|
HC FISH PROBE CYTOGEN 3-5 CELLS
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
CPT 88272
|
| Hospital Charge Code |
900918008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$1,841.18 |
| Rate for Payer: Adventist Health Commercial |
$26.20
|
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$222.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,841.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,841.18
|
| Rate for Payer: Blue Shield of California Commercial |
$126.85
|
| Rate for Payer: Blue Shield of California Commercial |
$60.39
|
| Rate for Payer: Blue Shield of California Commercial |
$83.90
|
| Rate for Payer: Blue Shield of California Commercial |
$91.31
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$58.95
|
| Rate for Payer: Cash Price |
$58.95
|
| Rate for Payer: Cigna of CA HMO |
$116.48
|
| Rate for Payer: Cigna of CA HMO |
$83.84
|
| Rate for Payer: Cigna of CA PPO |
$96.94
|
| Rate for Payer: Cigna of CA PPO |
$134.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.16
|
| Rate for Payer: EPIC Health Plan Senior |
$44.77
|
| Rate for Payer: EPIC Health Plan Senior |
$44.77
|
| Rate for Payer: Galaxy Health WC |
$111.35
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$78.60
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54.54
|
| Rate for Payer: Multiplan Commercial |
$145.60
|
| Rate for Payer: Multiplan Commercial |
$104.80
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Networks By Design Commercial |
$85.15
|
| Rate for Payer: Prime Health Services Commercial |
$111.35
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$109.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$109.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.97
|
| Rate for Payer: United Healthcare All Other HMO |
$32.97
|
| Rate for Payer: United Healthcare All Other HMO |
$32.97
|
| Rate for Payer: United Healthcare HMO Rider |
$32.97
|
| Rate for Payer: United Healthcare HMO Rider |
$32.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$40.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$40.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Vantage Medical Group Senior |
$40.70
|
| Rate for Payer: Vantage Medical Group Senior |
$40.70
|
|
|
HC FISH PROBE CYTOGEN 3-5 CELLS
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
CPT 88272
|
| Hospital Charge Code |
900918008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$154.70 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.80
|
| Rate for Payer: EPIC Health Plan Senior |
$72.80
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$107.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.68
|
| Rate for Payer: Multiplan Commercial |
$145.60
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
|
|
HC FISH PROBE CYTOGEN EA
|
Facility
|
IP
|
$385.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900918007
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$327.25 |
| Rate for Payer: Adventist Health Commercial |
$77.00
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Senior |
$154.00
|
| Rate for Payer: Galaxy Health WC |
$327.25
|
| Rate for Payer: Global Benefits Group Commercial |
$231.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.40
|
| Rate for Payer: Multiplan Commercial |
$308.00
|
| Rate for Payer: Networks By Design Commercial |
$250.25
|
| Rate for Payer: Prime Health Services Commercial |
$327.25
|
|
|
HC FISH PROBE CYTOGEN EA
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900918007
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$1,751.12 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
| Rate for Payer: Adventist Health Commercial |
$72.40
|
| Rate for Payer: Adventist Health Commercial |
$77.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$178.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$178.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,751.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,751.12
|
| Rate for Payer: Blue Shield of California Commercial |
$177.49
|
| Rate for Payer: Blue Shield of California Commercial |
$166.88
|
| Rate for Payer: Blue Shield of California Commercial |
$268.35
|
| Rate for Payer: Blue Shield of California Commercial |
$252.31
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$162.90
|
| Rate for Payer: Cash Price |
$162.90
|
| Rate for Payer: Cigna of CA HMO |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$231.68
|
| Rate for Payer: Cigna of CA PPO |
$267.88
|
| Rate for Payer: Cigna of CA PPO |
$284.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$253.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.34
|
| Rate for Payer: EPIC Health Plan Senior |
$23.56
|
| Rate for Payer: EPIC Health Plan Senior |
$23.56
|
| Rate for Payer: Galaxy Health WC |
$307.70
|
| Rate for Payer: Galaxy Health WC |
$327.25
|
| Rate for Payer: Global Benefits Group Commercial |
$217.20
|
| Rate for Payer: Global Benefits Group Commercial |
$231.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$28.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$229.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$308.00
|
| Rate for Payer: Multiplan Commercial |
$289.60
|
| Rate for Payer: Networks By Design Commercial |
$250.25
|
| Rate for Payer: Networks By Design Commercial |
$235.30
|
| Rate for Payer: Prime Health Services Commercial |
$307.70
|
| Rate for Payer: Prime Health Services Commercial |
$327.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$217.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$217.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
|
|
HC FISTULA/SINUS TRACT INJ
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
909000108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.60 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$300.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$194.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$264.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Cigna of CA HMO |
$225.92
|
| Rate for Payer: Cigna of CA PPO |
