|
HC MR ANGIO PELVIS WO FOL W CONT
|
Facility
|
IP
|
$4,972.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801099
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$994.40 |
| Max. Negotiated Rate |
$4,226.20 |
| Rate for Payer: Adventist Health Commercial |
$994.40
|
| Rate for Payer: Cash Price |
$2,237.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,480.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,988.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,988.80
|
| Rate for Payer: Galaxy Health WC |
$4,226.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,983.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,157.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,933.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,193.28
|
| Rate for Payer: Multiplan Commercial |
$3,977.60
|
| Rate for Payer: Networks By Design Commercial |
$3,231.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,226.20
|
|
|
HC MR ANGIO PELVIS WO FOL W CONT
|
Facility
|
IP
|
$4,972.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801034
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$994.40 |
| Max. Negotiated Rate |
$4,226.20 |
| Rate for Payer: Adventist Health Commercial |
$994.40
|
| Rate for Payer: Cash Price |
$2,237.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,480.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,988.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,988.80
|
| Rate for Payer: Galaxy Health WC |
$4,226.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,983.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,157.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,933.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,193.28
|
| Rate for Payer: Multiplan Commercial |
$3,977.60
|
| Rate for Payer: Networks By Design Commercial |
$3,231.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,226.20
|
|
|
HC MR ANGIO SPINAL CAN W OR WO CO
|
Facility
|
OP
|
$3,238.00
|
|
|
Service Code
|
CPT 72159
|
| Hospital Charge Code |
908801033
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$572.83 |
| Max. Negotiated Rate |
$2,752.30 |
| Rate for Payer: Adventist Health Commercial |
$647.60
|
| Rate for Payer: Adventist Health Commercial |
$539.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,752.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,291.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,482.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,780.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,022.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,428.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,730.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,077.82
|
| Rate for Payer: Blue Shield of California Commercial |
$2,065.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,720.05
|
| Rate for Payer: Blue Shield of California Commercial |
$1,135.02
|
| Rate for Payer: Blue Shield of California Commercial |
$1,363.20
|
| Rate for Payer: Cash Price |
$1,213.20
|
| Rate for Payer: Cash Price |
$1,457.10
|
| Rate for Payer: Cash Price |
$1,457.10
|
| Rate for Payer: Cash Price |
$1,213.20
|
| Rate for Payer: Cigna of CA HMO |
$2,072.32
|
| Rate for Payer: Cigna of CA HMO |
$1,725.44
|
| Rate for Payer: Cigna of CA PPO |
$1,995.04
|
| Rate for Payer: Cigna of CA PPO |
$2,396.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,291.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,752.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,291.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,752.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,291.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,752.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,266.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,887.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,295.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,078.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,295.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,078.40
|
| Rate for Payer: Galaxy Health WC |
$2,752.30
|
| Rate for Payer: Galaxy Health WC |
$2,291.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,617.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,942.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$572.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$572.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,056.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,711.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$647.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$647.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,590.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,910.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$647.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$777.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,266.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,887.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,266.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,887.20
|
| Rate for Payer: Multiplan Commercial |
$2,590.40
|
| Rate for Payer: Multiplan Commercial |
$2,156.80
|
| Rate for Payer: Networks By Design Commercial |
$1,752.40
|
| Rate for Payer: Networks By Design Commercial |
$2,104.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,752.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,291.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,617.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,942.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,942.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,617.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,168.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,168.48
|
| Rate for Payer: United Healthcare All Other HMO |
$1,168.48
|
| Rate for Payer: United Healthcare All Other HMO |
$1,168.48
|
| Rate for Payer: United Healthcare HMO Rider |
$1,168.48
|
| Rate for Payer: United Healthcare HMO Rider |
$1,168.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,168.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,168.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,752.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,291.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,291.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,752.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2,752.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2,291.60
|
|
|
HC MR ANGIO SPINAL CAN W OR WO CO
|
Facility
|
IP
|
$3,238.00
|
|
|
Service Code
|
CPT 72159
|
| Hospital Charge Code |
908801033
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$647.60 |
| Max. Negotiated Rate |
$2,752.30 |
| Rate for Payer: Adventist Health Commercial |
$647.60
|
| Rate for Payer: Cash Price |
