|
HC EXCISION TONGUE LESION W/O CLOSURE
|
Facility
|
OP
|
$6,548.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
900501147
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$253.95 |
| Max. Negotiated Rate |
$7,035.98 |
| Rate for Payer: Adventist Health Commercial |
$2,684.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$894.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$2,946.60
|
| Rate for Payer: Cash Price |
$2,946.60
|
| Rate for Payer: Cash Price |
$2,946.60
|
| Rate for Payer: Cigna of CA HMO |
$4,190.72
|
| Rate for Payer: Cigna of CA PPO |
$4,845.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,583.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$5,565.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,928.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,157.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$253.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,571.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,372.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$5,238.40
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$4,256.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,565.80
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,928.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,928.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC EXC SKIN LESION 0.6-1.0 CM
|
Facility
|
OP
|
$6,131.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
902890016
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$127.32 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$2,513.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$694.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$2,758.95
|
| Rate for Payer: Cash Price |
$2,758.95
|
| Rate for Payer: Cash Price |
$2,758.95
|
| Rate for Payer: Cigna of CA HMO |
$3,923.84
|
| Rate for Payer: Cigna of CA PPO |
$4,536.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,291.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$5,211.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,678.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,893.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,471.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$4,904.80
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,985.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,211.35
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,678.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,678.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC EXC SKIN LESION 0.6-1.0 CM
|
Facility
|
IP
|
$6,131.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
902890016
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,226.20 |
| Max. Negotiated Rate |
$5,211.35 |
| Rate for Payer: Adventist Health Commercial |
$1,226.20
|
| Rate for Payer: Cash Price |
$2,758.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,291.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,452.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,452.40
|
| Rate for Payer: Galaxy Health WC |
$5,211.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,678.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,893.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,617.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,471.44
|
| Rate for Payer: Multiplan Commercial |
$4,904.80
|
| Rate for Payer: Networks By Design Commercial |
$3,985.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,211.35
|
|
|
HC EXC SKIN LESION 1.1-2.0 CM
|
Facility
|
OP
|
$6,744.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
902890017
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$2,765.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$845.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$3,034.80
|
| Rate for Payer: Cash Price |
$3,034.80
|
| Rate for Payer: Cash Price |
$3,034.80
|
| Rate for Payer: Cigna of CA HMO |
$4,316.16
|
| Rate for Payer: Cigna of CA PPO |
$4,990.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,720.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$5,732.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,046.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,282.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,618.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$5,395.20
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$4,383.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,732.40
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,046.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,046.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC EXC SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$6,744.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
902890017
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,348.80 |
| Max. Negotiated Rate |
$5,732.40 |
| Rate for Payer: Adventist Health Commercial |
$1,348.80
|
| Rate for Payer: Cash Price |
$3,034.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,720.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,697.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,697.60
|
| Rate for Payer: Galaxy Health WC |
$5,732.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,046.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,282.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,978.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,618.56
|
| Rate for Payer: Multiplan Commercial |
$5,395.20
|
| Rate for Payer: Networks By Design Commercial |
$4,383.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,732.40
|
|
|
HC EXCSN EXT THROMBOTC HEMORRHOID
|
Facility
|
IP
|
$7,270.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
900501158
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,454.00 |
| Max. Negotiated Rate |
$6,179.50 |
| Rate for Payer: Adventist Health Commercial |
$1,454.00
|
| Rate for Payer: Cash Price |
$3,271.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,089.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,908.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,908.00
|
| Rate for Payer: Galaxy Health WC |
$6,179.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,362.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,616.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,289.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,744.80
|
| Rate for Payer: Multiplan Commercial |
$5,816.00
|
| Rate for Payer: Networks By Design Commercial |
$4,725.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,179.50
|
|
|
HC EXCSN EXT THROMBOTC HEMORRHOID
|
Facility
|
IP
|
$7,270.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
900501158
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,454.00 |
| Max. Negotiated Rate |
$6,179.50 |
| Rate for Payer: Cash Price |
$3,271.50
|
| Rate for Payer: Adventist Health Commercial |
$1,454.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,089.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,908.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,908.00
|
| Rate for Payer: Galaxy Health WC |
