|
HC C SPINE W/FLEX AND EXT COMPLETE
|
Facility
|
OP
|
$1,301.00
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
909001303
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$84.52 |
| Max. Negotiated Rate |
$1,105.85 |
| Rate for Payer: Adventist Health Commercial |
$260.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$354.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.31
|
| Rate for Payer: Blue Shield of California Commercial |
$547.72
|
| Rate for Payer: Blue Shield of California Commercial |
$830.04
|
| Rate for Payer: Cash Price |
$585.45
|
| Rate for Payer: Cash Price |
$585.45
|
| Rate for Payer: Cigna of CA HMO |
$832.64
|
| Rate for Payer: Cigna of CA PPO |
$962.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$910.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$1,105.85
|
| Rate for Payer: Global Benefits Group Commercial |
$780.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$84.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$826.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$95.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$312.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$1,040.80
|
| Rate for Payer: Networks By Design Commercial |
$845.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,105.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$780.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$780.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$193.23
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$193.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC C SPINE W/FLEX AND EXT COMPLETE
|
Facility
|
IP
|
$1,301.00
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
909001303
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$260.20 |
| Max. Negotiated Rate |
$1,105.85 |
| Rate for Payer: Adventist Health Commercial |
$260.20
|
| Rate for Payer: Cash Price |
$585.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$910.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$520.40
|
| Rate for Payer: EPIC Health Plan Senior |
$520.40
|
| Rate for Payer: Galaxy Health WC |
$1,105.85
|
| Rate for Payer: Global Benefits Group Commercial |
$780.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$826.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$767.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$312.24
|
| Rate for Payer: Multiplan Commercial |
$1,040.80
|
| Rate for Payer: Networks By Design Commercial |
$845.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,105.85
|
|
|
HC CT ABDOMEN & PELVIS W/CONTRAST
|
Facility
|
IP
|
$7,401.00
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
909202002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,480.20 |
| Max. Negotiated Rate |
$6,290.85 |
| Rate for Payer: Adventist Health Commercial |
$1,480.20
|
| Rate for Payer: Cash Price |
$3,330.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,180.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,960.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,960.40
|
| Rate for Payer: Galaxy Health WC |
$6,290.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,440.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,699.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,366.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,776.24
|
| Rate for Payer: Multiplan Commercial |
$5,920.80
|
| Rate for Payer: Networks By Design Commercial |
$4,810.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,290.85
|
|
|
HC CT ABDOMEN & PELVIS W/CONTRAST
|
Facility
|
OP
|
$3,967.00
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
909202002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$3,371.95 |
| Rate for Payer: Adventist Health Commercial |
$793.40
|
| Rate for Payer: Adventist Health Commercial |
$1,480.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,545.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,749.22
|
| Rate for Payer: Blue Shield of California Commercial |
$3,115.82
|
| Rate for Payer: Blue Shield of California Commercial |
$1,670.11
|
| Rate for Payer: Blue Shield of California Commercial |
$2,530.95
|
| Rate for Payer: Blue Shield of California Commercial |
$4,721.84
|
| Rate for Payer: Cash Price |
$1,785.15
|
| Rate for Payer: Cash Price |
$1,785.15
|
| Rate for Payer: Cash Price |
$3,330.45
|
| Rate for Payer: Cash Price |
$1,785.15
|
| Rate for Payer: Cash Price |
$3,330.45
|
| Rate for Payer: Cash Price |
$3,330.45
|
| Rate for Payer: Cigna of CA HMO |
$2,538.88
|
| Rate for Payer: Cigna of CA HMO |
$4,736.64
|
| Rate for Payer: Cigna of CA PPO |
$2,935.58
|
| Rate for Payer: Cigna of CA PPO |
$5,476.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,180.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,776.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$6,290.85
|
| Rate for Payer: Galaxy Health WC |
$3,371.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,380.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,440.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$473.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$473.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,699.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,519.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$535.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$535.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$952.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,776.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$3,173.60
|
| Rate for Payer: Multiplan Commercial |
$5,920.80
|
| Rate for Payer: Networks By Design Commercial |
$4,810.65
|
| Rate for Payer: Networks By Design Commercial |
$2,578.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,371.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,290.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,440.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,380.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,380.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,440.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC CT ABDOMEN & PELVIS W/O CONTRA
|
Facility
|
IP
|
$6,684.00
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
909202001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,336.80 |
| Max. Negotiated Rate |
