|
HC SURGERY LEVEL VI 1ST ADDL 30MIN
|
Facility
|
OP
|
$9,763.00
|
|
| Hospital Charge Code |
900700063
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,343.12 |
| Max. Negotiated Rate |
$8,298.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,403.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,298.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,369.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,369.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,816.80
|
| Rate for Payer: Blue Distinction Transplant |
$5,857.80
|
| 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 |
$4,393.35
|
| Rate for Payer: Cash Price |
$4,393.35
|
| Rate for Payer: Cigna of CA PPO |
$7,224.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,298.55
|
| Rate for Payer: Dignity Health Media |
$8,298.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,298.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,905.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,905.20
|
| Rate for Payer: Galaxy Health WC |
$8,298.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,857.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,322.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,511.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,719.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,343.12
|
| Rate for Payer: Multiplan Commercial |
$7,810.40
|
| Rate for Payer: Networks By Design Commercial |
$6,345.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,298.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,857.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,881.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,881.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,881.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,881.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,298.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,298.55
|
| Rate for Payer: Vantage Medical Group Senior |
$8,298.55
|
|
|
HC SURGERY LEVEL VI 1ST ADDL 30MIN
|
Facility
|
IP
|
$9,763.00
|
|
| Hospital Charge Code |
900700063
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,343.12 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$4,393.35
|
| Rate for Payer: Cash Price |
$4,393.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,905.20
|
| Rate for Payer: Galaxy Health WC |
$8,298.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,857.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,511.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,719.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,343.12
|
| Rate for Payer: Multiplan Commercial |
$7,810.40
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,298.55
|
|
|
HC SURGERY LEVEL VI 1ST HR
|
Facility
|
OP
|
$84,586.00
|
|
| Hospital Charge Code |
900700060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,340.48 |
| Max. Negotiated Rate |
$71,898.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,479.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71,898.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46,522.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$46,522.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50,396.34
|
| Rate for Payer: Blue Distinction Transplant |
$50,751.60
|
| 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 |
$38,063.70
|
| Rate for Payer: Cash Price |
$38,063.70
|
| Rate for Payer: Cigna of CA PPO |
$62,593.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71,898.10
|
| Rate for Payer: Dignity Health Media |
$71,898.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$71,898.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,834.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$33,834.40
|
| Rate for Payer: Galaxy Health WC |
$71,898.10
|
| Rate for Payer: Global Benefits Group Commercial |
$50,751.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$63,439.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56,418.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32,227.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,300.64
|
| Rate for Payer: Multiplan Commercial |
$67,668.80
|
| Rate for Payer: Networks By Design Commercial |
$54,980.90
|
| Rate for Payer: Prime Health Services Commercial |
$71,898.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50,751.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$42,293.00
|
| Rate for Payer: United Healthcare All Other HMO |
$42,293.00
|
| Rate for Payer: United Healthcare HMO Rider |
$42,293.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42,293.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71,898.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71,898.10
|
| Rate for Payer: Vantage Medical Group Senior |
$71,898.10
|
|
|
HC SURGERY LEVEL VI 1ST HR
|
Facility
|
IP
|
$84,586.00
|
|
| Hospital Charge Code |
900700060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$20,300.64 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$38,063.70
|
| Rate for Payer: Cash Price |
$38,063.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$33,834.40
|
| Rate for Payer: Galaxy Health WC |
$71,898.10
|
| Rate for Payer: Global Benefits Group Commercial |
$50,751.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56,418.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32,227.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,300.64
|
| Rate for Payer: Multiplan Commercial |
$67,668.80
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$71,898.10
|
|
|
HC SURGERY LEVEL VI EA SUBS 30 MIN
|
Facility
|
OP
|
$9,763.00
|
|
| Hospital Charge Code |
900700064
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,343.12 |
| Max. Negotiated Rate |
$8,298.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,403.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,298.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,369.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,369.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,816.80
|
| Rate for Payer: Blue Distinction Transplant |
$5,857.80
|
| 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 |
$4,393.35
|
| Rate for Payer: Cash Price |
$4,393.35
|
| Rate for Payer: Cigna of CA PPO |
$7,224.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,298.55
|
| Rate for Payer: Dignity Health Media |
$8,298.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,298.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,905.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,905.20
|
| Rate for Payer: Galaxy Health WC |
