|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
IP
|
$14,750.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,950.00 |
| Max. Negotiated Rate |
$12,537.50 |
| Rate for Payer: EPIC Health Plan Senior |
$5,900.00
|
| Rate for Payer: Galaxy Health WC |
$12,537.50
|
| Rate for Payer: Adventist Health Commercial |
$2,950.00
|
| Rate for Payer: Cash Price |
$6,637.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,900.00
|
| Rate for Payer: Global Benefits Group Commercial |
$8,850.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,838.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,619.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,130.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,540.00
|
| Rate for Payer: Multiplan Commercial |
$11,800.00
|
| Rate for Payer: Networks By Design Commercial |
$9,587.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,537.50
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
OP
|
$14,750.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$212.65 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,950.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,822.94
|
| Rate for Payer: Cash Price |
$6,637.50
|
| Rate for Payer: Cash Price |
$6,637.50
|
| Rate for Payer: Cash Price |
$6,637.50
|
| Rate for Payer: Cigna of CA HMO |
$9,440.00
|
| Rate for Payer: Cigna of CA PPO |
$10,915.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$12,537.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,850.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$212.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,838.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,540.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$11,800.00
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$9,587.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,537.50
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,850.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
OP
|
$15,628.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.58 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$3,125.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$7,032.60
|
| Rate for Payer: Cash Price |
$7,032.60
|
| Rate for Payer: Cash Price |
$7,032.60
|
| Rate for Payer: Cigna of CA HMO |
$10,001.92
|
| Rate for Payer: Cigna of CA PPO |
$11,564.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$13,283.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,376.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$436.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,423.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,750.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$12,502.40
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$10,158.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,283.80
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,376.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
IP
|
$15,628.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,125.60 |
| Max. Negotiated Rate |
$13,283.80 |
| Rate for Payer: Adventist Health Commercial |
$3,125.60
|
| Rate for Payer: Cash Price |
$7,032.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,251.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,251.20
|
| Rate for Payer: Galaxy Health WC |
$13,283.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,376.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,423.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,954.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,673.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,750.72
|
| Rate for Payer: Multiplan Commercial |
$12,502.40
|
| Rate for Payer: Networks By Design Commercial |
$10,158.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,283.80
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
IP
|
$13,590.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,718.00 |
| Max. Negotiated Rate |
$11,551.50 |
| Rate for Payer: Adventist Health Commercial |
$2,718.00
|
| Rate for Payer: Cash Price |
$6,115.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,436.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,436.00
|
| Rate for Payer: Galaxy Health WC |
$11,551.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,154.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,064.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,177.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,412.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,261.60
|
| Rate for Payer: Multiplan Commercial |
$10,872.00
|
| Rate for Payer: Networks By Design Commercial |
$8,833.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,551.50
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
OP
|
$13,590.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$493.75 |
| Max. Negotiated Rate |
$11,551.50 |
| Rate for Payer: Adventist Health Commercial |
$2,718.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$6,115.50
|
| Rate for Payer: Cash Price |
$6,115.50
|
| Rate for Payer: Cash Price |
$6,115.50
|
| Rate for Payer: Cigna of CA HMO |
$8,697.60
|
| Rate for Payer: Cigna of CA PPO |
$10,056.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$11,551.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,154.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,064.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,261.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$10,872.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$8,833.50
|
| Rate for Payer: Prime Health Services Commercial |
$11,551.50
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,154.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,795.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,795.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,795.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,795.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INS SUBQ CAR RHYTHM MTR W PRGM
|
Facility
|
IP
|
$17,341.00
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
906813406
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,468.20 |
| Max. Negotiated Rate |
$14,739.85 |
| Rate for Payer: Adventist Health Commercial |