$5,681.40 |
| Rate for Payer: Adventist Health Commercial |
$1,336.80
|
| Rate for Payer: Cash Price |
$3,007.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,678.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,673.60
|
| Rate for Payer: Galaxy Health WC |
$5,681.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,010.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,244.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,943.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,604.16
|
| Rate for Payer: Multiplan Commercial |
$5,347.20
|
| Rate for Payer: Networks By Design Commercial |
$4,344.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,681.40
|
|
|
HC CT ABDOMEN & PELVIS W/O CONTRA
|
Facility
|
OP
|
$3,581.00
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
909202001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$292.84 |
| Max. Negotiated Rate |
$3,043.85 |
| Rate for Payer: Adventist Health Commercial |
$716.20
|
| Rate for Payer: Adventist Health Commercial |
$1,336.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,297.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,289.12
|
| Rate for Payer: Blue Shield of California Commercial |
$2,813.96
|
| Rate for Payer: Blue Shield of California Commercial |
$1,507.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,284.68
|
| Rate for Payer: Blue Shield of California Commercial |
$4,264.39
|
| Rate for Payer: Cash Price |
$1,611.45
|
| Rate for Payer: Cash Price |
$1,611.45
|
| Rate for Payer: Cash Price |
$3,007.80
|
| Rate for Payer: Cash Price |
$1,611.45
|
| Rate for Payer: Cash Price |
$3,007.80
|
| Rate for Payer: Cash Price |
$3,007.80
|
| Rate for Payer: Cigna of CA HMO |
$2,291.84
|
| Rate for Payer: Cigna of CA HMO |
$4,277.76
|
| Rate for Payer: Cigna of CA PPO |
$2,649.94
|
| Rate for Payer: Cigna of CA PPO |
$4,946.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,678.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,506.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$5,681.40
|
| Rate for Payer: Galaxy Health WC |
$3,043.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,148.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,010.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$292.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$292.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,244.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,273.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$331.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$331.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$859.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,604.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$2,864.80
|
| Rate for Payer: Multiplan Commercial |
$5,347.20
|
| Rate for Payer: Networks By Design Commercial |
$4,344.60
|
| Rate for Payer: Networks By Design Commercial |
$2,327.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,043.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,681.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,010.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,148.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,148.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,010.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,037.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,037.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,037.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,037.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1,037.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1,037.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,037.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,037.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC CT ABDOMEN & PELVIS W & W/O CO
|
Facility
|
OP
|
$4,306.00
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
909202003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$3,660.10 |
| Rate for Payer: Adventist Health Commercial |
$861.20
|
| Rate for Payer: Adventist Health Commercial |
$1,606.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,763.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,154.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,381.89
|
| Rate for Payer: Blue Shield of California Commercial |
$1,812.83
|
| Rate for Payer: Blue Shield of California Commercial |
$2,747.23
|
| Rate for Payer: Blue Shield of California Commercial |
$5,125.05
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$3,614.85
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$3,614.85
|
| Rate for Payer: Cash Price |
$3,614.85
|
| Rate for Payer: Cigna of CA HMO |
$2,755.84
|
| Rate for Payer: Cigna of CA HMO |
$5,141.12
|
| Rate for Payer: Cigna of CA PPO |
$3,186.44
|
| Rate for Payer: Cigna of CA PPO |
$5,944.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,623.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,014.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$6,828.05
|
| Rate for Payer: Galaxy Health WC |
$3,660.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,583.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,819.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$536.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$536.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,100.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,734.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$606.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$606.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,927.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$3,444.80
|
| Rate for Payer: Multiplan Commercial |
$6,426.40
|
| Rate for Payer: Networks By Design Commercial |
$5,221.45
|
| Rate for Payer: Networks By Design Commercial |
$2,798.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,660.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,828.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,819.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,583.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,583.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,819.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC CT ABDOMEN & PELVIS W & W/O CO
|
Facility
|
IP
|
$8,033.00