$8,298.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,857.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,322.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,511.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,719.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,343.12
|
| Rate for Payer: Multiplan Commercial |
$7,810.40
|
| Rate for Payer: Networks By Design Commercial |
$6,345.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,298.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,857.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,881.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,881.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,881.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,881.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,298.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,298.55
|
| Rate for Payer: Vantage Medical Group Senior |
$8,298.55
|
|
|
HC SURGERY LEVEL VI EA SUBS 30 MIN
|
Facility
|
IP
|
$9,763.00
|
|
| Hospital Charge Code |
900700064
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,343.12 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$4,393.35
|
| Rate for Payer: Cash Price |
$4,393.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,905.20
|
| Rate for Payer: Galaxy Health WC |
$8,298.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,857.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,511.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,719.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,343.12
|
| Rate for Payer: Multiplan Commercial |
$7,810.40
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,298.55
|
|
|
HC SURGICAL COLONOSCOPY
|
Facility
|
OP
|
$2,229.00
|
|
|
Service Code
|
CPT 45399
|
| Hospital Charge Code |
906745399
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$534.96 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,328.04
|
| Rate for Payer: Blue Distinction Transplant |
$1,337.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,003.05
|
| Rate for Payer: Cash Price |
$1,003.05
|
| Rate for Payer: Cigna of CA PPO |
$1,649.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Media |
$1,141.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,894.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,337.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,671.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,872.77
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,872.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,849.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,849.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,486.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$534.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,783.20
|
| Rate for Payer: Networks By Design Commercial |
$1,448.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,894.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,337.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SURGICAL COLONOSCOPY
|
Facility
|
IP
|
$2,229.00
|
|
|
Service Code
|
CPT 45399
|
| Hospital Charge Code |
906745399
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$534.96 |
| Max. Negotiated Rate |
$1,894.65 |
| Rate for Payer: Cash Price |
$1,003.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$891.60
|
| Rate for Payer: Galaxy Health WC |
$1,894.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,337.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,486.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$849.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$534.96
|
| Rate for Payer: Multiplan Commercial |
$1,783.20
|
| Rate for Payer: Networks By Design Commercial |
$1,448.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,894.65
|
|
|
HC SURGICAL PROCEDURE
|
Facility
|
IP
|
$12,782.00
|
|
| Hospital Charge Code |
900501689
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,067.68 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$5,751.90
|
| Rate for Payer: Cash Price |
$5,751.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,112.80
|
| Rate for Payer: Galaxy Health WC |
$10,864.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,669.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,525.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,869.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,067.68
|
| Rate for Payer: Multiplan Commercial |
$10,225.60
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,864.70
|
|
|
HC SURGICAL PROCEDURE
|
Facility
|
OP
|
$12,782.00
|
|
| Hospital Charge Code |
900501689
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,067.68 |
| Max. Negotiated Rate |
$10,864.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,383.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,864.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,030.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,030.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,615.52
|
| Rate for Payer: Blue Distinction Transplant |
$7,669.20
|
| 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 |
$5,751.90
|
| Rate for Payer: Cash Price |
$5,751.90
|
| Rate for Payer: Cigna of CA PPO |
$9,458.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,864.70
|
| Rate for Payer: Dignity Health Media |
$10,864.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,864.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,112.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,112.80
|
| Rate for Payer: Galaxy Health WC |
$10,864.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,669.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,586.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,525.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,869.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,067.68
|
| Rate for Payer: Multiplan Commercial |
$10,225.60
|
| Rate for Payer: Networks By Design Commercial |
$8,308.30
|
| Rate for Payer: Prime Health Services Commercial |
$10,864.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,669.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,391.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,391.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,391.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,864.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,864.70
|
| Rate for Payer: Vantage Medical Group Senior |
$10,864.70
|
|
|
HC SURGICAL SPECIMEN
|
Facility
|
OP
|
$1,646.00
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
909001052
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$1,399.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$689.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.99
