|
HC NUTR THER-RE EVAL 15 MIN
|
Facility
OP
|
$213.00
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
902000201
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$224.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$117.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.91
|
| Rate for Payer: BCBS Transplant Transplant |
$127.80
|
| Rate for Payer: Blue Shield of California Commercial |
$156.98
|
| Rate for Payer: Blue Shield of California EPN |
$124.39
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Media |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$159.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
|
HC NUTR THER-RE EVAL 15 MIN
|
Facility
OP
|
$213.00
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
902000201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$224.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$224.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$117.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.91
|
| Rate for Payer: BCBS Transplant Transplant |
$127.80
|
| Rate for Payer: Blue Shield of California Commercial |
$156.98
|
| Rate for Payer: Blue Shield of California EPN |
$124.39
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Media |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$159.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$106.50
|
| Rate for Payer: United Healthcare All Other HMO |
$106.50
|
| Rate for Payer: United Healthcare HMO Rider |
$106.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
|
HC NUTR THER-RE EVAL 30 MN MCAL
|
Facility
IP
|
$132.00
|
|
| Hospital Charge Code |
902000207
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$112.20 |
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
|
|
HC NUTR THER-RE EVAL 30 MN MCAL
|
Facility
OP
|
$132.00
|
|
| Hospital Charge Code |
902000207
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$785.00 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$86.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$72.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$72.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.65
|
| Rate for Payer: BCBS Transplant Transplant |
$79.20
|
| Rate for Payer: Blue Shield of California Commercial |
$97.28
|
| Rate for Payer: Blue Shield of California EPN |
$77.09
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cigna of CA HMO |
$84.48
|
| Rate for Payer: Cigna of CA PPO |
$97.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.20
|
| Rate for Payer: Dignity Health Media |
$112.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$112.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$99.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.68
|
| Rate for Payer: Multiplan Commercial |
$105.60
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$79.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.00
|
| Rate for Payer: United Healthcare All Other HMO |
$785.00
|
| Rate for Payer: United Healthcare HMO Rider |
$593.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: Vantage Medical Group Senior |
$112.20
|
|
|
HC O2 UPTAKE REST EXERCISE
|
Facility
OP
|
$542.00
|
|
|
Service Code
|
CPT 94680
|
| Hospital Charge Code |
900801032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$77.90 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$317.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$322.92
|
| Rate for Payer: BCBS Transplant Transplant |
$325.20
|
| Rate for Payer: Blue Shield of California Commercial |
$320.32
|
| Rate for Payer: Blue Shield of California EPN |
$254.20
|
| Rate for Payer: Cash Price |
$243.90
|
| Rate for Payer: Cash Price |
$243.90
|
| Rate for Payer: Cash Price |
$243.90
|
| Rate for Payer: Cigna of CA HMO |
$346.88
|
| Rate for Payer: Cigna of CA PPO |
$401.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$460.70
|
| Rate for Payer: Global Benefits Group Commercial |
$325.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$406.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$320.08
|
| Rate for Payer: IEHP Medi-Cal |
$316.18
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$316.18
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$361.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$433.60
|
| Rate for Payer: Networks By Design Commercial |
$352.30
|
| Rate for Payer: Prime Health Services Commercial |
$460.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$325.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$325.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$325.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC O2 UPTAKE REST EXERCISE
|
Facility
IP
|
$542.00
|
|
|
Service Code
|
CPT 94680
|
| Hospital Charge Code |
900801032
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$130.08 |
| Max. Negotiated Rate |
$460.70 |
| Rate for Payer: Cash Price |
$243.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$216.80
|
| Rate for Payer: Galaxy Health WC |
$460.70
|
| Rate for Payer: Global Benefits Group Commercial |
$325.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$361.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.08
|
| Rate for Payer: Multiplan Commercial |
$433.60
|
| Rate for Payer: Networks By Design Commercial |
$352.30
|
| Rate for Payer: Prime Health Services Commercial |
$460.70
|
|
|
HC OB ULTRASOUND RPT/FOLLOW-UP ADDL FETUS
|
Facility
IP
|
$1,832.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
906601320
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$439.68 |
| Max. Negotiated Rate |
$1,557.20 |
| Rate for Payer: Cash Price |
$824.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.80
|
| Rate for Payer: Galaxy Health WC |
$1,557.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,099.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,221.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$697.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.68
|
| Rate for Payer: Multiplan Commercial |
$1,465.60
|
| Rate for Payer: Networks By Design Commercial |
$1,190.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,557.20
|
|
|
HC OB ULTRASOUND RPT/FOLLOW-UP ADDL FETUS
|
Facility
OP
|
$1,832.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
906601320
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$1,557.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$395.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,091.51
|
| Rate for Payer: BCBS Transplant Transplant |
$1,099.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,082.71
|
| Rate for Payer: Blue Shield of California EPN |
$859.21
|
| Rate for Payer: Cash Price |
$824.40
|
| Rate for Payer: Cash Price |
