|
HC VENOUS BLOOD SAMPLING
|
Facility
IP
|
$599.00
|
|
|
Service Code
|
CPT 36500
|
| Hospital Charge Code |
909081329
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$143.76 |
| Max. Negotiated Rate |
$509.15 |
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.60
|
| Rate for Payer: Galaxy Health WC |
$509.15
|
| Rate for Payer: Global Benefits Group Commercial |
$359.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$399.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$228.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.76
|
| Rate for Payer: Multiplan Commercial |
$479.20
|
| Rate for Payer: Networks By Design Commercial |
$389.35
|
| Rate for Payer: Prime Health Services Commercial |
$509.15
|
|
|
HC VENOUS MECH THROMBECTOMY
|
Facility
IP
|
$11,083.00
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
909081846
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,659.92 |
| Max. Negotiated Rate |
$9,420.55 |
| Rate for Payer: Cash Price |
$4,987.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,433.20
|
| Rate for Payer: Galaxy Health WC |
$9,420.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,649.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,392.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,222.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,659.92
|
| Rate for Payer: Multiplan Commercial |
$8,866.40
|
| Rate for Payer: Networks By Design Commercial |
$7,203.95
|
| Rate for Payer: Prime Health Services Commercial |
$9,420.55
|
|
|
HC VENOUS MECH THROMBECTOMY
|
Facility
OP
|
$11,083.00
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
909081846
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,659.92 |
| Max. Negotiated Rate |
$30,715.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,715.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,649.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$4,987.35
|
| Rate for Payer: Cash Price |
$4,987.35
|
| Rate for Payer: Cigna of CA PPO |
$8,201.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$9,420.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,649.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,312.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,542.16
|
| Rate for Payer: Heritage Provider Network Transplant |
$22,542.16
|
| Rate for Payer: IEHP Medi-Cal |
$22,267.26
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$22,267.26
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,392.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,874.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,659.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$8,866.40
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$7,203.95
|
| Rate for Payer: Prime Health Services Commercial |
$9,420.55
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,649.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,649.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC VENOUS M-THROMBECTOMY ADD-ON
|
Facility
IP
|
$12,343.00
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
909081847
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,962.32 |
| Max. Negotiated Rate |
$10,491.55 |
| Rate for Payer: Cash Price |
$5,554.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,937.20
|
| Rate for Payer: Galaxy Health WC |
$10,491.55
|
| Rate for Payer: Global Benefits Group Commercial |
$7,405.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,232.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,702.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,962.32
|
| Rate for Payer: Multiplan Commercial |
$9,874.40
|
| Rate for Payer: Networks By Design Commercial |
$8,022.95
|
| Rate for Payer: Prime Health Services Commercial |
$10,491.55
|
|
|
HC VENOUS M-THROMBECTOMY ADD-ON
|
Facility
OP
|
$12,343.00
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
909081847
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$844.61 |
| Max. Negotiated Rate |
$30,715.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,715.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,405.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$5,554.35
|
| Rate for Payer: Cash Price |
$5,554.35
|
| Rate for Payer: Cigna of CA PPO |
$9,133.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$10,491.55
|
| Rate for Payer: Global Benefits Group Commercial |
$7,405.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,257.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: IEHP Medi-Cal |
$6,451.73
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,232.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$844.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,962.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$9,874.40
|
| Rate for Payer: Networks By Design Commercial |
$8,022.95
|
| Rate for Payer: Prime Health Services Commercial |
$10,491.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,405.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,405.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC VENOUS SAMPLING
|
Facility
OP
|
$11,798.00
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
909081644
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$970.74 |
| Max. Negotiated Rate |
$11,260.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$970.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,271.01
|
| Rate for Payer: BCBS Transplant Transplant |
$7,078.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,972.62
|
| Rate for Payer: Blue Shield of California EPN |
$5,533.26
|
| Rate for Payer: Cash Price |
$5,309.10
|
| Rate for Payer: Cash Price |
$5,309.10
|
| Rate for Payer: Cigna of CA HMO |
$7,550.72
|
| Rate for Payer: Cigna of CA PPO |
$8,730.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$10,028.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,078.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,848.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,260.35
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,260.35
|
| Rate for Payer: IEHP Medi-Cal |
$11,123.03
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11,123.03
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,869.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,831.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,651.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$9,438.40
|
| Rate for Payer: Networks By Design Commercial |
$7,668.70
|
| Rate for Payer: Prime Health Services Commercial |
