|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$94,891.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906820215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18,978.20 |
| Max. Negotiated Rate |
$80,657.35 |
| Rate for Payer: Adventist Health Commercial |
$18,978.20
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,956.40
|
| Rate for Payer: EPIC Health Plan Senior |
$37,956.40
|
| Rate for Payer: Galaxy Health WC |
$80,657.35
|
| Rate for Payer: Global Benefits Group Commercial |
$56,934.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,292.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36,153.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58,737.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,773.84
|
| Rate for Payer: Multiplan Commercial |
$75,912.80
|
| Rate for Payer: Networks By Design Commercial |
$61,679.15
|
| Rate for Payer: Prime Health Services Commercial |
$80,657.35
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
IP
|
$65,554.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906811422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,110.80 |
| Max. Negotiated Rate |
$55,720.90 |
| Rate for Payer: Adventist Health Commercial |
$13,110.80
|
| Rate for Payer: Cash Price |
$36,054.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,221.60
|
| Rate for Payer: EPIC Health Plan Senior |
$26,221.60
|
| Rate for Payer: Galaxy Health WC |
$55,720.90
|
| Rate for Payer: Global Benefits Group Commercial |
$39,332.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43,724.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,976.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,577.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,732.96
|
| Rate for Payer: Multiplan Commercial |
$52,443.20
|
| Rate for Payer: Networks By Design Commercial |
$42,610.10
|
| Rate for Payer: Prime Health Services Commercial |
$55,720.90
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$94,891.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906820215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$506.62 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$18,978.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,133.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Cash Price |
$52,190.05
|
| Rate for Payer: Cigna of CA HMO |
$60,730.24
|
| Rate for Payer: Cigna of CA PPO |
$70,219.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$80,657.35
|
| Rate for Payer: Global Benefits Group Commercial |
$56,934.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$506.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,292.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,773.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$75,912.80
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$61,679.15
|
| Rate for Payer: Prime Health Services Commercial |
$80,657.35
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56,934.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICD REMV REPL EX SINGLE LEAD
|
Facility
|
OP
|
$65,554.00
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
906811422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$506.62 |
| Max. Negotiated Rate |
$109,559.00 |
| Rate for Payer: Adventist Health Commercial |
$13,110.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28,520.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,133.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$36,054.70
|
| Rate for Payer: Cash Price |
$36,054.70
|
| Rate for Payer: Cash Price |
$36,054.70
|
| Rate for Payer: Cigna of CA HMO |
$41,954.56
|
| Rate for Payer: Cigna of CA PPO |
$48,509.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,372.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28,520.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,502.18
|
| Rate for Payer: EPIC Health Plan Senior |
$28,520.13
|
| Rate for Payer: Galaxy Health WC |
$55,720.90
|
| Rate for Payer: Global Benefits Group Commercial |
$39,332.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$46,773.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$506.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$28,520.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43,724.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$572.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,520.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,732.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,935.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,216.97
|
| Rate for Payer: Multiplan Commercial |
$52,443.20
|
| Rate for Payer: Multiplan WC |
$45,441.74
|
| Rate for Payer: Networks By Design Commercial |
$42,610.10
|
| Rate for Payer: Prime Health Services Commercial |
$55,720.90
|
| Rate for Payer: Prime Health Services WC |
$44,978.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39,332.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$109,559.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97,437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$84,191.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77,134.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$28,520.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,780.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,372.14
|
| Rate for Payer: Vantage Medical Group Senior |
$28,520.13
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$5,036.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$454.54 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$1,007.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,303.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,280.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,769.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,777.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,092.61
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$2,769.80
|
| Rate for Payer: Cash Price |
$2,769.80
|
| Rate for Payer: Cash Price |
$2,769.80
|
| Rate for Payer: Cigna of CA HMO |
$3,223.04
|
| Rate for Payer: Cigna of CA PPO |
$3,726.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,280.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,280.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,280.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,014.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,014.40
|
| Rate for Payer: Galaxy Health WC |
$4,280.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,021.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$454.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,359.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,117.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,525.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,525.20
|
| Rate for Payer: Multiplan Commercial |