|
| Rate for Payer: Blue Distinction Transplant |
$987.60
|
| Rate for Payer: Blue Shield of California Commercial |
$972.79
|
| Rate for Payer: Blue Shield of California EPN |
$771.97
|
| Rate for Payer: Cash Price |
$740.70
|
| Rate for Payer: Cash Price |
$740.70
|
| Rate for Payer: Cigna of CA HMO |
$1,053.44
|
| Rate for Payer: Cigna of CA PPO |
$1,218.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Dignity Health Media |
$689.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$758.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$689.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$689.28
|
| Rate for Payer: Galaxy Health WC |
$1,399.10
|
| Rate for Payer: Global Benefits Group Commercial |
$987.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,234.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,130.42
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,130.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,116.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,116.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$689.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,097.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$689.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$395.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$868.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$923.64
|
| Rate for Payer: Multiplan Commercial |
$1,316.80
|
| Rate for Payer: Networks By Design Commercial |
$1,069.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,399.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$987.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$987.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,088.13
|
| Rate for Payer: United Healthcare All Other HMO |
$1,088.13
|
| Rate for Payer: United Healthcare HMO Rider |
$1,088.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,088.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Vantage Medical Group Senior |
$689.28
|
|
|
HC SURGICAL SPECIMEN
|
Facility
|
IP
|
$1,646.00
|
|
|
Service Code
|
CPT 76098
|
| Hospital Charge Code |
909001052
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$395.04 |
| Max. Negotiated Rate |
$1,399.10 |
| Rate for Payer: Cash Price |
$740.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$658.40
|
| Rate for Payer: Galaxy Health WC |
$1,399.10
|
| Rate for Payer: Global Benefits Group Commercial |
$987.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,097.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$627.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$395.04
|
| Rate for Payer: Multiplan Commercial |
$1,316.80
|
| Rate for Payer: Networks By Design Commercial |
$1,069.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,399.10
|
|
|
HC SUSCEPTIBILITY PANEL YEAST
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900914672
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.87
|
| Rate for Payer: Blue Distinction Transplant |
$46.80
|
| Rate for Payer: Blue Shield of California Commercial |
$50.39
|
| Rate for Payer: Blue Shield of California EPN |
$39.94
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cigna of CA HMO |
$49.92
|
| Rate for Payer: Cigna of CA PPO |
$57.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.98
|
| Rate for Payer: Dignity Health Media |
$8.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.65
|
| Rate for Payer: Galaxy Health WC |
$66.30
|
| Rate for Payer: Global Benefits Group Commercial |
$46.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$58.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$14.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$62.40
|
| Rate for Payer: Networks By Design Commercial |
$50.70
|
| Rate for Payer: Prime Health Services Commercial |
$66.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC SUTURE EYELID, FULL THICKNESS
|
Facility
|
OP
|
$5,613.00
|
|
|
Service Code
|
CPT 67935
|
| Hospital Charge Code |
900501309
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$662.09 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,919.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,367.80
|
| Rate for Payer: Cash Price |
$2,525.85
|
| Rate for Payer: Cash Price |
$2,525.85
|
| Rate for Payer: Cash Price |
$2,525.85
|
| Rate for Payer: Cigna of CA PPO |
$4,153.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Dignity Health Media |
$2,919.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,211.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,919.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,919.67
|
| Rate for Payer: Galaxy Health WC |
$4,771.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,209.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,788.26
|
| Rate for Payer: Heritage Provider Network Transplant |
$4,788.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,919.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,743.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$662.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,919.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,347.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,678.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,912.36
|
| Rate for Payer: Multiplan Commercial |
$4,490.40
|
| Rate for Payer: Networks By Design Commercial |
$3,648.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,771.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,367.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,806.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,806.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,806.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,806.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,919.67
|
|
|
HC SUTURE EYELID, FULL THICKNESS
|
Facility
|
IP
|
$5,613.00
|
|
|
Service Code
|
CPT 67935
|
| Hospital Charge Code |
900501309
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,347.12 |
| Max. Negotiated Rate |
$4,771.05 |
| Rate for Payer: Cash Price |
$2,525.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,245.20
|
| Rate for Payer: Galaxy Health WC |
$4,771.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,743.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,138.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,347.12
|
| Rate for Payer: Multiplan Commercial |
$4,490.40
|
| Rate for Payer: Networks By Design Commercial |
$3,648.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,771.05
|
|
|
HC SUTURE EYELID,PARTIAL THICKNES
|
Facility
|
OP
|
$5,079.00
|
|
|
Service Code
|
CPT 67930