$824.40
|
| Rate for Payer: Cigna of CA HMO |
$1,172.48
|
| Rate for Payer: Cigna of CA PPO |
$1,355.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,557.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,099.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,374.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,221.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$196.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,465.60
|
| Rate for Payer: Networks By Design Commercial |
$1,190.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,557.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,099.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,099.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,099.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC OB ULTRASOUND RPT/FOLLOW-UP SINGLE FETUS
|
Facility
IP
|
$1,832.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
906601311
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$439.68 |
| Max. Negotiated Rate |
$1,557.20 |
| Rate for Payer: Cash Price |
$824.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.80
|
| Rate for Payer: Galaxy Health WC |
$1,557.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,099.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,221.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$697.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.68
|
| Rate for Payer: Multiplan Commercial |
$1,465.60
|
| Rate for Payer: Networks By Design Commercial |
$1,190.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,557.20
|
|
|
HC OB ULTRASOUND RPT/FOLLOW-UP SINGLE FETUS
|
Facility
OP
|
$1,832.00
|
|
|
Service Code
|
CPT 76816
|
| Hospital Charge Code |
906601311
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$1,557.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$395.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,091.51
|
| Rate for Payer: BCBS Transplant Transplant |
$1,099.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,082.71
|
| Rate for Payer: Blue Shield of California EPN |
$859.21
|
| Rate for Payer: Cash Price |
$824.40
|
| Rate for Payer: Cash Price |
$824.40
|
| Rate for Payer: Cigna of CA HMO |
$1,172.48
|
| Rate for Payer: Cigna of CA PPO |
$1,355.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,557.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,099.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,374.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,221.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$196.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,465.60
|
| Rate for Payer: Networks By Design Commercial |
$1,190.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,557.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,099.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,099.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,099.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC OB US AFI LMTD 1 OR MORE FETUS
|
Facility
OP
|
$1,502.00
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
910400110
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$1,276.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$382.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$894.89
|
| Rate for Payer: BCBS Transplant Transplant |
$901.20
|
| Rate for Payer: Blue Shield of California Commercial |
$887.68
|
| Rate for Payer: Blue Shield of California EPN |
$704.44
|
| Rate for Payer: Cash Price |
$675.90
|
| Rate for Payer: Cash Price |
$675.90
|
| Rate for Payer: Cigna of CA HMO |
$961.28
|
| Rate for Payer: Cigna of CA PPO |
$1,111.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,276.70
|
| Rate for Payer: Global Benefits Group Commercial |
$901.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,126.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: IEHP Medi-Cal |
$222.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$222.52
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,001.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$360.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,201.60
|
| Rate for Payer: Networks By Design Commercial |
$976.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,276.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$901.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$901.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$901.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC OB US AFI LMTD 1 OR MORE FETUS
|
Facility
IP
|
$1,502.00
|
|
|
Service Code
|
CPT 76815
|
| Hospital Charge Code |
910400110
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$360.48 |
| Max. Negotiated Rate |
$1,276.70 |
| Rate for Payer: Cash Price |
$675.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$600.80
|
| Rate for Payer: Galaxy Health WC |
$1,276.70
|
| Rate for Payer: Global Benefits Group Commercial |
$901.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,001.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$572.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$360.48
|
| Rate for Payer: Multiplan Commercial |
$1,201.60
|
| Rate for Payer: Networks By Design Commercial |
$976.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,276.70
|
|
|
HC OCCLUSIVE DEVICE IN VEIN ART
|
Facility
OP
|
$1,074.00
|
|
|
Service Code
|
CPT G0269
|
| Hospital Charge Code |
906811384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.76 |
| Max. Negotiated Rate |
$18,738.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,738.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$912.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$590.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$590.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$644.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: Cigna of CA PPO |
$794.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$912.90
|
| Rate for Payer: Dignity Health Media |
$912.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$912.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$429.60
|
| Rate for Payer: Galaxy Health WC |
$912.90
|
| Rate for Payer: Global Benefits Group Commercial |
$644.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$805.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$716.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$409.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.76
|
| Rate for Payer: Multiplan Commercial |
$859.20
|
| Rate for Payer: Networks By Design Commercial |
$698.10
|
| Rate for Payer: Prime Health Services Commercial |