$4,028.80
|
| Rate for Payer: Networks By Design Commercial |
$3,273.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,280.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,021.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,021.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,280.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,280.60
|
| Rate for Payer: Vantage Medical Group Senior |
$4,280.60
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
OP
|
$9,354.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906820078
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$454.54 |
| Max. Negotiated Rate |
$7,950.90 |
| Rate for Payer: Adventist Health Commercial |
$1,870.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,135.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,950.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,144.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,015.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,744.29
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$5,144.70
|
| Rate for Payer: Cash Price |
$5,144.70
|
| Rate for Payer: Cash Price |
$5,144.70
|
| Rate for Payer: Cigna of CA HMO |
$5,986.56
|
| Rate for Payer: Cigna of CA PPO |
$6,921.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,950.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,950.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,741.60
|
| Rate for Payer: Galaxy Health WC |
$7,950.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,612.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$454.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,239.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$514.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,790.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,244.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,547.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,547.80
|
| Rate for Payer: Multiplan Commercial |
$7,483.20
|
| Rate for Payer: Networks By Design Commercial |
$6,080.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,950.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,612.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,612.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,950.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,950.90
|
| Rate for Payer: Vantage Medical Group Senior |
$7,950.90
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
IP
|
$5,036.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906812082
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,007.20 |
| Max. Negotiated Rate |
$4,280.60 |
| Rate for Payer: Adventist Health Commercial |
$1,007.20
|
| Rate for Payer: Cash Price |
$2,769.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,014.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,014.40
|
| Rate for Payer: Galaxy Health WC |
$4,280.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,021.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,359.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,918.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,117.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.64
|
| Rate for Payer: Multiplan Commercial |
$4,028.80
|
| Rate for Payer: Networks By Design Commercial |
$3,273.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,280.60
|
|
|
HC ICE INTRACARDIAC ECHO
|
Facility
|
IP
|
$9,354.00
|
|
|
Service Code
|
CPT 93662
|
| Hospital Charge Code |
906820078
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,870.80 |
| Max. Negotiated Rate |
$7,950.90 |
| Rate for Payer: Adventist Health Commercial |
$1,870.80
|
| Rate for Payer: Cash Price |
$5,144.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,741.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,741.60
|
| Rate for Payer: Galaxy Health WC |
$7,950.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,612.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,239.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,563.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,790.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,244.96
|
| Rate for Payer: Multiplan Commercial |
$7,483.20
|
| Rate for Payer: Networks By Design Commercial |
$6,080.10
|
| Rate for Payer: Prime Health Services Commercial |
$7,950.90
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
IP
|
$1,964.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$392.80 |
| Max. Negotiated Rate |
$1,669.40 |
| Rate for Payer: Adventist Health Commercial |
$392.80
|
| Rate for Payer: Cash Price |
$1,080.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$785.60
|
| Rate for Payer: EPIC Health Plan Senior |
$785.60
|
| Rate for Payer: Galaxy Health WC |
$1,669.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,178.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,309.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$748.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,215.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.36
|
| Rate for Payer: Multiplan Commercial |
$1,571.20
|
| Rate for Payer: Networks By Design Commercial |
$1,276.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,669.40
|
|
|
HC I & D ABSCESS COMPL OR MULT
|
Facility
|
OP
|
$1,964.00
|
|
|
Service Code
|
CPT 10061
|
| Hospital Charge Code |
900501001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$143.94 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$392.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,080.20
|
| Rate for Payer: Cash Price |
$1,080.20
|
| Rate for Payer: Cash Price |
$1,080.20
|
| Rate for Payer: Cigna of CA HMO |
$1,256.96
|
| Rate for Payer: Cigna of CA PPO |
$1,453.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$1,669.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,178.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,309.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$471.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$639.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,571.20
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,276.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,669.40
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,178.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$982.00
|
| Rate for Payer: United Healthcare All Other HMO |
$982.00
|
| Rate for Payer: United Healthcare HMO Rider |
$982.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$982.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.19 |
| Max. Negotiated Rate |
$6,427.00 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cigna of CA HMO |
$1,106.56
|
| Rate for Payer: Cigna of CA PPO |
$1,279.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,037.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$864.50