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
909202003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,606.60 |
| Max. Negotiated Rate |
$6,828.05 |
| Rate for Payer: Adventist Health Commercial |
$1,606.60
|
| Rate for Payer: Cash Price |
$3,614.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,623.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,213.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,213.20
|
| Rate for Payer: Galaxy Health WC |
$6,828.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,819.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,100.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,739.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,927.92
|
| Rate for Payer: Multiplan Commercial |
$6,426.40
|
| Rate for Payer: Networks By Design Commercial |
$5,221.45
|
| Rate for Payer: Prime Health Services Commercial |
$6,828.05
|
|
|
HC CT ABDOMEN W CONTRAS
|
Facility
|
OP
|
$2,996.00
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
909201928
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,754.00 |
| Rate for Payer: Adventist Health Commercial |
$599.20
|
| Rate for Payer: Adventist Health Commercial |
$1,211.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,922.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,885.49
|
| Rate for Payer: Blue Shield of California Commercial |
$2,549.16
|
| Rate for Payer: Blue Shield of California Commercial |
$1,261.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,911.45
|
| Rate for Payer: Blue Shield of California Commercial |
$3,863.09
|
| Rate for Payer: Cash Price |
$1,348.20
|
| Rate for Payer: Cash Price |
$1,348.20
|
| Rate for Payer: Cash Price |
$2,724.75
|
| Rate for Payer: Cash Price |
$1,348.20
|
| Rate for Payer: Cash Price |
$2,724.75
|
| Rate for Payer: Cash Price |
$2,724.75
|
| Rate for Payer: Cigna of CA HMO |
$1,917.44
|
| Rate for Payer: Cigna of CA HMO |
$3,875.20
|
| Rate for Payer: Cigna of CA PPO |
$2,217.04
|
| Rate for Payer: Cigna of CA PPO |
$4,480.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,238.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,097.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$5,146.75
|
| Rate for Payer: Galaxy Health WC |
$2,546.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,797.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,633.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$350.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$350.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,844.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,902.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$396.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$396.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$719.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,453.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$2,396.80
|
| Rate for Payer: Multiplan Commercial |
$4,844.00
|
| Rate for Payer: Networks By Design Commercial |
$3,935.75
|
| Rate for Payer: Networks By Design Commercial |
$1,947.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,546.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,146.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,633.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,797.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,633.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ABDOMEN W CONTRAS
|
Facility
|
IP
|
$6,055.00
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
909201928
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,211.00 |
| Max. Negotiated Rate |
$5,146.75 |
| Rate for Payer: Adventist Health Commercial |
$1,211.00
|
| Rate for Payer: Cash Price |
$2,724.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,238.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,422.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,422.00
|
| Rate for Payer: Galaxy Health WC |
$5,146.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,633.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,844.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,572.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,453.20
|
| Rate for Payer: Multiplan Commercial |
$4,844.00
|
| Rate for Payer: Networks By Design Commercial |
$3,935.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,146.75
|
|
|
HC CT ABDOMEN WO CONTR
|
Facility
|
IP
|
$5,018.00
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
909201927
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,003.60 |
| Max. Negotiated Rate |
$4,265.30 |
| Rate for Payer: Adventist Health Commercial |
$1,003.60
|
| Rate for Payer: Cash Price |
$2,258.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,512.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,007.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,007.20
|
| Rate for Payer: Galaxy Health WC |
$4,265.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,010.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,186.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,960.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,204.32
|
| Rate for Payer: Multiplan Commercial |
$4,014.40
|
| Rate for Payer: Networks By Design Commercial |
$3,261.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,265.30
|
|
|
HC CT ABDOMEN WO CONTR
|
Facility
|
OP
|
$2,665.00
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
909201927
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$134.46 |
| Max. Negotiated Rate |
$2,754.00 |
| Rate for Payer: Adventist Health Commercial |
$533.00
|
| Rate for Payer: Adventist Health Commercial |
$1,003.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,710.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,220.05
|
| Rate for Payer: Blue Shield of California Commercial |
$2,112.58
|
| Rate for Payer: Blue Shield of California Commercial |
$1,121.96
|
| Rate for Payer: Blue Shield of California Commercial |
$1,700.27
|
| Rate for Payer: Blue Shield of California Commercial |
$3,201.48
|
| Rate for Payer: Cash Price |
$1,199.25
|
| Rate for Payer: Cash Price |
$1,199.25
|
| Rate for Payer: Cash Price |
$2,258.10
|
| Rate for Payer: Cash Price |
$1,199.25
|
| Rate for Payer: Cash Price |
$2,258.10
|
| Rate for Payer: Cash Price |
$2,258.10
|
| Rate for Payer: Cigna of CA HMO |