$3,468.20
|
| Rate for Payer: Cash Price |
$7,803.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,936.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,936.40
|
| Rate for Payer: Galaxy Health WC |
$14,739.85
|
| Rate for Payer: Global Benefits Group Commercial |
$10,404.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,566.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,606.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,734.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,161.84
|
| Rate for Payer: Multiplan Commercial |
$13,872.80
|
| Rate for Payer: Networks By Design Commercial |
$11,271.65
|
| Rate for Payer: Prime Health Services Commercial |
$14,739.85
|
|
|
HC INS SUBQ CAR RHYTHM MTR W PRGM
|
Facility
|
OP
|
$16,853.00
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
906820138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,370.60 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$3,370.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$7,583.85
|
| Rate for Payer: Cash Price |
$7,583.85
|
| Rate for Payer: Cash Price |
$7,583.85
|
| Rate for Payer: Cigna of CA HMO |
$10,785.92
|
| Rate for Payer: Cigna of CA PPO |
$12,471.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$14,325.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10,111.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8,126.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,240.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,190.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,044.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$13,482.40
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$10,954.45
|
| Rate for Payer: Prime Health Services Commercial |
$14,325.05
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,111.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC INS SUBQ CAR RHYTHM MTR W PRGM
|
Facility
|
IP
|
$16,853.00
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
906820138
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,370.60 |
| Max. Negotiated Rate |
$14,325.05 |
| Rate for Payer: Adventist Health Commercial |
$3,370.60
|
| Rate for Payer: Cash Price |
$7,583.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,741.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,741.20
|
| Rate for Payer: Galaxy Health WC |
$14,325.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10,111.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,240.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,420.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,432.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,044.72
|
| Rate for Payer: Multiplan Commercial |
$13,482.40
|
| Rate for Payer: Networks By Design Commercial |
$10,954.45
|
| Rate for Payer: Prime Health Services Commercial |
$14,325.05
|
|
|
HC INS SUBQ CAR RHYTHM MTR W PRGM
|
Facility
|
OP
|
$17,341.00
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
906813406
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,429.00 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$3,468.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,515.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$7,803.45
|
| Rate for Payer: Cash Price |
$7,803.45
|
| Rate for Payer: Cash Price |
$7,803.45
|
| Rate for Payer: Cigna of CA HMO |
$11,098.24
|
| Rate for Payer: Cigna of CA PPO |
$12,832.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,567.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,515.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,195.87
|
| Rate for Payer: EPIC Health Plan Senior |
$10,515.46
|
| Rate for Payer: Galaxy Health WC |
$14,739.85
|
| Rate for Payer: Global Benefits Group Commercial |
$10,404.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,245.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8,126.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,515.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,566.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,190.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,515.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,161.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,249.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,090.72
|
| Rate for Payer: Multiplan Commercial |
$13,872.80
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$11,271.65
|
| Rate for Payer: Prime Health Services Commercial |
$14,739.85
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,404.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,515.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,773.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,567.01
|
| Rate for Payer: Vantage Medical Group Senior |
$10,515.46
|
|
|
HC INST WAVE FREE RATIO WO STRESS AGENT
|
Facility
|
IP
|
$10,781.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820291
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,156.20 |
| Max. Negotiated Rate |
$9,163.85 |
| Rate for Payer: Adventist Health Commercial |
$2,156.20
|
| Rate for Payer: Cash Price |
$4,851.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,312.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,312.40
|
| Rate for Payer: Galaxy Health WC |
$9,163.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,468.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,190.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,107.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,673.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,587.44
|
| Rate for Payer: Multiplan Commercial |
$8,624.80
|
| Rate for Payer: Networks By Design Commercial |
$7,007.65
|
| Rate for Payer: Prime Health Services Commercial |
$9,163.85
|
|
|
HC INST WAVE FREE RATIO WO STRESS AGENT
|
Facility
|
IP
|
$9,164.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906803801
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,832.80 |
| Max. Negotiated Rate |
$7,789.40 |
| Rate for Payer: Adventist Health Commercial |
$1,832.80
|
| Rate for Payer: Cash Price |
$4,123.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,665.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,665.60
|
| Rate for Payer: Galaxy Health WC |