$261.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$300.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$300.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$300.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$247.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.20
|
| Rate for Payer: EPIC Health Plan Senior |
$141.20
|
| Rate for Payer: Galaxy Health WC |
$300.05
|
| Rate for Payer: Global Benefits Group Commercial |
$211.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$375.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$224.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$424.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$208.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$247.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$247.10
|
| Rate for Payer: Multiplan Commercial |
$282.40
|
| Rate for Payer: Networks By Design Commercial |
$229.45
|
| Rate for Payer: Prime Health Services Commercial |
$300.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$211.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$176.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$300.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$300.05
|
| Rate for Payer: Vantage Medical Group Senior |
$300.05
|
|
|
HC FISTULA/SINUS TRACT INJ
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
909000108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.60 |
| Max. Negotiated Rate |
$300.05 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$247.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.20
|
| Rate for Payer: EPIC Health Plan Senior |
$141.20
|
| Rate for Payer: Galaxy Health WC |
$300.05
|
| Rate for Payer: Global Benefits Group Commercial |
$211.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$224.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$208.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.72
|
| Rate for Payer: Multiplan Commercial |
$282.40
|
| Rate for Payer: Networks By Design Commercial |
$229.45
|
| Rate for Payer: Prime Health Services Commercial |
$300.05
|
|
|
HC FIT & INSERT PESSARY SUPPORT D
|
Facility
|
OP
|
$552.00
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
900501760
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$110.40 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$110.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Cigna of CA HMO |
$353.28
|
| Rate for Payer: Cigna of CA PPO |
$408.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$386.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.05
|
| Rate for Payer: EPIC Health Plan Senior |
$286.03
|
| Rate for Payer: Galaxy Health WC |
$469.20
|
| Rate for Payer: Global Benefits Group Commercial |
$331.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$426.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$350.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$129.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$327.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$441.60
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$358.80
|
| Rate for Payer: Prime Health Services Commercial |
$469.20
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$331.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$276.00
|
| Rate for Payer: United Healthcare All Other HMO |
$276.00
|
| Rate for Payer: United Healthcare HMO Rider |
$276.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$276.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$260.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC FIT & INSERT PESSARY SUPPORT D
|
Facility
|
IP
|
$552.00
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
900501760
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$110.40 |
| Max. Negotiated Rate |
$469.20 |
| Rate for Payer: Adventist Health Commercial |
$110.40
|
| Rate for Payer: Cash Price |
$248.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$386.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.80
|
| Rate for Payer: EPIC Health Plan Senior |
$220.80
|
| Rate for Payer: Galaxy Health WC |
$469.20
|
| Rate for Payer: Global Benefits Group Commercial |
$331.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$350.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$325.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.48
|
| Rate for Payer: Multiplan Commercial |
$441.60
|
| Rate for Payer: Networks By Design Commercial |
$358.80
|
| Rate for Payer: Prime Health Services Commercial |
$469.20
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
IP
|
$12,216.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,443.20 |
| Max. Negotiated Rate |
$10,383.60 |
| Rate for Payer: Adventist Health Commercial |
$2,443.20
|
| Rate for Payer: Cash Price |
$5,497.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,551.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,886.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,886.40
|
| Rate for Payer: Galaxy Health WC |
$10,383.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,329.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,757.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,207.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,931.84
|
| Rate for Payer: Multiplan Commercial |
$9,772.80
|
| Rate for Payer: Networks By Design Commercial |
$7,940.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,383.60
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
OP
|
$12,216.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$973.00 |
| Max. Negotiated Rate |
$10,383.60 |
| Rate for Payer: Adventist Health Commercial |
$2,443.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$5,497.20
|
| Rate for Payer: Cash Price |
$5,497.20
|
| Rate for Payer: Cash Price |
$5,497.20
|
| Rate for Payer: Cigna of CA HMO |
$7,818.24
|
| Rate for Payer: Cigna of CA PPO |