|
| Rate for Payer: United Healthcare All Other HMO |
$864.50
|
| Rate for Payer: United Healthcare HMO Rider |
$864.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$864.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$6,427.00 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cigna of CA HMO |
$1,106.56
|
| Rate for Payer: Cigna of CA PPO |
$1,279.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,037.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,037.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$691.60
|
| Rate for Payer: EPIC Health Plan Senior |
$691.60
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$658.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$691.60
|
| Rate for Payer: EPIC Health Plan Senior |
$691.60
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$658.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
OP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$183.20 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: Cigna of CA HMO |
$1,106.56
|
| Rate for Payer: Cigna of CA PPO |
$1,279.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$183.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,037.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| 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: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$950.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$691.60
|
| Rate for Payer: EPIC Health Plan Senior |
$691.60
|
| Rate for Payer: Galaxy Health WC |
$1,469.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$658.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,070.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Multiplan Commercial |
$1,383.20
|
| Rate for Payer: Networks By Design Commercial |
$1,123.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.65
|
|
|
HC I & D ABSCESS,THROAT INTRAORAL
|
Facility
|
IP
|
$7,125.00
|
|
|
Service Code
|
CPT 42720
|
| Hospital Charge Code |
900501607
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$6,056.25 |
| Rate for Payer: Adventist Health Commercial |
$1,425.00
|
| Rate for Payer: Cash Price |
$3,918.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,850.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,850.00
|
| Rate for Payer: Galaxy Health WC |
$6,056.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,275.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,752.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,714.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,410.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,710.00
|
| Rate for Payer: Multiplan Commercial |
$5,700.00
|
| Rate for Payer: Networks By Design Commercial |
$4,631.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,056.25
|
|
|
HC I & D ABSCESS,THROAT INTRAORAL
|
Facility
|
OP
|
$7,125.00
|
|
|
Service Code
|
CPT 42720
|
| Hospital Charge Code |
900501607
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$329.63 |
| Max. Negotiated Rate |
$6,757.85 |
| Rate for Payer: Adventist Health Commercial |
$1,425.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$3,918.75
|
| Rate for Payer: Cash Price |
$3,918.75
|
| Rate for Payer: Cash Price |
$3,918.75
|
| Rate for Payer: Cigna of CA HMO |
$4,560.00
|
| Rate for Payer: Cigna of CA PPO |
$5,272.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$6,056.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,275.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,752.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$329.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,710.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,192.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$5,700.00
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$4,631.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,056.25
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,275.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,562.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,562.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,562.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,562.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC I & D ARM BURSA
|
Facility
|
OP
|
$4,761.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
900501660
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$216.45 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Adventist Health Commercial |
$952.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cigna of CA HMO |
$3,047.04
|
| Rate for Payer: Cigna of CA PPO |
$3,523.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$4,046.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,856.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,175.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$216.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,142.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$3,808.80
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,094.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,046.85
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,856.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,380.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,380.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,380.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,380.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC I & D ARM BURSA
|
Facility
|
IP
|
$4,761.00
|
|
|
Service Code
|
CPT 23931
|
| Hospital Charge Code |
900501660
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$952.20 |
| Max. Negotiated Rate |
$4,046.85 |
| Rate for Payer: Adventist Health Commercial |
$952.20
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,904.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,904.40
|
| Rate for Payer: Galaxy Health WC |
$4,046.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,856.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,175.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,813.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,947.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,142.64
|
| Rate for Payer: Multiplan Commercial |
$3,808.80
|
| Rate for Payer: Networks By Design Commercial |
$3,094.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,046.85
|
|
|
HC I&D BARTHOLIN ABSC
|
Facility
|
OP
|
$1,114.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
900501169
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$222.80 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$222.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$612.70
|
| Rate for Payer: Cash Price |
$612.70
|
| Rate for Payer: Cash Price |
$612.70
|
| Rate for Payer: Cigna of CA HMO |
$712.96
|
| Rate for Payer: Cigna of CA PPO |
