,019.00
|
|
| Hospital Charge Code |
912999245
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$203.80 |
| Max. Negotiated Rate |
$866.15 |
| Rate for Payer: Adventist Health Commercial |
$203.80
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$713.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$407.60
|
| Rate for Payer: EPIC Health Plan Senior |
$407.60
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$647.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$601.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$244.56
|
| Rate for Payer: Multiplan Commercial |
$815.20
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
|
|
HC CONSULT COMP/HIGH COMPLEX
|
Facility
|
OP
|
$1,212.00
|
|
| Hospital Charge Code |
908600122
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$242.40 |
| Max. Negotiated Rate |
$1,030.20 |
| Rate for Payer: Adventist Health Commercial |
$242.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$794.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,030.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$666.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$909.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$777.74
|
| Rate for Payer: Cash Price |
$545.40
|
| Rate for Payer: Cigna of CA HMO |
$775.68
|
| Rate for Payer: Cigna of CA PPO |
$896.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,030.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,030.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,030.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$848.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$484.80
|
| Rate for Payer: EPIC Health Plan Senior |
$484.80
|
| Rate for Payer: Galaxy Health WC |
$1,030.20
|
| Rate for Payer: Global Benefits Group Commercial |
$727.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$769.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$439.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$715.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$848.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$848.40
|
| Rate for Payer: Multiplan Commercial |
$969.60
|
| Rate for Payer: Networks By Design Commercial |
$787.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,030.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$727.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$727.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$606.00
|
| Rate for Payer: United Healthcare All Other HMO |
$606.00
|
| Rate for Payer: United Healthcare HMO Rider |
$606.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$606.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,030.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,030.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,030.20
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$627.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$569.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$529.23
|
| 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 |
$575.60
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$627.90
|
| 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 Foundation Hospitals Commercial/Self Funded |
$569.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$325.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$529.23
|
| 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
|
OP
|
$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: Aetna of CA HMO/PPO |
$699.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$906.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$586.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$799.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$684.05
|
| Rate for Payer: Cash Price |
$479.70
|
| Rate for Payer: Cigna of CA HMO |
$682.24
|
| Rate for Payer: Cigna of CA PPO |
$788.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$906.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$906.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$906.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$746.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$676.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$386.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$746.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$746.20
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$639.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$639.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$533.00
|
| Rate for Payer: United Healthcare All Other HMO |
$533.00
|
| Rate for Payer: United Healthcare HMO Rider |
$533.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$533.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$906.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$906.10
|
| Rate for Payer: Vantage Medical Group Senior |
$906.10
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$746.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$676.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.94
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$427.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$387.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$360.49
|
| 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 |
$560.20
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$554.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$316.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.07
|
| 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 |
$392.08
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$427.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$387.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$221.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$360.49
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$554.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.07
|
| 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
|
$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: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$400.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$372.29
|
| 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
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$279.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$259.60
|
| 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 |
$404.91
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$400.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$229.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$372.29
|
| 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
|
OP
|
$440.00
|
|
| Hospital Charge Code |
912999242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$374.00 |
| Rate for Payer: Cigna of CA HMO |
$281.60
|
| 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 |
$282.35
|
| Rate for Payer: Cash Price |
$198.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$279.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$159.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$259.60
|
| 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
|
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 |
$217.54
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$237.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$215.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$123.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$200.01
|
| 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
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$166.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$151.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$140.42
|
| 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
|
|