$9,039.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,551.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$10,383.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,329.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,757.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$988.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,931.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$9,772.80
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$7,940.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,383.60
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,329.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,108.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,108.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,108.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,108.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
OP
|
$12,216.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$440.00 |
| Max. Negotiated Rate |
$10,383.60 |
| Rate for Payer: Adventist Health Commercial |
$5,008.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,257.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$5,497.20
|
| Rate for Payer: Cash Price |
$5,497.20
|
| Rate for Payer: Cash Price |
$5,497.20
|
| Rate for Payer: Cigna of CA HMO |
$7,818.24
|
| Rate for Payer: Cigna of CA PPO |
$9,039.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,551.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$10,383.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,329.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,757.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$988.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,931.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$9,772.80
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$7,940.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,383.60
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,329.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,329.60
|
| 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 |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
IP
|
$12,216.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,443.20 |
| Max. Negotiated Rate |
$10,383.60 |
| Rate for Payer: EPIC Health Plan Commercial |
$4,886.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,886.40
|
| Rate for Payer: Galaxy Health WC |
$10,383.60
|
| Rate for Payer: Adventist Health Commercial |
$2,443.20
|
| Rate for Payer: Cash Price |
$5,497.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,551.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7,329.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,757.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,207.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,931.84
|
| Rate for Payer: Multiplan Commercial |
$9,772.80
|
| Rate for Payer: Networks By Design Commercial |
$7,940.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,383.60
|
|
|
HC FK 506 (TACROLIMUS)
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
900911039
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$153.15 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Adventist Health Commercial |
$42.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$114.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$114.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.15
|
| Rate for Payer: Blue Shield of California Commercial |
$147.07
|
| Rate for Payer: Blue Shield of California Commercial |
$105.94
|
| Rate for Payer: Blue Shield of California Commercial |
$97.27
|
| Rate for Payer: Blue Shield of California Commercial |
$70.07
|
| Rate for Payer: Cash Price |
$94.95
|
| Rate for Payer: Cash Price |
$94.95
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna of CA HMO |
$135.04
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Cigna of CA PPO |
$156.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$106.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.65
|
| Rate for Payer: EPIC Health Plan Senior |
$15.10
|
| Rate for Payer: EPIC Health Plan Senior |
$15.10
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Global Benefits Group Commercial |
$126.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$20.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$96.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.40
|
| Rate for Payer: Multiplan Commercial |
$168.80
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: Networks By Design Commercial |
$137.15
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Prime Health Services Commercial |
$179.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.12
|
| Rate for Payer: United Healthcare All Other HMO |
$11.12
|
| Rate for Payer: United Healthcare All Other HMO |
$11.12
|
| Rate for Payer: United Healthcare HMO Rider |
$11.12
|
| Rate for Payer: United Healthcare HMO Rider |
$11.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.10
|
| Rate for Payer: Vantage Medical Group Senior |
$13.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.73
|
|
|
HC FK 506 (TACROLIMUS)
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
900911039
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.20 |
| Max. Negotiated Rate |
$179.35 |
| Rate for Payer: Adventist Health Commercial |
$42.20
|
| Rate for Payer: Cash Price |
$94.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.40
|
| Rate for Payer: EPIC Health Plan Senior |
$84.40
|
| Rate for Payer: Galaxy Health WC |
$179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$126.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$124.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.64
|
| Rate for Payer: Multiplan Commercial |
$168.80
|
| Rate for Payer: Networks By Design Commercial |
$137.15
|
| Rate for Payer: Prime Health Services Commercial |
$179.35
|
|
|
HC FLEX/EXT/ROTATION WRIST UNIT
|
Facility
|
IP
|
$6,352.00
|
|
|
Service Code
|
CPT L6624
|
| Hospital Charge Code |
915356624
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,270.40 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$1,270.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cigna of CA HMO |
$4,446.40
|
| Rate for Payer: Cigna of CA PPO |