$7,789.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,498.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,112.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,491.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,672.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,199.36
|
| Rate for Payer: Multiplan Commercial |
$7,331.20
|
| Rate for Payer: Networks By Design Commercial |
$5,956.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,789.40
|
|
|
HC INST WAVE FREE RATIO WO STRESS AGENT
|
Facility
|
OP
|
$9,164.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906803801
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$7,789.40 |
| Rate for Payer: Adventist Health Commercial |
$1,832.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,010.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,627.61
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$4,123.80
|
| Rate for Payer: Cash Price |
$4,123.80
|
| Rate for Payer: Cash Price |
$4,123.80
|
| Rate for Payer: Cigna of CA HMO |
$5,864.96
|
| Rate for Payer: Cigna of CA PPO |
$6,781.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.38
|
| Rate for Payer: EPIC Health Plan Senior |
$198.80
|
| Rate for Payer: Galaxy Health WC |
$7,789.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,498.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,112.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,199.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.39
|
| Rate for Payer: Multiplan Commercial |
$7,331.20
|
| Rate for Payer: Networks By Design Commercial |
$5,956.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,789.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,498.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,498.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$198.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC INST WAVE FREE RATIO WO STRESS AGENT
|
Facility
|
OP
|
$10,781.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906820291
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$9,163.85 |
| Rate for Payer: Adventist Health Commercial |
$2,156.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,071.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,620.61
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$4,851.45
|
| Rate for Payer: Cash Price |
$4,851.45
|
| Rate for Payer: Cash Price |
$4,851.45
|
| Rate for Payer: Cigna of CA HMO |
$6,899.84
|
| Rate for Payer: Cigna of CA PPO |
$7,977.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.38
|
| Rate for Payer: EPIC Health Plan Senior |
$198.80
|
| Rate for Payer: Galaxy Health WC |
$9,163.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,468.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,190.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,587.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.39
|
| Rate for Payer: Multiplan Commercial |
$8,624.80
|
| Rate for Payer: Networks By Design Commercial |
$7,007.65
|
| Rate for Payer: Prime Health Services Commercial |
$9,163.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,468.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,468.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$198.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC INSULIN
|
Facility
|
OP
|
$41.08
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
900912130
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.22 |
| Max. Negotiated Rate |
$112.91 |
| Rate for Payer: Adventist Health Commercial |
$8.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.91
|
| Rate for Payer: Blue Shield of California Commercial |
$27.48
|
| Rate for Payer: Blue Shield of California EPN |
$18.16
|
| Rate for Payer: Cash Price |
$18.49
|
| Rate for Payer: Cash Price |
$18.49
|
| Rate for Payer: Cigna of CA HMO |
$26.29
|
| Rate for Payer: Cigna of CA PPO |
$30.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.43
|
| Rate for Payer: EPIC Health Plan Senior |
$11.43
|
| Rate for Payer: Galaxy Health WC |
$34.92
|
| Rate for Payer: Global Benefits Group Commercial |
$24.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.32
|
| Rate for Payer: Multiplan Commercial |
$32.86
|
| Rate for Payer: Networks By Design Commercial |
$26.70
|
| Rate for Payer: Prime Health Services Commercial |
$34.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.26
|
| Rate for Payer: United Healthcare All Other HMO |
$9.26
|
| Rate for Payer: United Healthcare HMO Rider |
$9.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.57
|
| Rate for Payer: Vantage Medical Group Senior |
$11.43
|
|
|
HC INSULIN
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
900912130
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.80 |
| Max. Negotiated Rate |
$152.15 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.60
|
| Rate for Payer: EPIC Health Plan Senior |
$71.60
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.96
|
| Rate for Payer: Multiplan Commercial |
$143.20
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
|
|
HC INTACT PTH
|
Facility
|
OP
|
$236.47
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
900910942
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.44 |
| Max. Negotiated Rate |
$407.69 |
| Rate for Payer: Adventist Health Commercial |
$47.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$155.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$407.69
|
| Rate for Payer: Blue Shield of California Commercial |
$158.20
|
| Rate for Payer: Blue Shield of California EPN |
$104.52
|
| Rate for Payer: Cash Price |
$106.41
|
| Rate for Payer: Cash Price |
$106.41
|
| Rate for Payer: Cigna of CA HMO |
$151.34
|
| Rate for Payer: Cigna of CA PPO |
$174.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.73
|
| Rate for Payer: EPIC Health Plan Senior |
$41.28
|
| Rate for Payer: Galaxy Health WC |
$201.00
|
| Rate for Payer: Global Benefits Group Commercial |
$141.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$67.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$58.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$157.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$52.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55.32