$1,457.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,266.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,295.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,295.20
|
| Rate for Payer: Galaxy Health WC |
$2,752.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,942.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,056.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,910.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$777.12
|
| Rate for Payer: Multiplan Commercial |
$2,590.40
|
| Rate for Payer: Networks By Design Commercial |
$2,104.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,752.30
|
|
|
HC MR ANGIO UPPER EXT W/WO CONTR
|
Facility
|
IP
|
$2,910.00
|
|
|
Service Code
|
CPT 73225
|
| Hospital Charge Code |
908801035
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$582.00 |
| Max. Negotiated Rate |
$2,473.50 |
| Rate for Payer: Adventist Health Commercial |
$582.00
|
| Rate for Payer: Cash Price |
$1,309.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,037.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,164.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,164.00
|
| Rate for Payer: Galaxy Health WC |
$2,473.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,746.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,847.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,716.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$698.40
|
| Rate for Payer: Multiplan Commercial |
$2,328.00
|
| Rate for Payer: Networks By Design Commercial |
$1,891.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,473.50
|
|
|
HC MR ANGIO UPPER EXT W/WO CONTR
|
Facility
|
OP
|
$2,531.00
|
|
|
Service Code
|
CPT 73225
|
| Hospital Charge Code |
908801035
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$506.20 |
| Max. Negotiated Rate |
$3,443.00 |
| Rate for Payer: Adventist Health Commercial |
$506.20
|
| Rate for Payer: Adventist Health Commercial |
$582.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,151.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,473.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,600.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,392.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,898.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,182.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,867.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,624.14
|
| Rate for Payer: Blue Shield of California Commercial |
$1,614.78
|
| Rate for Payer: Blue Shield of California Commercial |
$1,065.55
|
| Rate for Payer: Blue Shield of California Commercial |
$1,225.11
|
| Rate for Payer: Blue Shield of California Commercial |
$1,856.58
|
| Rate for Payer: Cash Price |
$1,309.50
|
| Rate for Payer: Cash Price |
$1,138.95
|
| Rate for Payer: Cash Price |
$1,309.50
|
| Rate for Payer: Cash Price |
$1,138.95
|
| Rate for Payer: Cash Price |
$1,138.95
|
| Rate for Payer: Cash Price |
$1,309.50
|
| Rate for Payer: Cigna of CA HMO |
$1,619.84
|
| Rate for Payer: Cigna of CA HMO |
$1,862.40
|
| Rate for Payer: Cigna of CA PPO |
$2,153.40
|
| Rate for Payer: Cigna of CA PPO |
$1,872.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,473.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,151.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,473.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,151.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,473.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,151.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,037.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,771.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,164.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,012.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,012.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,164.00
|
| Rate for Payer: Galaxy Health WC |
$2,473.50
|
| Rate for Payer: Galaxy Health WC |
$2,151.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,746.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,518.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$568.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$568.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,607.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,847.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$642.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$642.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,716.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,493.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$698.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,771.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,771.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,037.00
|
| Rate for Payer: Multiplan Commercial |
$2,024.80
|
| Rate for Payer: Multiplan Commercial |
$2,328.00
|
| Rate for Payer: Networks By Design Commercial |
$1,645.15
|
| Rate for Payer: Networks By Design Commercial |
$1,891.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,151.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,473.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,746.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,518.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,746.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,518.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,124.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,124.94
|
| Rate for Payer: United Healthcare All Other HMO |
$1,124.94
|
| Rate for Payer: United Healthcare All Other HMO |
$1,124.94
|
| Rate for Payer: United Healthcare HMO Rider |
$1,124.94
|
| Rate for Payer: United Healthcare HMO Rider |
$1,124.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,124.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,124.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,473.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,151.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,473.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,151.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,151.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,473.50
|
|
|
HC MR ANGIO W/O FOL W/CONT, ABD
|
Facility
|
OP
|
$7,718.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801096
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$557.81 |
| Max. Negotiated Rate |
$6,560.30 |
| Rate for Payer: Adventist Health Commercial |
$1,543.60
|
| Rate for Payer: Adventist Health Commercial |
$1,928.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,560.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,197.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,304.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,244.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,788.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,233.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,188.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,952.64