$4,446.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,446.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,540.80
|
| Rate for Payer: Galaxy Health WC |
$5,399.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,811.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,033.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,747.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.48
|
| Rate for Payer: Multiplan Commercial |
$5,081.60
|
| Rate for Payer: Networks By Design Commercial |
$4,128.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,399.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,383.91
|
| Rate for Payer: United Healthcare All Other HMO |
$2,320.39
|
| Rate for Payer: United Healthcare HMO Rider |
$2,270.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,080.28
|
|
|
HC FLEX/EXT/ROTATION WRIST UNIT
|
Facility
|
IP
|
$6,352.00
|
|
|
Service Code
|
CPT L6624
|
| Hospital Charge Code |
905356624
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,270.40 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$1,270.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cigna of CA HMO |
$4,446.40
|
| Rate for Payer: Cigna of CA PPO |
$4,446.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,446.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,540.80
|
| Rate for Payer: Galaxy Health WC |
$5,399.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,811.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,033.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,747.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.48
|
| Rate for Payer: Multiplan Commercial |
$5,081.60
|
| Rate for Payer: Networks By Design Commercial |
$4,128.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,399.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,383.91
|
| Rate for Payer: United Healthcare All Other HMO |
$2,320.39
|
| Rate for Payer: United Healthcare HMO Rider |
$2,270.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,080.28
|
|
|
HC FLEX/EXT/ROTATION WRIST UNIT
|
Facility
|
OP
|
$6,352.00
|
|
|
Service Code
|
CPT L6624
|
| Hospital Charge Code |
915356624
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,524.48 |
| Max. Negotiated Rate |
$5,399.20 |
| Rate for Payer: Adventist Health Commercial |
$2,604.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,399.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,493.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,764.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,844.87
|
| Rate for Payer: Blue Shield of California Commercial |
$4,884.69
|
| Rate for Payer: Blue Shield of California Commercial |
$3,220.46
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cigna of CA HMO |
$4,446.40
|
| Rate for Payer: Cigna of CA PPO |
$4,446.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,399.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,399.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,399.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,446.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,540.80
|
| Rate for Payer: Galaxy Health WC |
$5,399.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,811.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,156.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,033.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,700.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,747.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,446.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,446.40
|
| Rate for Payer: Multiplan Commercial |
$5,081.60
|
| Rate for Payer: Networks By Design Commercial |
$3,176.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,399.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,811.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,811.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,383.91
|
| Rate for Payer: United Healthcare All Other HMO |
$2,320.39
|
| Rate for Payer: United Healthcare HMO Rider |
$2,270.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,080.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,399.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,399.20
|
| Rate for Payer: Vantage Medical Group Senior |
$5,399.20
|
|
|
HC FLEX/EXT/ROTATION WRIST UNIT
|
Facility
|
OP
|
$6,352.00
|
|
|
Service Code
|
CPT L6624
|
| Hospital Charge Code |
905356624
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,524.48 |
| Max. Negotiated Rate |
$5,399.20 |
| Rate for Payer: Adventist Health Commercial |
$2,604.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,399.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,493.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,764.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,844.87
|
| Rate for Payer: Blue Shield of California Commercial |
$4,884.69
|
| Rate for Payer: Blue Shield of California Commercial |
$3,220.46
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cash Price |
$2,858.40
|
| Rate for Payer: Cigna of CA HMO |
$4,446.40
|
| Rate for Payer: Cigna of CA PPO |
$4,446.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,399.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,399.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,399.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,446.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,540.80
|
| Rate for Payer: Galaxy Health WC |
$5,399.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,811.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,156.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,033.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,700.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,747.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,524.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,446.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,446.40
|
| Rate for Payer: Multiplan Commercial |
$5,081.60
|
| Rate for Payer: Networks By Design Commercial |
