|
HC LIFT HEEL AND SOLE PER INCH
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT L3310
|
| Hospital Charge Code |
905353310
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$33.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna of CA HMO |
$117.60
|
| Rate for Payer: Cigna of CA PPO |
$117.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$117.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.20
|
| Rate for Payer: EPIC Health Plan Senior |
$67.20
|
| Rate for Payer: Galaxy Health WC |
$142.80
|
| Rate for Payer: Global Benefits Group Commercial |
$100.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$106.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$99.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.32
|
| Rate for Payer: Multiplan Commercial |
$134.40
|
| Rate for Payer: Networks By Design Commercial |
$109.20
|
| Rate for Payer: Prime Health Services Commercial |
$142.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.05
|
| Rate for Payer: United Healthcare All Other HMO |
$61.37
|
| Rate for Payer: United Healthcare HMO Rider |
$60.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.02
|
|
|
HC LIFT HEEL AND SOLE PER INCH
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT L3310
|
| Hospital Charge Code |
905353310
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.32 |
| Max. Negotiated Rate |
$142.80 |
| Rate for Payer: Adventist Health Commercial |
$68.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$142.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$92.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$126.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$101.69
|
| Rate for Payer: Blue Shield of California Commercial |
$85.18
|
| Rate for Payer: Blue Shield of California Commercial |
$129.19
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cash Price |
$75.60
|
| Rate for Payer: Cigna of CA HMO |
$117.60
|
| Rate for Payer: Cigna of CA PPO |
$117.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$142.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$142.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$142.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$117.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.20
|
| Rate for Payer: EPIC Health Plan Senior |
$67.20
|
| Rate for Payer: Galaxy Health WC |
$142.80
|
| Rate for Payer: Global Benefits Group Commercial |
$100.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$69.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$106.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$78.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$99.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$117.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$117.60
|
| Rate for Payer: Multiplan Commercial |
$134.40
|
| Rate for Payer: Networks By Design Commercial |
$84.00
|
| Rate for Payer: Prime Health Services Commercial |
$142.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$100.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$100.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.05
|
| Rate for Payer: United Healthcare All Other HMO |
$61.37
|
| Rate for Payer: United Healthcare HMO Rider |
$60.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$142.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$142.80
|
| Rate for Payer: Vantage Medical Group Senior |
$142.80
|
|
|
HC LIFT HEEL PER INCH
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT L3334
|
| Hospital Charge Code |
905353334
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$16.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.02
|
| Rate for Payer: United Healthcare All Other HMO |
$29.22
|
| Rate for Payer: United Healthcare HMO Rider |
$28.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.20
|
|
|
HC LIFT HEEL PER INCH
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT L3334
|
| Hospital Charge Code |
915353334
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$16.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$52.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.02
|
| Rate for Payer: United Healthcare All Other HMO |
$29.22
|
| Rate for Payer: United Healthcare HMO Rider |
$28.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.20
|
|
|
HC LIFT HEEL PER INCH
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT L3334
|
| Hospital Charge Code |
915353334
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.28 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Adventist Health Commercial |
$32.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.42
|
| Rate for Payer: Blue Shield of California Commercial |
$61.52
|
| Rate for Payer: Blue Shield of California Commercial |
$40.56
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56.00
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$40.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.02
|
| Rate for Payer: United Healthcare All Other HMO |
$29.22
|
| Rate for Payer: United Healthcare HMO Rider |
$28.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.00
|
| Rate for Payer: Vantage Medical Group Senior |
$68.00
|
|
|
HC LIFT HEEL PER INCH
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT L3334
|
| Hospital Charge Code |
905353334
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.28 |
| Max. Negotiated Rate |
$68.00 |
| Rate for Payer: Adventist Health Commercial |
$32.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.42
|
| Rate for Payer: Blue Shield of California Commercial |
$61.52
|
| Rate for Payer: Blue Shield of California Commercial |
$40.56
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cigna of CA HMO |
$56.00
|
| Rate for Payer: Cigna of CA PPO |
$56.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Senior |
$32.00
|
| Rate for Payer: Galaxy Health WC |
$68.00
|
| Rate for Payer: Global Benefits Group Commercial |
$48.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56.00
|
| Rate for Payer: Multiplan Commercial |
$64.00
|
| Rate for Payer: Networks By Design Commercial |
$40.00
|
| Rate for Payer: Prime Health Services Commercial |
$68.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.02
|
| Rate for Payer: United Healthcare All Other HMO |
$29.22
|
| Rate for Payer: United Healthcare HMO Rider |
$28.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.00
|
| Rate for Payer: Vantage Medical Group Senior |
$68.00
|
|
|
HC LIFT HEEL TAPPERED TO MET/INCH
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT L3300
|
| Hospital Charge Code |
905353300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$24.72 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Adventist Health Commercial |
$42.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$77.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.35
|
| Rate for Payer: Blue Shield of California Commercial |
$79.21
|