$6,179.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,362.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,616.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,289.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,744.80
|
| Rate for Payer: Multiplan Commercial |
$5,816.00
|
| Rate for Payer: Networks By Design Commercial |
$4,725.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,179.50
|
|
|
HC EXCSN EXT THROMBOTC HEMORRHOID
|
Facility
|
OP
|
$7,270.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
900501158
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.13 |
| Max. Negotiated Rate |
$6,179.50 |
| Rate for Payer: Adventist Health Commercial |
$1,454.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$3,271.50
|
| Rate for Payer: Cash Price |
$3,271.50
|
| Rate for Payer: Cash Price |
$3,271.50
|
| Rate for Payer: Cigna of CA HMO |
$4,652.80
|
| Rate for Payer: Cigna of CA PPO |
$5,379.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,089.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$6,179.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,362.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,616.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$176.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,654.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,744.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$5,816.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$4,725.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,179.50
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,362.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,635.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,635.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,635.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC EXCSN EXT THROMBOTC HEMORRHOID
|
Facility
|
OP
|
$7,270.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
900501158
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$176.13 |
| Max. Negotiated Rate |
$6,179.50 |
| Rate for Payer: Adventist Health Commercial |
$2,980.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$692.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$3,271.50
|
| Rate for Payer: Cash Price |
$3,271.50
|
| Rate for Payer: Cash Price |
$3,271.50
|
| Rate for Payer: Cigna of CA HMO |
$4,652.80
|
| Rate for Payer: Cigna of CA PPO |
$5,379.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,089.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$6,179.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,362.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,616.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$176.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,654.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,744.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,939.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$5,816.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$4,725.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,179.50
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,362.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,362.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC EXCSN,TUMOR, FOOT, S/C TISSUE
|
Facility
|
IP
|
$12,464.00
|
|
|
Service Code
|
CPT 28043
|
| Hospital Charge Code |
902890285
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,492.80 |
| Max. Negotiated Rate |
$10,594.40 |
| Rate for Payer: Adventist Health Commercial |
$2,492.80
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,724.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,985.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,985.60
|
| Rate for Payer: Galaxy Health WC |
$10,594.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,478.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,914.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,353.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,991.36
|
| Rate for Payer: Multiplan Commercial |
$9,971.20
|
| Rate for Payer: Networks By Design Commercial |
$8,101.60
|
| Rate for Payer: Prime Health Services Commercial |
$10,594.40
|
|
|
HC EXCSN,TUMOR, FOOT, S/C TISSUE
|
Facility
|
OP
|
$12,464.00
|
|
|
Service Code
|
CPT 28043
|
| Hospital Charge Code |
902890285
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$440.00 |
| Max. Negotiated Rate |
$10,594.40 |
| Rate for Payer: Adventist Health Commercial |
$5,110.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,735.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Cash Price |
$5,608.80
|
| Rate for Payer: Cigna of CA HMO |
$7,976.96
|
| Rate for Payer: Cigna of CA PPO |
$9,223.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,724.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$10,594.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,478.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,914.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$573.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,991.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$9,971.20
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$8,101.60
|
| Rate for Payer: Prime Health Services Commercial |
$10,594.40
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,478.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,478.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC EXC TST BRNCHSPSM WO EC RCRDG
|
Facility
|
OP
|
$159.00
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
900894619
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$31.80 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$31.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$357.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.03
|
| Rate for Payer: Blue Shield of California Commercial |
$101.44
|
| Rate for Payer: Blue Shield of California Commercial |
$66.94
|
| Rate for Payer: Cash Price |
$71.55
|
| Rate for Payer: Cash Price |
$71.55
|
| Rate for Payer: Cash Price |
$71.55
|
| Rate for Payer: Cigna of CA HMO |
$101.76
|
| Rate for Payer: Cigna of CA PPO |
$117.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$111.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.19
|
| Rate for Payer: EPIC Health Plan Senior |
$83.46
|
| Rate for Payer: Galaxy Health WC |
$135.15
|
| Rate for Payer: Global Benefits Group Commercial |
$95.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$124.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$111.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$100.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$126.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.67
|
| Rate for Payer: Multiplan Commercial |
$127.20
|
| Rate for Payer: Networks By Design Commercial |
$103.35
|
| Rate for Payer: Prime Health Services Commercial |
$135.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$95.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$95.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.46
|
| Rate for Payer: Vantage Medical Group Senior |
$75.87
|
|
|
HC EXC TST BRNCHSPSM WO EC RCRDG
|
Facility
|
IP
|
$159.00