$3,176.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,399.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,811.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,811.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,383.91
|
| Rate for Payer: United Healthcare All Other HMO |
$2,320.39
|
| Rate for Payer: United Healthcare HMO Rider |
$2,270.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,080.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,399.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,399.20
|
| Rate for Payer: Vantage Medical Group Senior |
$5,399.20
|
|
|
HC FLEX/EXT WRIST W/WO FRICTION
|
Facility
|
IP
|
$3,760.00
|
|
|
Service Code
|
CPT L6621
|
| Hospital Charge Code |
915356621
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$752.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$752.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cigna of CA HMO |
$2,632.00
|
| Rate for Payer: Cigna of CA PPO |
$2,632.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,632.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.00
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,387.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,218.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$902.40
|
| Rate for Payer: Multiplan Commercial |
$3,008.00
|
| Rate for Payer: Networks By Design Commercial |
$2,444.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,411.13
|
| Rate for Payer: United Healthcare All Other HMO |
$1,373.53
|
| Rate for Payer: United Healthcare HMO Rider |
$1,343.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,231.40
|
|
|
HC FLEX/EXT WRIST W/WO FRICTION
|
Facility
|
OP
|
$3,760.00
|
|
|
Service Code
|
CPT L6621
|
| Hospital Charge Code |
905356621
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$902.40 |
| Max. Negotiated Rate |
$3,196.00 |
| Rate for Payer: Adventist Health Commercial |
$1,541.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,196.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,068.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,820.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,275.93
|
| Rate for Payer: Blue Shield of California Commercial |
$2,891.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,906.32
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cigna of CA HMO |
$2,632.00
|
| Rate for Payer: Cigna of CA PPO |
$2,632.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,196.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,196.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,196.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,632.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.00
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,420.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,387.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,737.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,218.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$902.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,632.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,632.00
|
| Rate for Payer: Multiplan Commercial |
$3,008.00
|
| Rate for Payer: Networks By Design Commercial |
$1,880.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,256.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,256.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,411.13
|
| Rate for Payer: United Healthcare All Other HMO |
$1,373.53
|
| Rate for Payer: United Healthcare HMO Rider |
$1,343.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,231.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,196.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,196.00
|
|
|
HC FLEX/EXT WRIST W/WO FRICTION
|
Facility
|
IP
|
$3,760.00
|
|
|
Service Code
|
CPT L6621
|
| Hospital Charge Code |
905356621
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$752.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$752.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cigna of CA HMO |
$2,632.00
|
| Rate for Payer: Cigna of CA PPO |
$2,632.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,632.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.00
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,387.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,218.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$902.40
|
| Rate for Payer: Multiplan Commercial |
$3,008.00
|
| Rate for Payer: Networks By Design Commercial |
$2,444.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,411.13
|
| Rate for Payer: United Healthcare All Other HMO |
$1,373.53
|
| Rate for Payer: United Healthcare HMO Rider |
$1,343.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,231.40
|
|
|
HC FLEX/EXT WRIST W/WO FRICTION
|
Facility
|
OP
|
$3,760.00
|
|
|
Service Code
|
CPT L6621
|
| Hospital Charge Code |
915356621
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$902.40 |
| Max. Negotiated Rate |
$3,196.00 |
| Rate for Payer: Adventist Health Commercial |
$1,541.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,196.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,068.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,820.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,275.93
|
| Rate for Payer: Blue Shield of California Commercial |
$2,891.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,906.32
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cash Price |
$1,692.00
|
| Rate for Payer: Cigna of CA HMO |
$2,632.00
|
| Rate for Payer: Cigna of CA PPO |
$2,632.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,196.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,196.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,196.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,632.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.00
|
| Rate for Payer: Galaxy Health WC |