$912.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$644.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$644.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$912.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$912.90
|
| Rate for Payer: Vantage Medical Group Senior |
$912.90
|
|
|
HC OCCLUSIVE DEVICE IN VEIN ART
|
Facility
IP
|
$1,074.00
|
|
|
Service Code
|
CPT G0269
|
| Hospital Charge Code |
906811384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.76 |
| Max. Negotiated Rate |
$912.90 |
| Rate for Payer: Cash Price |
$483.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.60
|
| Rate for Payer: Galaxy Health WC |
$912.90
|
| Rate for Payer: Global Benefits Group Commercial |
$644.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$716.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$409.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.76
|
| Rate for Payer: Multiplan Commercial |
$859.20
|
| Rate for Payer: Networks By Design Commercial |
$698.10
|
| Rate for Payer: Prime Health Services Commercial |
$912.90
|
|
|
HC OCCULT BLOOD GASTRIC
|
Facility
OP
|
$7.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900912329
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$28.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.99
|
| Rate for Payer: BCBS Transplant Transplant |
$4.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4.52
|
| Rate for Payer: Blue Shield of California EPN |
$3.58
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cash Price |
$3.15
|
| Rate for Payer: Cigna of CA HMO |
$4.48
|
| Rate for Payer: Cigna of CA PPO |
$5.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.98
|
| Rate for Payer: Dignity Health Media |
$5.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.32
|
| Rate for Payer: Galaxy Health WC |
$5.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.72
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.72
|
| Rate for Payer: IEHP Medi-Cal |
$8.62
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$8.62
|
| Rate for Payer: IEHP Medicare Advantage |
$5.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.13
|
| Rate for Payer: Multiplan Commercial |
$5.60
|
| Rate for Payer: Networks By Design Commercial |
$4.55
|
| Rate for Payer: Prime Health Services Commercial |
$5.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.31
|
| Rate for Payer: United Healthcare All Other HMO |
$4.31
|
| Rate for Payer: United Healthcare HMO Rider |
$4.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5.32
|
|
|
HC OCCULT BLOOD OTHR SOURCE
|
Facility
OP
|
$9.00
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
900911536
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$28.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.99
|
| Rate for Payer: BCBS Transplant Transplant |
$5.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5.81
|
| Rate for Payer: Blue Shield of California EPN |
$4.61
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cash Price |
$4.05
|
| Rate for Payer: Cigna of CA HMO |
$5.76
|
| Rate for Payer: Cigna of CA PPO |
$6.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.98
|
| Rate for Payer: Dignity Health Media |
$5.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.18
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.32
|
| Rate for Payer: Galaxy Health WC |
$7.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.72
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.72
|
| Rate for Payer: IEHP Medi-Cal |
$8.62
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$8.62
|
| Rate for Payer: IEHP Medicare Advantage |
$5.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.13
|
| Rate for Payer: Multiplan Commercial |
$7.20
|
| Rate for Payer: Networks By Design Commercial |
$5.85
|
| Rate for Payer: Prime Health Services Commercial |
$7.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.31
|
| Rate for Payer: United Healthcare All Other HMO |
$4.31
|
| Rate for Payer: United Healthcare HMO Rider |
$4.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.85
|
| Rate for Payer: Vantage Medical Group Senior |
$5.32
|
|
|
HC OPEN FX DISTAL TIBIA/FIBULA
|
Facility
OP
|
$10,534.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
900501606
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$14,659.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,320.40
|
| Rate for Payer: Cash Price |
$4,740.30
|
| Rate for Payer: Cash Price |
$4,740.30
|
| Rate for Payer: Cash Price |
$4,740.30
|
| Rate for Payer: Cigna of CA PPO |
$7,795.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$8,953.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,320.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,900.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,026.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,528.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$8,427.20
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$6,847.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,953.90
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,320.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,320.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,267.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,267.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,267.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,267.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC OPEN FX DISTAL TIBIA/FIBULA
|
Facility
IP
|
$10,534.00
|
|
|
Service Code
|
CPT 27814
|
| Hospital Charge Code |
900501606
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,528.16 |
| Max. Negotiated Rate |
$8,953.90 |
| Rate for Payer: Cash Price |
$4,740.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,213.60
|
| Rate for Payer: Galaxy Health WC |
$8,953.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,320.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,026.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,013.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,528.16
|
| Rate for Payer: Multiplan Commercial |
$8,427.20
|
| Rate for Payer: Networks By Design Commercial |
$6,847.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,953.90
|
|
|
HC OPEN TREAT ELBOW DISLOCATION
|
Facility
IP
|
$26,062.00
|
|
|
Service Code
|
CPT 24615
|
| Hospital Charge Code |
900524615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6,254.88 |
| Max. Negotiated Rate |
$22,152.70 |
| Rate for Payer: Cash Price |
$11,727.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,424.80
|
| Rate for Payer: Galaxy Health WC |
$22,152.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,637.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,383.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,929.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,254.88