$1,705.60
|
| Rate for Payer: Cigna of CA HMO |
$3,211.52
|
| Rate for Payer: Cigna of CA PPO |
$1,972.10
|
| Rate for Payer: Cigna of CA PPO |
$3,713.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,512.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,865.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$4,265.30
|
| Rate for Payer: Galaxy Health WC |
$2,265.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,599.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,010.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$220.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$220.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,186.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,692.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$249.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$249.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$639.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,204.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$2,132.00
|
| Rate for Payer: Multiplan Commercial |
$4,014.40
|
| Rate for Payer: Networks By Design Commercial |
$3,261.70
|
| Rate for Payer: Networks By Design Commercial |
$1,732.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,265.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,265.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,010.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,599.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,599.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,010.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.23
|
| Rate for Payer: United Healthcare All Other HMO |
$491.23
|
| Rate for Payer: United Healthcare All Other HMO |
$491.23
|
| Rate for Payer: United Healthcare HMO Rider |
$491.23
|
| Rate for Payer: United Healthcare HMO Rider |
$491.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC CT ABDOMEN W/WO CONT
|
Facility
|
OP
|
$3,505.00
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
909201929
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$2,979.25 |
| Rate for Payer: Adventist Health Commercial |
$701.00
|
| Rate for Payer: Adventist Health Commercial |
$1,307.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,249.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,196.08
|
| Rate for Payer: Blue Shield of California Commercial |
$2,752.92
|
| Rate for Payer: Blue Shield of California Commercial |
$1,475.61
|
| Rate for Payer: Blue Shield of California Commercial |
$2,236.19
|
| Rate for Payer: Blue Shield of California Commercial |
$4,171.88
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$2,942.55
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$2,942.55
|
| Rate for Payer: Cash Price |
$2,942.55
|
| Rate for Payer: Cigna of CA HMO |
$2,243.20
|
| Rate for Payer: Cigna of CA HMO |
$4,184.96
|
| Rate for Payer: Cigna of CA PPO |
$2,593.70
|
| Rate for Payer: Cigna of CA PPO |
$4,838.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,577.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,453.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$5,558.15
|
| Rate for Payer: Galaxy Health WC |
$2,979.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,103.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,923.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$399.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$399.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,152.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,225.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$451.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$451.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$841.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,569.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$2,804.00
|
| Rate for Payer: Multiplan Commercial |
$5,231.20
|
| Rate for Payer: Networks By Design Commercial |
$4,250.35
|
| Rate for Payer: Networks By Design Commercial |
$2,278.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,979.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,558.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,923.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,103.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,103.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,923.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ABDOMEN W/WO CONT
|
Facility
|
IP
|
$6,539.00
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
909201929
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,307.80 |
| Max. Negotiated Rate |
$5,558.15 |
| Rate for Payer: Adventist Health Commercial |
$1,307.80
|
| Rate for Payer: Cash Price |
$2,942.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,577.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,615.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,615.60
|
| Rate for Payer: Galaxy Health WC |
$5,558.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,923.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,152.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,858.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,569.36
|
| Rate for Payer: Multiplan Commercial |
$5,231.20
|
| Rate for Payer: Networks By Design Commercial |
$4,250.35
|
| Rate for Payer: Prime Health Services Commercial |
$5,558.15
|
|
|
HC CT ANGIO ABD AORTA-AIF W/WO CO
|
Facility
|
OP
|
$4,310.00
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
909201809
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$3,663.50 |
| Rate for Payer: Adventist Health Commercial |
$862.00
|
| Rate for Payer: Adventist Health Commercial |
$1,354.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,765.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,345.59
|
| Rate for Payer: Blue Shield of California Commercial |
$2,851.01
|
| Rate for Payer: Blue Shield of California Commercial |
$1,814.51
|
| Rate for Payer: Blue Shield of California Commercial |
$2,749.78
|
| Rate for Payer: Blue Shield of California Commercial |
$4,320.54
|
| Rate for Payer: Cash Price |
$1,939.50
|
| Rate for Payer: Cash Price |
$1,939.50
|
| Rate for Payer: Cash Price |
$3,047.40
|
| Rate for Payer: Cash Price |
$1,939.50
|
| Rate for Payer: Cash Price |
$3,047.40
|
| Rate for Payer: Cash Price |