|
| Hospital Charge Code |
900501413
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$463.33 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,919.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,047.40
|
| Rate for Payer: Cash Price |
$2,285.55
|
| Rate for Payer: Cash Price |
$2,285.55
|
| Rate for Payer: Cash Price |
$2,285.55
|
| Rate for Payer: Cigna of CA PPO |
$3,758.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Dignity Health Media |
$2,919.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,211.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,919.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,919.67
|
| Rate for Payer: Galaxy Health WC |
$4,317.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,047.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,809.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,788.26
|
| Rate for Payer: Heritage Provider Network Transplant |
$4,788.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,919.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,387.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$463.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,919.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,218.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,678.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,912.36
|
| Rate for Payer: Multiplan Commercial |
$4,063.20
|
| Rate for Payer: Networks By Design Commercial |
$3,301.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,317.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,047.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,539.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,539.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,539.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,539.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,919.67
|
|
|
HC SUTURE EYELID,PARTIAL THICKNES
|
Facility
|
IP
|
$5,079.00
|
|
|
Service Code
|
CPT 67930
|
| Hospital Charge Code |
900501413
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,218.96 |
| Max. Negotiated Rate |
$4,317.15 |
| Rate for Payer: Cash Price |
$2,285.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,031.60
|
| Rate for Payer: Galaxy Health WC |
$4,317.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,047.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,387.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,935.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,218.96
|
| Rate for Payer: Multiplan Commercial |
$4,063.20
|
| Rate for Payer: Networks By Design Commercial |
$3,301.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,317.15
|
|
|
HC SUTURE HAND/FOOT 1 DIGIT NERVE
|
Facility
|
OP
|
$12,995.00
|
|
|
Service Code
|
CPT 64831
|
| Hospital Charge Code |
900501398
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.52 |
| Max. Negotiated Rate |
$12,491.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,412.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,797.00
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cigna of CA PPO |
$9,616.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Dignity Health Media |
$2,412.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,653.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,256.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,412.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,412.38
|
| Rate for Payer: Galaxy Health WC |
$11,045.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,797.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,746.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,956.30
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,956.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,412.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,667.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,412.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,118.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,039.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,232.59
|
| Rate for Payer: Multiplan Commercial |
$10,396.00
|
| Rate for Payer: Networks By Design Commercial |
$8,446.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,045.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,797.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,497.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,497.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,497.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,497.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: Vantage Medical Group Senior |
$2,412.38
|
|
|
HC SUTURE HAND/FOOT 1 DIGIT NERVE
|
Facility
|
IP
|
$12,995.00
|
|
|
Service Code
|
CPT 64831
|
| Hospital Charge Code |
900501398
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,118.80 |
| Max. Negotiated Rate |
$11,045.75 |
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,198.00
|
| Rate for Payer: Galaxy Health WC |
$11,045.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,797.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,667.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,951.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,118.80
|
| Rate for Payer: Multiplan Commercial |
$10,396.00
|
| Rate for Payer: Networks By Design Commercial |
$8,446.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,045.75
|
|
|
HC SUTURE HAND/FOOT NERVE EA ADDL
|
Facility
|
IP
|
$12,995.00
|
|
|
Service Code
|
CPT 64832
|
| Hospital Charge Code |
900501552
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,118.80 |
| Max. Negotiated Rate |
$11,045.75 |
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,198.00
|
| Rate for Payer: Galaxy Health WC |
$11,045.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,797.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,667.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,951.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,118.80
|
| Rate for Payer: Multiplan Commercial |
$10,396.00
|
| Rate for Payer: Networks By Design Commercial |
$8,446.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,045.75
|
|
|
HC SUTURE HAND/FOOT NERVE EA ADDL
|
Facility
|
OP
|
$12,995.00
|
|
|
Service Code
|
CPT 64832
|
| Hospital Charge Code |
900501552
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$290.74 |
| Max. Negotiated Rate |
$11,045.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,045.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,147.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,147.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,797.00