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
900894619
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$31.80 |
| Max. Negotiated Rate |
$135.15 |
| Rate for Payer: Adventist Health Commercial |
$31.80
|
| Rate for Payer: Cash Price |
$71.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$111.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.60
|
| Rate for Payer: EPIC Health Plan Senior |
$63.60
|
| Rate for Payer: Galaxy Health WC |
$135.15
|
| Rate for Payer: Global Benefits Group Commercial |
$95.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$100.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.16
|
| Rate for Payer: Multiplan Commercial |
$127.20
|
| Rate for Payer: Networks By Design Commercial |
$103.35
|
| Rate for Payer: Prime Health Services Commercial |
$135.15
|
|
|
HC EXERCISE TEST BRONCHOSPASM
|
Facility
|
IP
|
$303.00
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
900894620
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$60.60 |
| Max. Negotiated Rate |
$257.55 |
| Rate for Payer: Adventist Health Commercial |
$60.60
|
| Rate for Payer: Cash Price |
$136.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$121.20
|
| Rate for Payer: EPIC Health Plan Senior |
$121.20
|
| Rate for Payer: Galaxy Health WC |
$257.55
|
| Rate for Payer: Global Benefits Group Commercial |
$181.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$178.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.72
|
| Rate for Payer: Multiplan Commercial |
$242.40
|
| Rate for Payer: Networks By Design Commercial |
$196.95
|
| Rate for Payer: Prime Health Services Commercial |
$257.55
|
|
|
HC EXERCISE TEST BRONCHOSPASM
|
Facility
|
OP
|
$303.00
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
900894620
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$60.60 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$60.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$446.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$194.44
|
| Rate for Payer: Blue Shield of California Commercial |
$127.56
|
| Rate for Payer: Blue Shield of California Commercial |
$193.31
|
| Rate for Payer: Cash Price |
$136.35
|
| Rate for Payer: Cash Price |
$136.35
|
| Rate for Payer: Cash Price |
$136.35
|
| Rate for Payer: Cigna of CA HMO |
$193.92
|
| Rate for Payer: Cigna of CA PPO |
$224.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$212.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$257.55
|
| Rate for Payer: Global Benefits Group Commercial |
$181.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$164.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$242.40
|
| Rate for Payer: Networks By Design Commercial |
$196.95
|
| Rate for Payer: Prime Health Services Commercial |
$257.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC EX OF NAIL & MAT PART OR COMP
|
Facility
|
IP
|
$1,486.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
900501017
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$297.20 |
| Max. Negotiated Rate |
$1,263.10 |
| Rate for Payer: Adventist Health Commercial |
$297.20
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,040.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$594.40
|
| Rate for Payer: EPIC Health Plan Senior |
$594.40
|
| Rate for Payer: Galaxy Health WC |
$1,263.10
|
| Rate for Payer: Global Benefits Group Commercial |
$891.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$943.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$876.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.64
|
| Rate for Payer: Multiplan Commercial |
$1,188.80
|
| Rate for Payer: Networks By Design Commercial |
$965.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,263.10
|
|
|
HC EX OF NAIL & MAT PART OR COMP
|
Facility
|
IP
|
$1,486.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
900501017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$297.20 |
| Max. Negotiated Rate |
$1,263.10 |
| Rate for Payer: Adventist Health Commercial |
$297.20
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,040.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$594.40
|
| Rate for Payer: EPIC Health Plan Senior |
$594.40
|
| Rate for Payer: Galaxy Health WC |
$1,263.10
|
| Rate for Payer: Global Benefits Group Commercial |
$891.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$943.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$876.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.64
|
| Rate for Payer: Multiplan Commercial |
$1,188.80
|
| Rate for Payer: Networks By Design Commercial |
$965.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,263.10
|
|
|
HC EX OF NAIL & MAT PART OR COMP
|
Facility
|
OP
|
$1,486.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
900501017
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.41 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$297.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cigna of CA HMO |
$951.04
|
| Rate for Payer: Cigna of CA PPO |
$1,099.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,040.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,263.10
|
| Rate for Payer: Global Benefits Group Commercial |
$891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$943.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,188.80
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$965.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,263.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$891.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$743.00
|
| Rate for Payer: United Healthcare All Other HMO |
$743.00
|
| Rate for Payer: United Healthcare HMO Rider |
$743.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$743.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC EX OF NAIL & MAT PART OR COMP
|
Facility
|
OP
|
$1,486.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
900501017
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$281.41 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cigna of CA HMO |
$951.04
|
| Rate for Payer: Cigna of CA PPO |
$1,099.64
|
| Rate for Payer: Adventist Health Commercial |
$609.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,090.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,040.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,263.10
|
| Rate for Payer: Global Benefits Group Commercial |
$891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$943.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,188.80
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$965.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,263.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$891.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$891.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC EX OF NAIL & MAT PART OR COMP
|
Facility
|
OP
|
$1,486.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
900501017
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$248.82 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$297.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,090.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Cigna of CA HMO |