$3,047.40
|
| Rate for Payer: Cigna of CA HMO |
$2,758.40
|
| Rate for Payer: Cigna of CA HMO |
$4,334.08
|
| Rate for Payer: Cigna of CA PPO |
$3,189.40
|
| Rate for Payer: Cigna of CA PPO |
$5,011.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,740.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,017.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$5,756.20
|
| Rate for Payer: Galaxy Health WC |
$3,663.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,586.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,063.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$575.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$575.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,300.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,736.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$650.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$650.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,034.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,625.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$3,448.00
|
| Rate for Payer: Multiplan Commercial |
$5,417.60
|
| Rate for Payer: Networks By Design Commercial |
$4,401.80
|
| Rate for Payer: Networks By Design Commercial |
$2,801.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,663.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,756.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,063.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,586.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,586.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,063.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ANGIO ABD AORTA-AIF W/WO CO
|
Facility
|
IP
|
$6,772.00
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
909201809
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,354.40 |
| Max. Negotiated Rate |
$5,756.20 |
| Rate for Payer: Adventist Health Commercial |
$1,354.40
|
| Rate for Payer: Cash Price |
$3,047.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,740.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,708.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,708.80
|
| Rate for Payer: Galaxy Health WC |
$5,756.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,063.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,300.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,995.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,625.28
|
| Rate for Payer: Multiplan Commercial |
$5,417.60
|
| Rate for Payer: Networks By Design Commercial |
$4,401.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,756.20
|
|
|
HC CT ANGIO ABDOMEN/PELVIS
|
Facility
|
OP
|
$3,802.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
909201991
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$3,231.70 |
| Rate for Payer: Adventist Health Commercial |
$760.40
|
| Rate for Payer: Adventist Health Commercial |
$1,419.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,439.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,553.50
|
| Rate for Payer: Blue Shield of California Commercial |
$2,987.42
|
| Rate for Payer: Blue Shield of California Commercial |
$1,600.64
|
| Rate for Payer: Blue Shield of California Commercial |
$2,425.68
|
| Rate for Payer: Blue Shield of California Commercial |
$4,527.25
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Cash Price |
$3,193.20
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Cash Price |
$3,193.20
|
| Rate for Payer: Cash Price |
$3,193.20
|
| Rate for Payer: Cigna of CA HMO |
$2,433.28
|
| Rate for Payer: Cigna of CA HMO |
$4,541.44
|
| Rate for Payer: Cigna of CA PPO |
$2,813.48
|
| Rate for Payer: Cigna of CA PPO |
$5,251.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,967.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,661.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$6,031.60
|
| Rate for Payer: Galaxy Health WC |
$3,231.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,257.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$590.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$590.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,505.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,414.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$668.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$668.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,703.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$3,041.60
|
| Rate for Payer: Multiplan Commercial |
$5,676.80
|
| Rate for Payer: Networks By Design Commercial |
$4,612.40
|
| Rate for Payer: Networks By Design Commercial |
$2,471.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,231.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,031.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,257.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,257.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC CT ANGIO ABDOMEN/PELVIS
|
Facility
|
IP
|
$7,096.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
909201991
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,419.20 |
| Max. Negotiated Rate |
$6,031.60 |
| Rate for Payer: Adventist Health Commercial |
$1,419.20
|
| Rate for Payer: Cash Price |
$3,193.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,967.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,838.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,838.40
|
| Rate for Payer: Galaxy Health WC |
$6,031.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,257.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,505.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,186.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,703.04
|
| Rate for Payer: Multiplan Commercial |
$5,676.80
|
| Rate for Payer: Networks By Design Commercial |
$4,612.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,031.60
|
|
|
HC CT ANGIO ABDOMEN W/WO CONTRAST
|
Facility
|
OP
|
$3,890.00
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
909201808
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$3,306.50 |
| Rate for Payer: Adventist Health Commercial |
$778.00
|
| Rate for Payer: Adventist Health Commercial |
$1,161.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,496.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,725.71
|