|
| Rate for Payer: Multiplan Commercial |
$20,849.60
|
| Rate for Payer: Networks By Design Commercial |
$16,940.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,152.70
|
|
|
HC OPEN TREAT ELBOW DISLOCATION
|
Facility
OP
|
$26,062.00
|
|
|
Service Code
|
CPT 24615
|
| Hospital Charge Code |
900524615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$22,152.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: BCBS Transplant Transplant |
$15,637.20
|
| Rate for Payer: Cash Price |
$11,727.90
|
| Rate for Payer: Cash Price |
$11,727.90
|
| Rate for Payer: Cash Price |
$11,727.90
|
| Rate for Payer: Cigna of CA PPO |
$19,285.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$22,152.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,637.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19,546.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,383.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,254.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$20,849.60
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$16,940.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,152.70
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15,637.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,637.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,031.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13,031.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,031.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,031.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC OPEN TREAT FINGER FX, EA
|
Facility
IP
|
$17,489.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
900501422
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,197.36 |
| Max. Negotiated Rate |
$14,865.65 |
| Rate for Payer: Cash Price |
$7,870.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,995.60
|
| Rate for Payer: Galaxy Health WC |
$14,865.65
|
| Rate for Payer: Global Benefits Group Commercial |
$10,493.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,665.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,663.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,197.36
|
| Rate for Payer: Multiplan Commercial |
$13,991.20
|
| Rate for Payer: Networks By Design Commercial |
$11,367.85
|
| Rate for Payer: Prime Health Services Commercial |
$14,865.65
|
|
|
HC OPEN TREAT FINGER FX, EA
|
Facility
OP
|
$17,489.00
|
|
|
Service Code
|
CPT 26735
|
| Hospital Charge Code |
900501422
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$14,865.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: BCBS Transplant Transplant |
$10,493.40
|
| Rate for Payer: Cash Price |
$7,870.05
|
| Rate for Payer: Cash Price |
$7,870.05
|
| Rate for Payer: Cash Price |
$7,870.05
|
| Rate for Payer: Cigna of CA PPO |
$12,941.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$14,865.65
|
| Rate for Payer: Global Benefits Group Commercial |
$10,493.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,116.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,665.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,197.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$13,991.20
|
| Rate for Payer: Networks By Design Commercial |
$11,367.85
|
| Rate for Payer: Prime Health Services Commercial |
$14,865.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10,493.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,493.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,744.50
|
| Rate for Payer: United Healthcare All Other HMO |
$8,744.50
|
| Rate for Payer: United Healthcare HMO Rider |
$8,744.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,744.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC OPEN TREAT FINGER/THUMB FX EA
|
Facility
OP
|
$16,070.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
900501389
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$936.00 |
| Max. Negotiated Rate |
$13,659.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: BCBS Transplant Transplant |
$9,642.00
|
| Rate for Payer: Cash Price |
$7,231.50
|
| Rate for Payer: Cash Price |
$7,231.50
|
| Rate for Payer: Cash Price |
$7,231.50
|
| Rate for Payer: Cigna of CA PPO |
$11,891.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$13,659.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,642.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12,052.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,856.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$12,856.00
|
| Rate for Payer: Networks By Design Commercial |
$10,445.50
|
| Rate for Payer: Prime Health Services Commercial |
$13,659.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9,642.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,642.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,035.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,035.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,035.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,035.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC OPEN TREAT FINGER/THUMB FX EA
|
Facility
IP
|
$16,070.00
|
|
|
Service Code
|
CPT 26765
|
| Hospital Charge Code |
900501389
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,856.80 |
| Max. Negotiated Rate |
$13,659.50 |
| Rate for Payer: Cash Price |
$7,231.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,428.00
|
| Rate for Payer: Galaxy Health WC |
$13,659.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,642.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,718.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,122.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,856.80
|
| Rate for Payer: Multiplan Commercial |
$12,856.00
|
| Rate for Payer: Networks By Design Commercial |
$10,445.50
|
| Rate for Payer: Prime Health Services Commercial |
$13,659.50
|
|
|
HC OPEN TREAT/FINGER/TOE FRACTURE
|
Facility
IP
|
$14,727.00
|
|
|
Service Code
|
CPT 26746
|
| Hospital Charge Code |
900501351
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,534.48 |
| Max. Negotiated Rate |
$12,517.95 |
| Rate for Payer: Cash Price |
$6,627.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.80
|
| Rate for Payer: Galaxy Health WC |
$12,517.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,836.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,822.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,610.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,534.48
|
| Rate for Payer: Multiplan Commercial |
$11,781.60
|
| Rate for Payer: Networks By Design Commercial |
$9,572.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,517.95
|
|