| Rate for Payer: Blue Shield of California Commercial |
$52.22
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cigna of CA HMO |
$72.10
|
| Rate for Payer: Cigna of CA PPO |
$72.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$87.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$55.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$65.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72.10
|
| Rate for Payer: Multiplan Commercial |
$82.40
|
| Rate for Payer: Networks By Design Commercial |
$51.50
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.66
|
| Rate for Payer: United Healthcare All Other HMO |
$37.63
|
| Rate for Payer: United Healthcare HMO Rider |
$36.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.55
|
| Rate for Payer: Vantage Medical Group Senior |
$87.55
|
|
|
HC LIFT HEEL TAPPERED TO MET/INCH
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT L3300
|
| Hospital Charge Code |
905353300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$20.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cigna of CA HMO |
$72.10
|
| Rate for Payer: Cigna of CA PPO |
$72.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$65.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.72
|
| Rate for Payer: Multiplan Commercial |
$82.40
|
| Rate for Payer: Networks By Design Commercial |
$66.95
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.66
|
| Rate for Payer: United Healthcare All Other HMO |
$37.63
|
| Rate for Payer: United Healthcare HMO Rider |
$36.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.73
|
|
|
HC LIFT HEEL TAPPERED TO MET/INCH
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT L3300
|
| Hospital Charge Code |
915353300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$20.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cigna of CA HMO |
$72.10
|
| Rate for Payer: Cigna of CA PPO |
$72.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$65.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.72
|
| Rate for Payer: Multiplan Commercial |
$82.40
|
| Rate for Payer: Networks By Design Commercial |
$66.95
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.66
|
| Rate for Payer: United Healthcare All Other HMO |
$37.63
|
| Rate for Payer: United Healthcare HMO Rider |
$36.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.73
|
|
|
HC LIFT HEEL TAPPERED TO MET/INCH
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT L3300
|
| Hospital Charge Code |
915353300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$24.72 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Adventist Health Commercial |
$42.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$77.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.35
|
| Rate for Payer: Blue Shield of California Commercial |
$79.21
|
| Rate for Payer: Blue Shield of California Commercial |
$52.22
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cigna of CA HMO |
$72.10
|
| Rate for Payer: Cigna of CA PPO |
$72.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$87.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$55.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$65.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72.10
|
| Rate for Payer: Multiplan Commercial |
$82.40
|
| Rate for Payer: Networks By Design Commercial |
$51.50
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$38.66
|
| Rate for Payer: United Healthcare All Other HMO |
$37.63
|
| Rate for Payer: United Healthcare HMO Rider |
$36.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.55
|
| Rate for Payer: Vantage Medical Group Senior |
$87.55
|
|
|
HC LIFT INSIDE SHOE TAPERED
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT L3332
|
| Hospital Charge Code |
915353332
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna of CA HMO |
$126.00
|
| Rate for Payer: Cigna of CA PPO |
$126.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.20
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.55
|
| Rate for Payer: United Healthcare All Other HMO |
$65.75
|
| Rate for Payer: United Healthcare HMO Rider |
$64.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.95
|
|
|
HC LIFT INSIDE SHOE TAPERED
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT L3332
|
| Hospital Charge Code |
905353332
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna of CA HMO |
$126.00
|
| Rate for Payer: Cigna of CA PPO |
$126.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.20
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.55
|
| Rate for Payer: United Healthcare All Other HMO |
$65.75
|
| Rate for Payer: United Healthcare HMO Rider |
$64.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.95
|
|
|
HC LIFT INSIDE SHOE TAPERED
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT L3332
|
| Hospital Charge Code |
905353332
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$43.20 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$73.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.95
|
| Rate for Payer: Blue Shield of California Commercial |
$91.26
|
| Rate for Payer: Blue Shield of California Commercial |
$138.42
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna of CA HMO |
$126.00
|
| Rate for Payer: Cigna of CA PPO |
$126.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$153.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$153.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$65.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$74.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$90.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.55
|
| Rate for Payer: United Healthcare All Other HMO |
$65.75
|
| Rate for Payer: United Healthcare HMO Rider |
$64.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC LIFT INSIDE SHOE TAPERED
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT L3332
|
| Hospital Charge Code |
915353332
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$43.20 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$73.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.95
|
| Rate for Payer: Blue Shield of California Commercial |
$91.26
|
| Rate for Payer: Blue Shield of California Commercial |
$138.42
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna of CA HMO |
$126.00
|
| Rate for Payer: Cigna of CA PPO |
$126.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$153.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$153.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$126.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$65.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$114.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$74.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$90.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$67.55
|
| Rate for Payer: United Healthcare All Other HMO |
$65.75
|
| Rate for Payer: United Healthcare HMO Rider |