$10,028.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,078.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,078.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,078.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC VENOUS SAMPLING
|
Facility
IP
|
$11,798.00
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
909081644
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,831.52 |
| Max. Negotiated Rate |
$10,028.30 |
| Rate for Payer: Cash Price |
$5,309.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,719.20
|
| Rate for Payer: Galaxy Health WC |
$10,028.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,078.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,869.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,495.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,831.52
|
| Rate for Payer: Multiplan Commercial |
$9,438.40
|
| Rate for Payer: Networks By Design Commercial |
$7,668.70
|
| Rate for Payer: Prime Health Services Commercial |
$10,028.30
|
|
|
HC VENOUS THROMBUS SCAN
|
Facility
OP
|
$1,513.00
|
|
|
Service Code
|
CPT 78458
|
| Hospital Charge Code |
909301387
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$179.21 |
| Max. Negotiated Rate |
$1,286.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$975.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$901.45
|
| Rate for Payer: BCBS Transplant Transplant |
$907.80
|
| Rate for Payer: Blue Shield of California Commercial |
$894.18
|
| Rate for Payer: Blue Shield of California EPN |
$709.60
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: Cigna of CA HMO |
$968.32
|
| Rate for Payer: Cigna of CA PPO |
$1,119.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: Dignity Health Media |
$515.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$1,286.05
|
| Rate for Payer: Global Benefits Group Commercial |
$907.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,134.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$845.12
|
| Rate for Payer: Heritage Provider Network Transplant |
$845.12
|
| Rate for Payer: IEHP Medi-Cal |
$834.82
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$834.82
|
| Rate for Payer: IEHP Medicare Advantage |
$515.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,009.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$179.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$649.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$1,210.40
|
| Rate for Payer: Networks By Design Commercial |
$983.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,286.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$907.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$907.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$907.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.46
|
| Rate for Payer: United Healthcare All Other HMO |
$396.46
|
| Rate for Payer: United Healthcare HMO Rider |
$396.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC VENOUS THROMBUS SCAN
|
Facility
IP
|
$1,513.00
|
|
|
Service Code
|
CPT 78458
|
| Hospital Charge Code |
909301387
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$363.12 |
| Max. Negotiated Rate |
$1,286.05 |
| Rate for Payer: Cash Price |
$680.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$605.20
|
| Rate for Payer: Galaxy Health WC |
$1,286.05
|
| Rate for Payer: Global Benefits Group Commercial |
$907.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,009.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$576.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.12
|
| Rate for Payer: Multiplan Commercial |
$1,210.40
|
| Rate for Payer: Networks By Design Commercial |
$983.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,286.05
|
|
|
HC VENT ASSIST& MGT-INITIAL DAILY
|
Facility
OP
|
$9,607.00
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
900800100
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$85.12 |
| Max. Negotiated Rate |
$8,165.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$580.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,174.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$861.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$782.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,764.20
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$4,323.15
|
| Rate for Payer: Cash Price |
$4,323.15
|
| Rate for Payer: Cash Price |
$4,323.15
|
| Rate for Payer: Cash Price |
$4,323.15
|
| Rate for Payer: Cigna of CA HMO |
$6,148.48
|
| Rate for Payer: Cigna of CA PPO |
$7,109.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,174.46
|
| Rate for Payer: Dignity Health Media |
$782.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$861.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,057.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$782.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$782.97
|
| Rate for Payer: Galaxy Health WC |
$8,165.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,764.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,205.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,284.07
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,284.07
|
| Rate for Payer: IEHP Medi-Cal |
$1,268.41
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,268.41
|
| Rate for Payer: IEHP Medicare Advantage |
$782.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,407.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$85.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$782.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,305.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$986.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,049.18
|
| Rate for Payer: Multiplan Commercial |
$7,685.60
|
| Rate for Payer: Networks By Design Commercial |
$6,244.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,165.95
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,764.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,764.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,764.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,174.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$861.27
|
| Rate for Payer: Vantage Medical Group Senior |
$782.97
|
|
|
HC VENT ASSIST& MGT-INITIAL DAILY
|
Facility
IP
|
$9,607.00
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
900800100
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$2,305.68 |
| Max. Negotiated Rate |
$8,165.95 |
| Rate for Payer: Cash Price |
