|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,020.11
|
| 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
|
510
|
| Min. Negotiated Rate |
$71.30 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$593.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| 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 |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| 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/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$71.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$325.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$345.79
|
| 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 |
$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 |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
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 |
$778.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,020.11
|
| 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
|
720
|
| Min. Negotiated Rate |
$71.30 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$593.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| 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 |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| 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/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$71.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$325.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$345.79
|
| 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 |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
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 |
$71.30 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| 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 |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| 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/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$71.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$361.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$325.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$345.79
|
| 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: 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 |
$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 |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
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 |
$80.64 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| 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 |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| 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/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$325.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$345.79
|
| 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 |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC I & D ABSCESS SIMPLE
|
Facility
|
IP
|
$1,729.00
|
|
|
Service Code
|
CPT 10060
|
| Hospital Charge Code |
900501000
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$345.80 |
| Max. Negotiated Rate |
$1,469.65 |
| Rate for Payer: Adventist Health Commercial |
$345.80
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,020.11
|
| 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
|
456
|
| Min. Negotiated Rate |
$80.64 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$708.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$593.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| Rate for Payer: Cash Price |
$778.05
|
| 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 |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| 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/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,097.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$325.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$345.79
|
| 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: TriValley Medical Group Commercial/Senior |
$1,037.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
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 |
$3,206.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,987.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$4,524.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,203.75
|
| 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 |
$7,035.98 |
| Rate for Payer: Adventist Health Commercial |
$1,425.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$3,206.25
|
| Rate for Payer: Cash Price |
$3,206.25
|
| Rate for Payer: Cash Price |
$3,206.25
|
| 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 |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,987.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$6,056.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,275.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,524.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$329.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,710.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,372.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$5,700.00
|
| 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 |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC 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 |
$2,142.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,332.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,023.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,808.99
|
| 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 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 |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$952.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$2,142.45
|
| Rate for Payer: Cash Price |
$2,142.45
|
| Rate for Payer: Cash Price |
$2,142.45
|
| 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 |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,332.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$4,046.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,856.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,023.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$216.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,142.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$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 |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC I&D BARTHOLIN ABSC
|
Facility
|
OP
|
$1,114.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
900501169
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$260.03 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$456.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$648.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$501.30
|
| Rate for Payer: Cash Price |
$501.30
|
| Rate for Payer: Cash Price |
$501.30
|
| 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 |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$779.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.05
|
| Rate for Payer: EPIC Health Plan Senior |
$286.03
|
| Rate for Payer: Galaxy Health WC |
$946.90
|
| Rate for Payer: Global Benefits Group Commercial |
$668.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$426.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$707.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$327.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$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: TriValley Medical Group Commercial/Senior |
$668.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$260.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC I&D BARTHOLIN ABSC
|
Facility
|
IP
|
$1,114.00
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
900501169
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$222.80 |
| Max. Negotiated Rate |
$946.90 |
| Rate for Payer: Adventist Health Commercial |
$222.80
|
| Rate for Payer: Cash Price |
$501.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$779.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$707.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$657.26
|
| 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 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 |
$501.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$779.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$707.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$657.26
|
| 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 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 |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$222.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$501.30
|
| Rate for Payer: Cash Price |
$501.30
|
| Rate for Payer: Cash Price |
$501.30
|
| 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 |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$779.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.05
|
| Rate for Payer: EPIC Health Plan Senior |
$286.03
|
| Rate for Payer: Galaxy Health WC |
$946.90
|
| Rate for Payer: Global Benefits Group Commercial |
$668.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$426.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$707.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$327.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$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 |
$260.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC 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 |
$1,105.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$4,758.75
|
| Rate for Payer: Cash Price |
$4,758.75
|
| Rate for Payer: Cash Price |
$4,758.75
|
| 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 |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,402.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| 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/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$197.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,715.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$223.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,538.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| 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 |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC I & D COMPL POST-OP WND INF
|
Facility
|
OP
|
$10,575.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
900501007
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$223.53 |
| Max. Negotiated Rate |
$8,988.75 |
| Rate for Payer: Adventist Health Commercial |
$4,335.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,105.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$4,758.75
|
| Rate for Payer: Cash Price |
$4,758.75
|
| Rate for Payer: Cash Price |
$4,758.75
|
| 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 |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,402.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| 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/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,715.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$223.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,016.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,538.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| 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: TriValley Medical Group Commercial/Senior |
$6,345.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC I & D COMPL POST-OP WND INF
|
Facility
|
IP
|
$10,575.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
900501007
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,115.00 |
| Max. Negotiated Rate |
$8,988.75 |
| Rate for Payer: Cash Price |
$4,758.75
|
| Rate for Payer: Adventist Health Commercial |
$2,115.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,402.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$6,715.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,239.25
|
| 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
|
|
|
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 |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$4,758.75
|
| Rate for Payer: Cash Price |
$4,758.75
|
| Rate for Payer: Cash Price |
$4,758.75
|
| 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 |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,402.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| 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/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,715.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$223.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,016.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,538.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| 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 |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC I & D COMPL POST-OP WND INF
|
Facility
|
IP
|
$10,575.00
|
|
|
Service Code
|
CPT 10180
|
| Hospital Charge Code |
900501007
|
|
Hospital Revenue Code
|
456
|
| 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 |
$4,758.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,402.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$6,715.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,239.25
|
| 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
|
|
|
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 |
$4,758.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,402.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$6,715.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,239.25
|
| 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
|
|
|
HC I & D DEEP ABSCESS NECK/THORAX
|
Facility
|
OP
|
$8,385.00
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
900501670
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$96.92 |
| Max. Negotiated Rate |
$7,127.25 |
| Rate for Payer: Adventist Health Commercial |
$1,677.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$3,773.25
|
| Rate for Payer: Cash Price |
$3,773.25
|
| Rate for Payer: Cash Price |
$3,773.25
|
| Rate for Payer: Cigna of CA HMO |
$5,366.40
|
| Rate for Payer: Cigna of CA PPO |
$6,204.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,869.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$7,127.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,031.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,324.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,016.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,012.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$6,708.00
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$5,450.25
|
| Rate for Payer: Prime Health Services Commercial |
$7,127.25
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,031.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,192.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,192.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,192.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,192.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC I & D DEEP ABSCESS NECK/THORAX
|
Facility
|
IP
|
$8,385.00
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
900501670
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,677.00 |
| Max. Negotiated Rate |
$7,127.25 |
| Rate for Payer: Adventist Health Commercial |
$1,677.00
|
| Rate for Payer: Cash Price |
$3,773.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,869.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,354.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,354.00
|
| Rate for Payer: Galaxy Health WC |
$7,127.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,031.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,324.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,947.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,012.40
|
| Rate for Payer: Multiplan Commercial |
$6,708.00
|
| Rate for Payer: Networks By Design Commercial |
$5,450.25
|
| Rate for Payer: Prime Health Services Commercial |
$7,127.25
|
|
|
HC I&D DENTOALVEOLAR ABSC/HEMAT
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 41800
|
| Hospital Charge Code |
900501150
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$94.79 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$412.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$934.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cigna of CA HMO |
$643.84
|
| Rate for Payer: Cigna of CA PPO |
$744.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$704.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$638.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$94.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$183.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$804.80
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$603.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$603.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