$64.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC LIGATION/BIOPSY,TEMP ARTERY
|
Facility
|
IP
|
$6,055.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
900501523
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,211.00 |
| Max. Negotiated Rate |
$5,146.75 |
| Rate for Payer: Adventist Health Commercial |
$1,211.00
|
| Rate for Payer: Cash Price |
$2,724.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,238.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,422.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,422.00
|
| Rate for Payer: Galaxy Health WC |
$5,146.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,633.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,844.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,572.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,453.20
|
| Rate for Payer: Multiplan Commercial |
$4,844.00
|
| Rate for Payer: Networks By Design Commercial |
$3,935.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,146.75
|
|
|
HC LIGATION/BIOPSY,TEMP ARTERY
|
Facility
|
OP
|
$6,055.00
|
|
|
Service Code
|
CPT 37609
|
| Hospital Charge Code |
900501523
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$973.00 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$1,211.00
|
| 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 |
$2,724.75
|
| Rate for Payer: Cash Price |
$2,724.75
|
| Rate for Payer: Cash Price |
$2,724.75
|
| Rate for Payer: Cigna of CA HMO |
$3,875.20
|
| Rate for Payer: Cigna of CA PPO |
$4,480.70
|
| 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 |
$4,238.50
|
| 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 |
$5,146.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,633.00
|
| 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 |
$3,844.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,453.20
|
| 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 |
$4,844.00
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,935.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,146.75
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,633.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,027.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,027.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,027.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,027.50
|
| 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 LIGATION DIV/EXC VARICOSEVEIN
|
Facility
|
IP
|
$12,821.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
900501325
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,564.20 |
| Max. Negotiated Rate |
$10,897.85 |
| Rate for Payer: Adventist Health Commercial |
$2,564.20
|
| Rate for Payer: Cash Price |
$5,769.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,974.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,128.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,128.40
|
| Rate for Payer: Galaxy Health WC |
$10,897.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,692.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,141.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,564.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,077.04
|
| Rate for Payer: Multiplan Commercial |
$10,256.80
|
| Rate for Payer: Networks By Design Commercial |
$8,333.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,897.85
|
|
|
HC LIGATION DIV/EXC VARICOSEVEIN
|
Facility
|
OP
|
$12,821.00
|
|
|
Service Code
|
CPT 37785
|
| Hospital Charge Code |
900501325
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$357.92 |
| Max. Negotiated Rate |
$10,897.85 |
| Rate for Payer: Adventist Health Commercial |
$2,564.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$5,769.45
|
| Rate for Payer: Cash Price |
$5,769.45
|
| Rate for Payer: Cash Price |
$5,769.45
|
| Rate for Payer: Cigna of CA HMO |
$8,205.44
|
| Rate for Payer: Cigna of CA PPO |
$9,487.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,974.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$10,897.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,692.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,141.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$357.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,365.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,077.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$10,256.80
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$8,333.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,897.85
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,692.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,410.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,410.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,410.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,410.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
|
IP
|
$4,963.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$992.60 |
| Max. Negotiated Rate |
$4,218.55 |
| Rate for Payer: Adventist Health Commercial |
$992.60
|
| Rate for Payer: Cash Price |
$2,233.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,474.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,985.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,985.20
|
| Rate for Payer: Galaxy Health WC |
$4,218.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,977.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,151.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,928.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.12
|
| Rate for Payer: Multiplan Commercial |
$3,970.40
|
| Rate for Payer: Networks By Design Commercial |
$3,225.95
|
| Rate for Payer: Prime Health Services Commercial |
$4,218.55
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
|
OP
|
$4,963.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$129.48 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$992.60
|
| Rate for Payer: Adventist Health Commercial |
$593.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$2,233.35
|
| Rate for Payer: Cash Price |
$2,233.35
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$2,233.35
|
| Rate for Payer: Cigna of CA HMO |
$3,176.32
|
| Rate for Payer: Cigna of CA HMO |
$1,899.52
|
| Rate for Payer: Cigna of CA PPO |
$2,196.32
|
| Rate for Payer: Cigna of CA PPO |
$3,672.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,474.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,218.55
|
| Rate for Payer: Galaxy Health WC |
$2,522.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,780.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,977.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$129.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$129.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,151.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,884.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$712.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,507.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,507.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$2,374.40