$4,323.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,842.80
|
| Rate for Payer: Galaxy Health WC |
$8,165.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,764.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,407.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,660.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,305.68
|
| Rate for Payer: Multiplan Commercial |
$7,685.60
|
| Rate for Payer: Networks By Design Commercial |
$6,244.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,165.95
|
|
|
HC VENT ASSIST & MGT SUB DAILY
|
Facility
IP
|
$7,649.00
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
900800101
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,835.76 |
| Max. Negotiated Rate |
$6,501.65 |
| Rate for Payer: Cash Price |
$3,442.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,059.60
|
| Rate for Payer: Galaxy Health WC |
$6,501.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,589.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,101.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,914.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,835.76
|
| Rate for Payer: Multiplan Commercial |
$6,119.20
|
| Rate for Payer: Networks By Design Commercial |
$4,971.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,501.65
|
|
|
HC VENT ASSIST & MGT SUB DAILY
|
Facility
OP
|
$7,649.00
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
900800101
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$67.07 |
| Max. Negotiated Rate |
$6,501.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$419.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,174.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$861.27
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$782.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,589.40
|
| Rate for Payer: Blue Shield of California Commercial |
$407.00
|
| Rate for Payer: Blue Shield of California EPN |
$293.00
|
| Rate for Payer: Cash Price |
$3,442.05
|
| Rate for Payer: Cash Price |
$3,442.05
|
| Rate for Payer: Cash Price |
$3,442.05
|
| Rate for Payer: Cash Price |
$3,442.05
|
| Rate for Payer: Cigna of CA HMO |
$4,895.36
|
| Rate for Payer: Cigna of CA PPO |
$5,660.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,174.46
|
| Rate for Payer: Dignity Health Media |
$782.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$861.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,057.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$782.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$782.97
|
| Rate for Payer: Galaxy Health WC |
$6,501.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,589.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,736.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,284.07
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,284.07
|
| Rate for Payer: IEHP Medi-Cal |
$1,268.41
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$1,268.41
|
| Rate for Payer: IEHP Medicare Advantage |
$782.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,101.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$67.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$782.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,835.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$986.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,049.18
|
| Rate for Payer: Multiplan Commercial |
$6,119.20
|
| Rate for Payer: Networks By Design Commercial |
$4,971.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,501.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,589.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,589.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,589.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,174.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$861.27
|
| Rate for Payer: Vantage Medical Group Senior |
$782.97
|
|
|
HC VENT PUNC THR PREV BURR HOLE
|
Facility
OP
|
$2,754.00
|
|
|
Service Code
|
CPT 61020
|
| Hospital Charge Code |
900501253
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,708.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,252.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,138.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,652.40
|
| Rate for Payer: Cash Price |
$1,239.30
|
| Rate for Payer: Cash Price |
$1,239.30
|
| Rate for Payer: Cash Price |
$1,239.30
|
| Rate for Payer: Cigna of CA PPO |
$2,037.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,708.24
|
| Rate for Payer: Dignity Health Media |
$1,138.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,252.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,537.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,138.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,138.83
|
| Rate for Payer: Galaxy Health WC |
$2,340.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,652.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,065.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,867.68
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,867.68
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,138.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,836.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,138.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$660.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,434.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,526.03
|
| Rate for Payer: Multiplan Commercial |
$2,203.20
|
| Rate for Payer: Networks By Design Commercial |
$1,790.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,340.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,652.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,652.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,377.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,377.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,377.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,377.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,708.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,252.71
|
| Rate for Payer: Vantage Medical Group Senior |
$1,138.83
|
|
|
HC VENT PUNC THR PREV BURR HOLE
|
Facility
IP
|
$2,754.00
|
|
|
Service Code
|
CPT 61020
|
| Hospital Charge Code |
900501253
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$660.96 |
| Max. Negotiated Rate |
$2,340.90 |
| Rate for Payer: Cash Price |
$1,239.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,101.60
|
| Rate for Payer: Galaxy Health WC |