|
| Rate for Payer: Multiplan Commercial |
$189.18
|
| Rate for Payer: Networks By Design Commercial |
$153.71
|
| Rate for Payer: Prime Health Services Commercial |
$201.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.44
|
| Rate for Payer: United Healthcare All Other HMO |
$33.44
|
| Rate for Payer: United Healthcare HMO Rider |
$33.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.44
|
| Rate for Payer: Upland Medical Group Pediatric |
$41.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.41
|
| Rate for Payer: Vantage Medical Group Senior |
$41.28
|
|
|
HC INTACT PTH
|
Facility
|
IP
|
$763.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
900910942
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$152.60 |
| Max. Negotiated Rate |
$648.55 |
| Rate for Payer: Adventist Health Commercial |
$152.60
|
| Rate for Payer: Cash Price |
$343.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.20
|
| Rate for Payer: EPIC Health Plan Senior |
$305.20
|
| Rate for Payer: Galaxy Health WC |
$648.55
|
| Rate for Payer: Global Benefits Group Commercial |
$457.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$508.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$290.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$472.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$183.12
|
| Rate for Payer: Multiplan Commercial |
$610.40
|
| Rate for Payer: Networks By Design Commercial |
$495.95
|
| Rate for Payer: Prime Health Services Commercial |
$648.55
|
|
|
HC INT AUDITORY MEATUS
|
Facility
|
OP
|
$673.00
|
|
|
Service Code
|
CPT 70134
|
| Hospital Charge Code |
909001133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$77.01 |
| Max. Negotiated Rate |
$1,142.54 |
| Rate for Payer: Adventist Health Commercial |
$134.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$441.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$696.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$209.47
|
| Rate for Payer: Blue Shield of California Commercial |
$411.88
|
| Rate for Payer: Blue Shield of California EPN |
$271.89
|
| Rate for Payer: Cash Price |
$302.85
|
| Rate for Payer: Cash Price |
$302.85
|
| Rate for Payer: Cigna of CA HMO |
$430.72
|
| Rate for Payer: Cigna of CA PPO |
$498.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$696.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$940.50
|
| Rate for Payer: EPIC Health Plan Senior |
$696.67
|
| Rate for Payer: Galaxy Health WC |
$572.05
|
| Rate for Payer: Global Benefits Group Commercial |
$403.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,142.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$77.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$696.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$448.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$696.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$877.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$933.54
|
| Rate for Payer: Multiplan Commercial |
$538.40
|
| Rate for Payer: Networks By Design Commercial |
$437.45
|
| Rate for Payer: Prime Health Services Commercial |
$572.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$403.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$403.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$193.23
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$193.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$696.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,045.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.34
|
| Rate for Payer: Vantage Medical Group Senior |
$696.67
|
|
|
HC INT AUDITORY MEATUS
|
Facility
|
IP
|
$673.00
|
|
|
Service Code
|
CPT 70134
|
| Hospital Charge Code |
909001133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$134.60 |
| Max. Negotiated Rate |
$572.05 |
| Rate for Payer: Adventist Health Commercial |
$134.60
|
| Rate for Payer: Cash Price |
$302.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$269.20
|
| Rate for Payer: EPIC Health Plan Senior |
$269.20
|
| Rate for Payer: Galaxy Health WC |
$572.05
|
| Rate for Payer: Global Benefits Group Commercial |
$403.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$448.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$256.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$416.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.52
|
| Rate for Payer: Multiplan Commercial |
$538.40
|
| Rate for Payer: Networks By Design Commercial |
$437.45
|
| Rate for Payer: Prime Health Services Commercial |
$572.05
|
|
|
HC INTENSITY MOD RADIO TX PLAN
|
Facility
|
IP
|
$6,270.00
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
909100275
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,254.00 |
| Max. Negotiated Rate |
$5,329.50 |
| Rate for Payer: Adventist Health Commercial |
$1,254.00
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,508.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,508.00
|
| Rate for Payer: Galaxy Health WC |
$5,329.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,762.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,182.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,388.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,881.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,504.80
|
| Rate for Payer: Multiplan Commercial |
$5,016.00
|
| Rate for Payer: Networks By Design Commercial |
$4,075.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,329.50
|
|
|
HC INTENSITY MOD RADIO TX PLAN
|
Facility
|
OP
|
$6,270.00
|
|
|
Service Code
|
CPT 77301
|
| Hospital Charge Code |
909100275
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,221.00 |
| Max. Negotiated Rate |
$7,523.40 |
| Rate for Payer: Adventist Health Commercial |
$1,254.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,112.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,607.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,912.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,738.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,523.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,837.24
|
| Rate for Payer: Blue Shield of California EPN |
$2,533.08