|
| Rate for Payer: Multiplan Commercial |
$3,970.40
|
| Rate for Payer: Networks By Design Commercial |
$3,225.95
|
| Rate for Payer: Networks By Design Commercial |
$1,929.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,218.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,522.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,977.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,780.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,484.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,481.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
|
IP
|
$4,963.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$992.60 |
| Max. Negotiated Rate |
$4,218.55 |
| Rate for Payer: Adventist Health Commercial |
$992.60
|
| Rate for Payer: Cash Price |
$2,233.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,474.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,985.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,985.20
|
| Rate for Payer: Galaxy Health WC |
$4,218.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,977.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,151.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,928.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.12
|
| Rate for Payer: Multiplan Commercial |
$3,970.40
|
| Rate for Payer: Networks By Design Commercial |
$3,225.95
|
| Rate for Payer: Prime Health Services Commercial |
$4,218.55
|
|
|
HC LIGATION HEMORRHOID(S)
|
Facility
|
OP
|
$2,968.00
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
906746221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$146.43 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$593.60
|
| Rate for Payer: Adventist Health Commercial |
$992.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$2,233.35
|
| Rate for Payer: Cash Price |
$2,233.35
|
| Rate for Payer: Cash Price |
$1,335.60
|
| Rate for Payer: Cash Price |
$2,233.35
|
| Rate for Payer: Cigna of CA HMO |
$3,176.32
|
| Rate for Payer: Cigna of CA HMO |
$1,899.52
|
| Rate for Payer: Cigna of CA PPO |
$2,196.32
|
| Rate for Payer: Cigna of CA PPO |
$3,672.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,474.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$2,522.80
|
| Rate for Payer: Galaxy Health WC |
$4,218.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,977.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,780.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,884.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,151.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$712.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,191.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,507.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,507.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,970.40
|
| Rate for Payer: Multiplan Commercial |
$2,374.40
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$3,225.95
|
| Rate for Payer: Networks By Design Commercial |
$1,929.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,522.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,218.55
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,977.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,780.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,484.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,481.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,481.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,484.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,484.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,481.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,484.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,481.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC LIGATION OF NECK ARTERY
|
Facility
|
IP
|
$4,251.00
|
|
|
Service Code
|
CPT 37615
|
| Hospital Charge Code |
900501435
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$850.20 |
| Max. Negotiated Rate |
$3,613.35 |
| Rate for Payer: Adventist Health Commercial |
$850.20
|
| Rate for Payer: Cash Price |
$1,912.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,975.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,700.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,700.40
|
| Rate for Payer: Galaxy Health WC |
$3,613.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,550.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,699.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,508.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.24
|
| Rate for Payer: Multiplan Commercial |
$3,400.80
|
| Rate for Payer: Networks By Design Commercial |
$2,763.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,613.35
|
|
|
HC LIGATION OF NECK ARTERY
|
Facility
|
OP
|
$4,251.00
|
|
|
Service Code
|
CPT 37615
|
| Hospital Charge Code |
900501435
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$850.20 |
| Max. Negotiated Rate |
$8,240.00 |
| Rate for Payer: Adventist Health Commercial |
$850.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$1,912.95
|
| Rate for Payer: Cash Price |
$1,912.95
|
| Rate for Payer: Cash Price |
$1,912.95
|
| Rate for Payer: Cigna of CA HMO |
$2,720.64
|
| Rate for Payer: Cigna of CA PPO |
$3,145.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,975.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$3,613.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,550.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,699.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,365.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$3,400.80
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$2,763.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,613.35
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,550.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,125.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,125.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,125.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,125.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC LIMB MUSCLE TESTING MANUAL MCAL
|
Facility
|
IP
|
$367.00
|
|
|
Service Code
|
CPT 95831
|
| Hospital Charge Code |
900400008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$311.95 |
| Rate for Payer: Adventist Health Commercial |
$73.40
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.80
|
| Rate for Payer: EPIC Health Plan Senior |
$146.80
|
| Rate for Payer: Galaxy Health WC |
$311.95
|
| Rate for Payer: Global Benefits Group Commercial |
$220.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$216.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.08
|
| Rate for Payer: Multiplan Commercial |
$293.60
|
| Rate for Payer: Networks By Design Commercial |
$238.55
|
| Rate for Payer: Prime Health Services Commercial |
$311.95
|
|