$2,340.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,652.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,836.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,049.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$660.96
|
| Rate for Payer: Multiplan Commercial |
$2,203.20
|
| Rate for Payer: Networks By Design Commercial |
$1,790.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,340.90
|
|
|
HC VEP, CHECKERBOARD/FLASH
|
Facility
OP
|
$1,781.00
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
900600218
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$65.44 |
| Max. Negotiated Rate |
$1,513.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$795.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,061.12
|
| Rate for Payer: BCBS Transplant Transplant |
$1,068.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,052.57
|
| Rate for Payer: Blue Shield of California EPN |
$835.29
|
| Rate for Payer: Cash Price |
$801.45
|
| Rate for Payer: Cash Price |
$801.45
|
| Rate for Payer: Cash Price |
$801.45
|
| Rate for Payer: Cigna of CA HMO |
$1,139.84
|
| Rate for Payer: Cigna of CA PPO |
$1,317.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Media |
$392.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$1,513.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,068.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,335.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$643.16
|
| Rate for Payer: Heritage Provider Network Transplant |
$643.16
|
| Rate for Payer: IEHP Medi-Cal |
$635.32
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$635.32
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,187.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$427.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$494.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$1,424.80
|
| Rate for Payer: Networks By Design Commercial |
$1,157.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,513.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,068.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,068.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,068.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,231.00
|
| Rate for Payer: United Healthcare All Other HMO |
$975.00
|
| Rate for Payer: United Healthcare HMO Rider |
$739.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC VEP, CHECKERBOARD/FLASH
|
Facility
IP
|
$1,781.00
|
|
|
Service Code
|
CPT 95930
|
| Hospital Charge Code |
900600218
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$427.44 |
| Max. Negotiated Rate |
$1,513.85 |
| Rate for Payer: Cash Price |
$801.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$712.40
|
| Rate for Payer: Galaxy Health WC |
$1,513.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,068.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,187.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$678.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$427.44
|
| Rate for Payer: Multiplan Commercial |
$1,424.80
|
| Rate for Payer: Networks By Design Commercial |
$1,157.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,513.85
|
|
|
HC VERTEBRAL UNI
|
Facility
IP
|
$17,995.00
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
909020149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,318.80 |
| Max. Negotiated Rate |
$15,295.75 |
| Rate for Payer: Cash Price |
$8,097.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,198.00
|
| Rate for Payer: Galaxy Health WC |
$15,295.75
|
| Rate for Payer: Global Benefits Group Commercial |
$10,797.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,002.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,856.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,318.80
|
| Rate for Payer: Multiplan Commercial |
$14,396.00
|
| Rate for Payer: Networks By Design Commercial |
$11,696.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,295.75
|
|
|
HC VERTEBRAL UNI
|
Facility
OP
|
$17,995.00
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
909020149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$534.77 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: BCBS Transplant Transplant |
$10,797.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$8,097.75
|
| Rate for Payer: Cash Price |
$8,097.75
|
| Rate for Payer: Cigna of CA PPO |
$13,316.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$15,295.75
|
| Rate for Payer: Global Benefits Group Commercial |
$10,797.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,496.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,260.35
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,260.35
|
| Rate for Payer: IEHP Medi-Cal |
$11,123.03
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11,123.03
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,002.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$534.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,318.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,651.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$14,396.00
|
| Rate for Payer: Networks By Design Commercial |
$11,696.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,295.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10,797.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,797.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC VESTIBULE OF MOUTH
|
Facility
IP
|
$1,324.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
900501785
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.76 |
| Max. Negotiated Rate |
$1,125.40 |
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.60
|
| Rate for Payer: Galaxy Health WC |
$1,125.40
|
| Rate for Payer: Global Benefits Group Commercial |
$794.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$883.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$504.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.76
|
| Rate for Payer: Multiplan Commercial |
$1,059.20
|
| Rate for Payer: Networks By Design Commercial |
$860.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,125.40
|
|
|
HC VESTIBULE OF MOUTH
|
Facility
OP
|
$1,324.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
900501785
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.83 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$687.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$794.40
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cigna of CA PPO |
$979.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Media |