$3,196.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,256.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,420.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,387.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,737.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,218.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$902.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,632.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,632.00
|
| Rate for Payer: Multiplan Commercial |
$3,008.00
|
| Rate for Payer: Networks By Design Commercial |
$1,880.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,196.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,256.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,256.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,411.13
|
| Rate for Payer: United Healthcare All Other HMO |
$1,373.53
|
| Rate for Payer: United Healthcare HMO Rider |
$1,343.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,231.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,196.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,196.00
|
|
|
HC FLEXISEAL FECAL SYSTEM MGMT
|
Facility
|
IP
|
$681.03
|
|
| Hospital Charge Code |
901698766
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$136.21 |
| Max. Negotiated Rate |
$578.88 |
| Rate for Payer: Adventist Health Commercial |
$136.21
|
| Rate for Payer: Cash Price |
$306.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$476.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$272.41
|
| Rate for Payer: EPIC Health Plan Senior |
$272.41
|
| Rate for Payer: Galaxy Health WC |
$578.88
|
| Rate for Payer: Global Benefits Group Commercial |
$408.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$432.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$401.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.45
|
| Rate for Payer: Multiplan Commercial |
$544.82
|
| Rate for Payer: Networks By Design Commercial |
$442.67
|
| Rate for Payer: Prime Health Services Commercial |
$578.88
|
|
|
HC FLEXISEAL FECAL SYSTEM MGMT
|
Facility
|
OP
|
$681.03
|
|
| Hospital Charge Code |
901698766
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$136.21 |
| Max. Negotiated Rate |
$578.88 |
| Rate for Payer: Adventist Health Commercial |
$136.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$446.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$578.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$374.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$437.02
|
| Rate for Payer: Cash Price |
$306.46
|
| Rate for Payer: Cigna of CA HMO |
$435.86
|
| Rate for Payer: Cigna of CA PPO |
$503.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$578.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$578.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$578.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$476.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$272.41
|
| Rate for Payer: EPIC Health Plan Senior |
$272.41
|
| Rate for Payer: Galaxy Health WC |
$578.88
|
| Rate for Payer: Global Benefits Group Commercial |
$408.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$432.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$247.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$401.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$476.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$476.72
|
| Rate for Payer: Multiplan Commercial |
$544.82
|
| Rate for Payer: Networks By Design Commercial |
$442.67
|
| Rate for Payer: Prime Health Services Commercial |
$578.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$408.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$408.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$340.51
|
| Rate for Payer: United Healthcare All Other HMO |
$340.51
|
| Rate for Payer: United Healthcare HMO Rider |
$340.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$340.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$578.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$578.88
|
| Rate for Payer: Vantage Medical Group Senior |
$578.88
|
|
|
HC FLEX VIDEOSCOPE AMBU
|
Facility
|
OP
|
$1,696.00
|
|
| Hospital Charge Code |
900800002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$339.20 |
| Max. Negotiated Rate |
$1,441.60 |
| Rate for Payer: Adventist Health Commercial |
$339.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,112.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,441.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$932.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,272.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,088.32
|
| Rate for Payer: Cash Price |
$763.20
|
| Rate for Payer: Cigna of CA HMO |
$1,085.44
|
| Rate for Payer: Cigna of CA PPO |
$1,255.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,441.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,441.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,441.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,187.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$678.40
|
| Rate for Payer: EPIC Health Plan Senior |
$678.40
|
| Rate for Payer: Galaxy Health WC |
$1,441.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,017.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,076.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$615.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,000.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,187.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,187.20
|
| Rate for Payer: Multiplan Commercial |
$1,356.80
|
| Rate for Payer: Networks By Design Commercial |
$1,102.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,441.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,017.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,017.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$848.00
|
| Rate for Payer: United Healthcare All Other HMO |
$848.00
|
| Rate for Payer: United Healthcare HMO Rider |
$848.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$848.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,441.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,441.60
|
| Rate for Payer: Vantage Medical Group Senior |
$1,441.60
|
|