| Rate for Payer: Blue Shield of California Commercial |
$2,444.33
|
| Rate for Payer: Blue Shield of California Commercial |
$1,637.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2,481.82
|
| Rate for Payer: Blue Shield of California Commercial |
$3,704.23
|
| Rate for Payer: Cash Price |
$1,750.50
|
| Rate for Payer: Cash Price |
$1,750.50
|
| Rate for Payer: Cash Price |
$2,612.70
|
| Rate for Payer: Cash Price |
$1,750.50
|
| Rate for Payer: Cash Price |
$2,612.70
|
| Rate for Payer: Cash Price |
$2,612.70
|
| Rate for Payer: Cigna of CA HMO |
$2,489.60
|
| Rate for Payer: Cigna of CA HMO |
$3,715.84
|
| Rate for Payer: Cigna of CA PPO |
$2,878.60
|
| Rate for Payer: Cigna of CA PPO |
$4,296.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,064.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,723.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$4,935.10
|
| Rate for Payer: Galaxy Health WC |
$3,306.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,334.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,483.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$465.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$465.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,686.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,470.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$526.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$526.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$933.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,393.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$3,112.00
|
| Rate for Payer: Multiplan Commercial |
$4,644.80
|
| Rate for Payer: Networks By Design Commercial |
$3,773.90
|
| Rate for Payer: Networks By Design Commercial |
$2,528.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,306.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,935.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,483.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,334.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,334.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,483.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ANGIO ABDOMEN W/WO CONTRAST
|
Facility
|
IP
|
$5,806.00
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
909201808
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,161.20 |
| Max. Negotiated Rate |
$4,935.10 |
| Rate for Payer: Adventist Health Commercial |
$1,161.20
|
| Rate for Payer: Cash Price |
$2,612.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,064.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,322.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,322.40
|
| Rate for Payer: Galaxy Health WC |
$4,935.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,483.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,686.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,425.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,393.44
|
| Rate for Payer: Multiplan Commercial |
$4,644.80
|
| Rate for Payer: Networks By Design Commercial |
$3,773.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,935.10
|
|
|
HC CT ANGIO CHEST W/WO CONTRAST
|
Facility
|
OP
|
$3,658.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
909201802
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$3,109.30 |
| Rate for Payer: Adventist Health Commercial |
$731.60
|
| Rate for Payer: Adventist Health Commercial |
$1,191.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,347.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,823.25
|
| Rate for Payer: Blue Shield of California Commercial |
$2,508.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,540.02
|
| Rate for Payer: Blue Shield of California Commercial |
$2,333.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,801.20
|
| Rate for Payer: Cash Price |
$1,646.10
|
| Rate for Payer: Cash Price |
$1,646.10
|
| Rate for Payer: Cash Price |
$2,681.10
|
| Rate for Payer: Cash Price |
$1,646.10
|
| Rate for Payer: Cash Price |
$2,681.10
|
| Rate for Payer: Cash Price |
$2,681.10
|
| Rate for Payer: Cigna of CA HMO |
$2,341.12
|
| Rate for Payer: Cigna of CA HMO |
$3,813.12
|
| Rate for Payer: Cigna of CA PPO |
$2,706.92
|
| Rate for Payer: Cigna of CA PPO |
$4,408.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,170.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,560.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$5,064.30
|
| Rate for Payer: Galaxy Health WC |
$3,109.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,194.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$455.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$455.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,783.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,322.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$514.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$514.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$877.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$2,926.40
|
| Rate for Payer: Multiplan Commercial |
$4,766.40
|
| Rate for Payer: Networks By Design Commercial |
$3,872.70
|
| Rate for Payer: Networks By Design Commercial |
$2,377.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,109.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,064.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,574.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,194.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,194.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,574.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
|
HC CT ANGIO CHEST W/WO CONTRAST
|
Facility
|
IP
|
$5,958.00
|
|
|
Service Code
|
CPT 71275
|
| Hospital Charge Code |
909201802
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,191.60 |
| Max. Negotiated Rate |
$5,064.30 |
| Rate for Payer: Adventist Health Commercial |
$1,191.60
|
| Rate for Payer: Cash Price |
$2,681.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,170.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,383.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,383.20
|
| Rate for Payer: Galaxy Health WC |
$5,064.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,574.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,783.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,515.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.92