$687.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$1,125.40
|
| Rate for Payer: Global Benefits Group Commercial |
$794.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$993.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,127.40
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,127.40
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$687.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$883.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$866.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$1,059.20
|
| Rate for Payer: Networks By Design Commercial |
$860.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,125.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$794.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$794.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$662.00
|
| Rate for Payer: United Healthcare All Other HMO |
$662.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$662.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC VITAL CAPACITY TOTAL
|
Facility
IP
|
$562.00
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
900800430
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$134.88 |
| Max. Negotiated Rate |
$477.70 |
| Rate for Payer: Cash Price |
$252.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.80
|
| Rate for Payer: Galaxy Health WC |
$477.70
|
| Rate for Payer: Global Benefits Group Commercial |
$337.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$374.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$214.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.88
|
| Rate for Payer: Multiplan Commercial |
$449.60
|
| Rate for Payer: Networks By Design Commercial |
$365.30
|
| Rate for Payer: Prime Health Services Commercial |
$477.70
|
|
|
HC VITAL CAPACITY TOTAL
|
Facility
OP
|
$562.00
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
900800430
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$10.58 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$139.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$334.84
|
| Rate for Payer: BCBS Transplant Transplant |
$337.20
|
| Rate for Payer: Blue Shield of California Commercial |
$332.14
|
| Rate for Payer: Blue Shield of California EPN |
$263.58
|
| Rate for Payer: Cash Price |
$252.90
|
| Rate for Payer: Cash Price |
$252.90
|
| Rate for Payer: Cash Price |
$252.90
|
| Rate for Payer: Cigna of CA HMO |
$359.68
|
| Rate for Payer: Cigna of CA PPO |
$415.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$477.70
|
| Rate for Payer: Global Benefits Group Commercial |
$337.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$421.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$320.08
|
| Rate for Payer: IEHP Medi-Cal |
$316.18
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$316.18
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$374.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$134.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$449.60
|
| Rate for Payer: Networks By Design Commercial |
$365.30
|
| Rate for Payer: Prime Health Services Commercial |
$477.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$337.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$337.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$337.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC VITAMIN B12
|
Facility
OP
|
$30.00
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
900910830
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$137.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$125.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.53
|
| Rate for Payer: BCBS Transplant Transplant |
$18.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19.38
|
| Rate for Payer: Blue Shield of California EPN |
$15.36
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Cigna of CA HMO |
$19.20
|
| Rate for Payer: Cigna of CA PPO |
$22.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.62
|
| Rate for Payer: Dignity Health Media |
$15.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$15.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.08
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.73
|
| Rate for Payer: Heritage Provider Network Transplant |
$24.73
|
| Rate for Payer: IEHP Medi-Cal |
$24.43
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$24.43
|
| Rate for Payer: IEHP Medicare Advantage |
$15.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.21
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$19.50
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.21
|
| Rate for Payer: United Healthcare All Other HMO |
$12.21
|
| Rate for Payer: United Healthcare HMO Rider |
$12.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Vantage Medical Group Senior |
$15.08
|
|
|
HC VITAMIN D TOTAL
|
Facility
OP
|
$45.00
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
900912240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$270.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$246.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$270.08
|
| Rate for Payer: BCBS Transplant Transplant |
$27.00
|
| Rate for Payer: Blue Shield of California Commercial |
$29.07
|
| Rate for Payer: Blue Shield of California EPN |
$23.04
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cigna of CA HMO |
$28.80
|
| Rate for Payer: Cigna of CA PPO |
$33.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.40
|
| Rate for Payer: Dignity Health Media |
$29.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.96
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$29.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.60
|
| Rate for Payer: Galaxy Health WC |
$38.25
|
| Rate for Payer: Global Benefits Group Commercial |
$27.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.54
|
| Rate for Payer: Heritage Provider Network Transplant |
$48.54
|
| Rate for Payer: IEHP Medi-Cal |
$47.95
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$47.95
|
| Rate for Payer: IEHP Medicare Advantage |
$29.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.66
|
| Rate for Payer: Multiplan Commercial |
$36.00
|
| Rate for Payer: Networks By Design Commercial |
$29.25
|
| Rate for Payer: Prime Health Services Commercial |
$38.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.98
|
| Rate for Payer: United Healthcare All Other HMO |
$23.98
|
| Rate for Payer: United Healthcare HMO Rider |
$23.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: Vantage Medical Group Senior |
$29.60
|
|