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Cigna of CA HMO |
$4,012.80
|
| Rate for Payer: Cigna of CA PPO |
$4,639.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,607.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,912.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,738.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,346.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,738.51
|
| Rate for Payer: Galaxy Health WC |
$5,329.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,762.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,851.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,078.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,738.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,182.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,350.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,738.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,504.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,190.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,329.60
|
| Rate for Payer: Multiplan Commercial |
$5,016.00
|
| Rate for Payer: Networks By Design Commercial |
$4,075.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,329.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,762.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,738.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,607.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,912.36
|
| Rate for Payer: Vantage Medical Group Senior |
$1,738.51
|
|
|
HC INTERCOSTAL NERVE BLOCK SINGLE
|
Facility
|
OP
|
$1,857.00
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
900501673
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.18 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$371.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$835.65
|
| Rate for Payer: Cash Price |
$835.65
|
| Rate for Payer: Cash Price |
$835.65
|
| Rate for Payer: Cigna of CA HMO |
$1,188.48
|
| Rate for Payer: Cigna of CA PPO |
$1,374.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$967.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$879.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,187.89
|
| Rate for Payer: EPIC Health Plan Senior |
$879.92
|
| Rate for Payer: Galaxy Health WC |
$1,578.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,114.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,443.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,238.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$445.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,108.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,179.09
|
| Rate for Payer: Multiplan Commercial |
$1,485.60
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$1,207.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,578.45
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,114.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$928.50
|
| Rate for Payer: United Healthcare All Other HMO |
$928.50
|
| Rate for Payer: United Healthcare HMO Rider |
$928.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$928.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$879.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,319.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$967.91
|
| Rate for Payer: Vantage Medical Group Senior |
$879.92
|
|
|
HC INTERCOSTAL NERVE BLOCK SINGLE
|
Facility
|
IP
|
$1,857.00
|
|
|
Service Code
|
CPT 64420
|
| Hospital Charge Code |
900501673
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$371.40 |
| Max. Negotiated Rate |
$1,578.45 |
| Rate for Payer: Adventist Health Commercial |
$371.40
|
| Rate for Payer: Cash Price |
$835.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$742.80
|
| Rate for Payer: EPIC Health Plan Senior |
$742.80
|
| Rate for Payer: Galaxy Health WC |
$1,578.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,114.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,238.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$707.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,149.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$445.68
|
| Rate for Payer: Multiplan Commercial |
$1,485.60
|
| Rate for Payer: Networks By Design Commercial |
$1,207.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,578.45
|
|
|
HC INTERDENTAL WIRING,OTH THN FRX
|
Facility
|
OP
|
$10,260.00
|
|
|
Service Code
|
CPT 21497
|
| Hospital Charge Code |
900501322
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$101.16 |
| Max. Negotiated Rate |
$8,721.00 |
| Rate for Payer: Adventist Health Commercial |
$2,052.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,882.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$4,617.00
|
| Rate for Payer: Cash Price |
$4,617.00
|
| Rate for Payer: Cash Price |
$4,617.00
|
| Rate for Payer: Cigna of CA HMO |
$6,566.40
|
| Rate for Payer: Cigna of CA PPO |
$7,592.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,070.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,882.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.85
|
| Rate for Payer: EPIC Health Plan Senior |
$1,882.11
|
| Rate for Payer: Galaxy Health WC |
$8,721.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,156.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,086.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,882.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,843.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,882.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,462.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,371.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,522.03
|
| Rate for Payer: Multiplan Commercial |
$8,208.00
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$6,669.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,721.00
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,156.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,130.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,130.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,130.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,130.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,882.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,882.11
|
|