$951.04
|
| Rate for Payer: Cigna of CA PPO |
$1,099.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,040.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,263.10
|
| Rate for Payer: Global Benefits Group Commercial |
$891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$248.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$943.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,188.80
|
| Rate for Payer: Networks By Design Commercial |
$965.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,263.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$891.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$891.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$743.00
|
| Rate for Payer: United Healthcare All Other HMO |
$743.00
|
| Rate for Payer: United Healthcare HMO Rider |
$743.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$743.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC EX OF NAIL & MAT PART OR COMP
|
Facility
|
IP
|
$1,486.00
|
|
|
Service Code
|
CPT 11750
|
| Hospital Charge Code |
900501017
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$297.20 |
| Max. Negotiated Rate |
$1,263.10 |
| Rate for Payer: Adventist Health Commercial |
$297.20
|
| Rate for Payer: Cash Price |
$668.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,040.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$594.40
|
| Rate for Payer: EPIC Health Plan Senior |
$594.40
|
| Rate for Payer: Galaxy Health WC |
$1,263.10
|
| Rate for Payer: Global Benefits Group Commercial |
$891.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$943.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$876.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.64
|
| Rate for Payer: Multiplan Commercial |
$1,188.80
|
| Rate for Payer: Networks By Design Commercial |
$965.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,263.10
|
|
|
HC EXPIRED CARBON DIOXIDE DETERM
|
Facility
|
IP
|
$493.00
|
|
|
Service Code
|
CPT 94770
|
| Hospital Charge Code |
900800104
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$98.60 |
| Max. Negotiated Rate |
$419.05 |
| Rate for Payer: Adventist Health Commercial |
$98.60
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$345.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$197.20
|
| Rate for Payer: EPIC Health Plan Senior |
$197.20
|
| Rate for Payer: Galaxy Health WC |
$419.05
|
| Rate for Payer: Global Benefits Group Commercial |
$295.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$313.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$290.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.32
|
| Rate for Payer: Multiplan Commercial |
$394.40
|
| Rate for Payer: Networks By Design Commercial |
$320.45
|
| Rate for Payer: Prime Health Services Commercial |
$419.05
|
|
|
HC EXPIRED CARBON DIOXIDE DETERM
|
Facility
|
OP
|
$493.00
|
|
|
Service Code
|
CPT 94770
|
| Hospital Charge Code |
900800104
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$98.60 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$98.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$323.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$419.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$271.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$369.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$316.36
|
| Rate for Payer: Blue Shield of California Commercial |
$314.53
|
| Rate for Payer: Blue Shield of California Commercial |
$207.55
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cash Price |
$221.85
|
| Rate for Payer: Cigna of CA HMO |
$315.52
|
| Rate for Payer: Cigna of CA PPO |
$364.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$419.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$419.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$419.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$345.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$197.20
|
| Rate for Payer: EPIC Health Plan Senior |
$197.20
|
| Rate for Payer: Galaxy Health WC |
$419.05
|
| Rate for Payer: Global Benefits Group Commercial |
$295.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$313.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$178.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$290.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$345.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$345.10
|
| Rate for Payer: Multiplan Commercial |
$394.40
|
| Rate for Payer: Networks By Design Commercial |
$320.45
|
| Rate for Payer: Prime Health Services Commercial |
$419.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$295.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$295.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$419.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$419.05
|
| Rate for Payer: Vantage Medical Group Senior |
$419.05
|
|
|
HC EXPIRED CO2 DETERM
|
Facility
|
OP
|
$341.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900800910
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$68.20 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$68.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$223.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.82
|
| Rate for Payer: Blue Shield of California Commercial |
$143.56
|
| Rate for Payer: Blue Shield of California Commercial |
$217.56
|
| Rate for Payer: Cash Price |
$153.45
|
| Rate for Payer: Cash Price |
$153.45
|
| Rate for Payer: Cash Price |
$153.45
|
| Rate for Payer: Cigna of CA HMO |
$218.24
|
| Rate for Payer: Cigna of CA PPO |
$252.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$238.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$289.85
|
| Rate for Payer: Global Benefits Group Commercial |
$204.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$216.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$272.80
|
| Rate for Payer: Networks By Design Commercial |
$221.65
|
| Rate for Payer: Prime Health Services Commercial |
$289.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$204.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$204.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC EXPIRED CO2 DETERM
|
Facility
|
IP
|
$341.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900800910
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$68.20 |
| Max. Negotiated Rate |
$289.85 |
| Rate for Payer: Adventist Health Commercial |
$68.20
|
| Rate for Payer: Cash Price |
$153.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$238.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.40
|
| Rate for Payer: EPIC Health Plan Senior |
$136.40
|
| Rate for Payer: Galaxy Health WC |
$289.85
|
| Rate for Payer: Global Benefits Group Commercial |
$204.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$216.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$201.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.84
|
| Rate for Payer: Multiplan Commercial |
$272.80
|
| Rate for Payer: Networks By Design Commercial |
$221.65
|
| Rate for Payer: Prime Health Services Commercial |
$289.85
|
|