$824.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$383.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$281.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.07
|
| Rate for Payer: EPIC Health Plan Senior |
$255.61
|
| Rate for Payer: Galaxy Health WC |
$946.90
|
| Rate for Payer: Global Benefits Group Commercial |
$668.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$419.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$255.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$743.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$330.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$255.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$322.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$342.52
|
| Rate for Payer: Multiplan Commercial |
$891.20
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$724.10
|
| Rate for Payer: Prime Health Services Commercial |
$946.90
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$668.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$557.00
|
| Rate for Payer: United Healthcare All Other HMO |
$557.00
|
| Rate for Payer: United Healthcare HMO Rider |
$557.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$557.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$255.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Vantage Medical Group Senior |
$255.61
|
|
|
HC I&D BARTHOLIN ABSC
|
Facility
|
IP
|
$1,114.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
900501169
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$222.80 |
| Max. Negotiated Rate |
$946.90 |
| Rate for Payer: Adventist Health Commercial |
$222.80
|
| Rate for Payer: Cash Price |
$612.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$445.60
|
| Rate for Payer: EPIC Health Plan Senior |
$445.60
|
| Rate for Payer: Galaxy Health WC |
$946.90
|
| Rate for Payer: Global Benefits Group Commercial |
$668.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$743.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$424.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$689.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.36
|
| Rate for Payer: Multiplan Commercial |
$891.20
|
| Rate for Payer: Networks By Design Commercial |
$724.10
|
| Rate for Payer: Prime Health Services Commercial |
$946.90
|
|
|
HC I & D COMPL POST-OP WND INF
|
Facility
|
OP
|
$10,575.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
900501007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$197.65 |
| Max. Negotiated Rate |
$8,988.75 |
| Rate for Payer: Adventist Health Commercial |
$2,115.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$5,816.25
|
| Rate for Payer: Cash Price |
$5,816.25
|
| Rate for Payer: Cash Price |
$5,816.25
|
| Rate for Payer: Cigna of CA HMO |
$6,768.00
|
| Rate for Payer: Cigna of CA PPO |
$7,825.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$8,988.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,345.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$197.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,053.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$223.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,538.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,582.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$8,460.00
|
| Rate for Payer: Networks By Design Commercial |
$6,873.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,988.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,345.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,345.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,287.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,287.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,287.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,287.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC I & D COMPL POST-OP WND INF
|
Facility
|
OP
|
$10,575.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
900501007
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$223.53 |
| Max. Negotiated Rate |
$8,988.75 |
| Rate for Payer: Adventist Health Commercial |
$2,115.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,636.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$5,816.25
|
| Rate for Payer: Cash Price |
$5,816.25
|
| Rate for Payer: Cash Price |
$5,816.25
|
| Rate for Payer: Cigna of CA HMO |
$6,768.00
|
| Rate for Payer: Cigna of CA PPO |
$7,825.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,000.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,636.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,909.30
|
| Rate for Payer: EPIC Health Plan Senior |
$3,636.52
|
| Rate for Payer: Galaxy Health WC |
$8,988.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,345.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,963.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,636.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,053.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$223.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,636.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,538.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,582.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,872.94
|
| Rate for Payer: Multiplan Commercial |
$8,460.00
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$6,873.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,988.75
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,345.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,287.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,287.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,287.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,287.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,636.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,454.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,000.17
|
| Rate for Payer: Vantage Medical Group Senior |
$3,636.52
|
|
|
HC I & D COMPL POST-OP WND INF
|
Facility
|
IP
|
$10,575.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
900501007
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,115.00 |
| Max. Negotiated Rate |
$8,988.75 |
| Rate for Payer: Adventist Health Commercial |
$2,115.00
|
| Rate for Payer: Cash Price |
$5,816.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,230.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,230.00
|
| Rate for Payer: Galaxy Health WC |
$8,988.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,345.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,053.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,029.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,545.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,538.00
|
| Rate for Payer: Multiplan Commercial |
$8,460.00
|
| Rate for Payer: Networks By Design Commercial |
$6,873.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,988.75
|
|