|
| Rate for Payer: Multiplan Commercial |
$4,766.40
|
| Rate for Payer: Networks By Design Commercial |
$3,872.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,064.30
|
|
|
HC CT ANGIO HEAD AND NECK W WO CONTRAST
|
Facility
|
OP
|
$1,093.00
|
|
|
Service Code
|
CPT 70471
|
| Hospital Charge Code |
909201820
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$218.60 |
| Max. Negotiated Rate |
$2,754.00 |
| Rate for Payer: Adventist Health Commercial |
$218.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$701.38
|
| Rate for Payer: Blue Shield of California Commercial |
$697.33
|
| Rate for Payer: Blue Shield of California Commercial |
$460.15
|
| Rate for Payer: Cash Price |
$491.85
|
| Rate for Payer: Cash Price |
$491.85
|
| Rate for Payer: Cash Price |
$491.85
|
| Rate for Payer: Cigna of CA HMO |
$699.52
|
| Rate for Payer: Cigna of CA PPO |
$808.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$765.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$929.05
|
| Rate for Payer: Global Benefits Group Commercial |
$655.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$694.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$874.40
|
| Rate for Payer: Networks By Design Commercial |
$710.45
|
| Rate for Payer: Prime Health Services Commercial |
$929.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$655.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$655.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$546.50
|
| Rate for Payer: United Healthcare All Other HMO |
$546.50
|
| Rate for Payer: United Healthcare HMO Rider |
$546.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$546.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC CT ANGIO HEAD AND NECK W WO CONTRAST
|
Facility
|
IP
|
$1,093.00
|
|
|
Service Code
|
CPT 70471
|
| Hospital Charge Code |
909201820
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$218.60 |
| Max. Negotiated Rate |
$929.05 |
| Rate for Payer: Adventist Health Commercial |
$218.60
|
| Rate for Payer: Cash Price |
$491.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$765.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.20
|
| Rate for Payer: EPIC Health Plan Senior |
$437.20
|
| Rate for Payer: Galaxy Health WC |
$929.05
|
| Rate for Payer: Global Benefits Group Commercial |
$655.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$694.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$644.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.32
|
| Rate for Payer: Multiplan Commercial |
$874.40
|
| Rate for Payer: Networks By Design Commercial |
$710.45
|
| Rate for Payer: Prime Health Services Commercial |
$929.05
|
|
|
HC CT ANGIO HEAD W/WO CONTRAST
|
Facility
|
OP
|
$7,722.00
|
|
|
Service Code
|
CPT 70496
|
| Hospital Charge Code |
909201800
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$225.59 |
| Max. Negotiated Rate |
$6,563.70 |
| Rate for Payer: Adventist Health Commercial |
$1,544.40
|
| Rate for Payer: Adventist Health Commercial |
$857.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,955.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,749.68
|
| Rate for Payer: Blue Shield of California Commercial |
$1,803.98
|
| Rate for Payer: Blue Shield of California Commercial |
$2,733.83
|
| Rate for Payer: Blue Shield of California Commercial |
$3,250.96
|
| Rate for Payer: Blue Shield of California Commercial |
$4,926.64
|
| Rate for Payer: Cash Price |
$3,474.90
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$3,474.90
|
| Rate for Payer: Cash Price |
$1,928.25
|
| Rate for Payer: Cash Price |
$3,474.90
|
| Rate for Payer: Cigna of CA HMO |
$2,742.40
|
| Rate for Payer: Cigna of CA HMO |
$4,942.08
|
| Rate for Payer: Cigna of CA PPO |
$3,170.90
|
| Rate for Payer: Cigna of CA PPO |
$5,714.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$338.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,999.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,405.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.22
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: EPIC Health Plan Senior |
$248.15
|
| Rate for Payer: Galaxy Health WC |
$6,563.70
|
| Rate for Payer: Galaxy Health WC |
$3,642.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,633.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,571.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$369.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$446.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$446.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$225.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,903.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,720.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$505.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,853.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,028.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$284.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.29
|
| Rate for Payer: Multiplan Commercial |
$3,428.00
|
| Rate for Payer: Multiplan Commercial |
$6,177.60
|
| Rate for Payer: Networks By Design Commercial |
$5,019.30
|
| Rate for Payer: Networks By Design Commercial |
$2,785.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,642.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,563.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,633.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,571.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,571.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,633.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,142.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,861.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,861.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,142.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,861.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,142.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,142.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,861.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$225.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$338.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.15
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
| Rate for Payer: Vantage Medical Group Senior |
$225.59
|
|