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cigna of CA PPO |
$9,616.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,045.75
|
| Rate for Payer: Dignity Health Media |
$11,045.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,045.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,198.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,198.00
|
| Rate for Payer: Galaxy Health WC |
$11,045.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,797.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,746.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,667.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$290.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,118.80
|
| Rate for Payer: Multiplan Commercial |
$10,396.00
|
| Rate for Payer: Networks By Design Commercial |
$8,446.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,045.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,797.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,497.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,497.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,497.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,497.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,045.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,045.75
|
| Rate for Payer: Vantage Medical Group Senior |
$11,045.75
|
|
|
HC SWALLOWING STUDY W VIDEO
|
Facility
|
IP
|
$1,223.00
|
|
|
Service Code
|
CPT 74230
|
| Hospital Charge Code |
909001803
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$293.52 |
| Max. Negotiated Rate |
$1,039.55 |
| Rate for Payer: Cash Price |
$550.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$489.20
|
| Rate for Payer: Galaxy Health WC |
$1,039.55
|
| Rate for Payer: Global Benefits Group Commercial |
$733.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$815.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$465.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.52
|
| Rate for Payer: Multiplan Commercial |
$978.40
|
| Rate for Payer: Networks By Design Commercial |
$794.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,039.55
|
|
|
HC SWALLOWING STUDY W VIDEO
|
Facility
|
OP
|
$1,223.00
|
|
|
Service Code
|
CPT 74230
|
| Hospital Charge Code |
909001803
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$98.63 |
| Max. Negotiated Rate |
$1,039.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$416.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$340.90
|
| Rate for Payer: Blue Distinction Transplant |
$733.80
|
| Rate for Payer: Blue Shield of California Commercial |
$722.79
|
| Rate for Payer: Blue Shield of California EPN |
$573.59
|
| Rate for Payer: Cash Price |
$550.35
|
| Rate for Payer: Cash Price |
$550.35
|
| Rate for Payer: Cigna of CA HMO |
$782.72
|
| Rate for Payer: Cigna of CA PPO |
$905.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: Dignity Health Media |
$229.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$229.56
|
| Rate for Payer: Galaxy Health WC |
$1,039.55
|
| Rate for Payer: Global Benefits Group Commercial |
$733.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$917.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$376.48
|
| Rate for Payer: Heritage Provider Network Transplant |
$376.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$371.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$371.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$229.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$815.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$229.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$307.61
|
| Rate for Payer: Multiplan Commercial |
$978.40
|
| Rate for Payer: Networks By Design Commercial |
$794.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,039.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$733.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$733.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$219.73
|
| Rate for Payer: United Healthcare All Other HMO |
$219.73
|
| Rate for Payer: United Healthcare HMO Rider |
$219.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$219.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC SWEAT CHLORIDE, IONTOPHORESIS
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
900910257
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$114.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.92
|
| Rate for Payer: Blue Distinction Transplant |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$20.03
|
| Rate for Payer: Blue Shield of California EPN |
$15.87
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cigna of CA HMO |
$19.84
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.55
|
| Rate for Payer: Dignity Health Media |
$67.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.40
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$67.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$67.70
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$111.03
|
| Rate for Payer: Heritage Provider Network Transplant |
$111.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$109.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$109.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$85.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90.72
|
| Rate for Payer: Multiplan Commercial |
$24.80
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.47
|
| Rate for Payer: Vantage Medical Group Senior |
$67.70
|
|
|
HC SWEAT CHLORIDE MEASUREMENT
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
900910680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$44.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$40.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.59
|
| Rate for Payer: Blue Distinction Transplant |
$11.40
|
| Rate for Payer: Blue Shield of California Commercial |
$12.27
|
| Rate for Payer: Blue Shield of California EPN |
$9.73
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cigna of CA HMO |
$12.16
|
| Rate for Payer: Cigna of CA PPO |
$14.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.50
|
| Rate for Payer: Dignity Health Media |
$5.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.00
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.20
|
| Rate for Payer: Heritage Provider Network Transplant |
$8.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$8.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.70
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.05
|
| Rate for Payer: United Healthcare All Other HMO |
$4.05
|
| Rate for Payer: United Healthcare HMO Rider |
$4.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5.00
|
|