|
| Rate for Payer: Blue Shield of California Commercial |
$4,924.08
|
| Rate for Payer: Blue Shield of California Commercial |
$3,249.28
|
| Rate for Payer: Blue Shield of California Commercial |
$4,060.12
|
| Rate for Payer: Blue Shield of California Commercial |
$6,152.87
|
| Rate for Payer: Cash Price |
$4,339.80
|
| Rate for Payer: Cash Price |
$3,473.10
|
| Rate for Payer: Cash Price |
$4,339.80
|
| Rate for Payer: Cash Price |
$3,473.10
|
| Rate for Payer: Cash Price |
$3,473.10
|
| Rate for Payer: Cash Price |
$4,339.80
|
| Rate for Payer: Cigna of CA HMO |
$4,939.52
|
| Rate for Payer: Cigna of CA HMO |
$6,172.16
|
| Rate for Payer: Cigna of CA PPO |
$7,136.56
|
| Rate for Payer: Cigna of CA PPO |
$5,711.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,197.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,560.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,197.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,560.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,197.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,560.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,750.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,402.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,857.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,087.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,087.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,857.60
|
| Rate for Payer: Galaxy Health WC |
$8,197.40
|
| Rate for Payer: Galaxy Health WC |
$6,560.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,786.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,630.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$557.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$557.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,900.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,123.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$630.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$630.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,689.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,553.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,314.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,402.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,750.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,402.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,750.80
|
| Rate for Payer: Multiplan Commercial |
$6,174.40
|
| Rate for Payer: Multiplan Commercial |
$7,715.20
|
| Rate for Payer: Networks By Design Commercial |
$5,016.70
|
| Rate for Payer: Networks By Design Commercial |
$6,268.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,560.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,197.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,786.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,630.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,786.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,630.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,197.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,560.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,197.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,560.30
|
| Rate for Payer: Vantage Medical Group Senior |
$6,560.30
|
| Rate for Payer: Vantage Medical Group Senior |
$8,197.40
|
|
|
HC MR ANGIO W/O FOL W/CONT, ABD
|
Facility
|
IP
|
$9,644.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801096
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,928.80 |
| Max. Negotiated Rate |
$8,197.40 |
| Rate for Payer: Adventist Health Commercial |
$1,928.80
|
| Rate for Payer: Cash Price |
$4,339.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,750.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,857.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,857.60
|
| Rate for Payer: Galaxy Health WC |
$8,197.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,786.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,123.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,689.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,314.56
|
| Rate for Payer: Multiplan Commercial |
$7,715.20
|
| Rate for Payer: Networks By Design Commercial |
$6,268.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,197.40
|
|
|
HC MRI ABDOMEN W/CONTRAST
|
Facility
|
IP
|
$7,024.00
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
908801301
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,404.80 |
| Max. Negotiated Rate |
$5,970.40 |
| Rate for Payer: Adventist Health Commercial |
$1,404.80
|
| Rate for Payer: Cash Price |
$3,160.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,916.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,809.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,809.60
|
| Rate for Payer: Galaxy Health WC |
$5,970.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,214.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,460.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,144.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,685.76
|
| Rate for Payer: Multiplan Commercial |
$5,619.20
|
| Rate for Payer: Networks By Design Commercial |
$4,565.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,970.40
|
|
|
HC MRI ABDOMEN W/CONTRAST
|
Facility
|
OP
|
$5,375.00
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
908801301
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$4,568.75 |
| Rate for Payer: Adventist Health Commercial |
$1,075.00
|
| Rate for Payer: Adventist Health Commercial |
$1,404.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,449.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,507.30
|
| Rate for Payer: Blue Shield of California Commercial |
$2,957.10
|
| Rate for Payer: Blue Shield of California Commercial |
$2,262.88
|
| Rate for Payer: Blue Shield of California Commercial |
$3,429.25
|
| Rate for Payer: Blue Shield of California Commercial |
$4,481.31
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$3,160.80
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$3,160.80
|
| Rate for Payer: Cash Price |
$3,160.80
|
| Rate for Payer: Cigna of CA HMO |
$3,440.00
|
| Rate for Payer: Cigna of CA HMO |
$4,495.36
|
| Rate for Payer: Cigna of CA PPO |
$3,977.50
|
| Rate for Payer: Cigna of CA PPO |
$5,197.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,916.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,762.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$5,970.40
|
| Rate for Payer: Galaxy Health WC |
$4,568.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,225.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,214.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$502.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$502.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,460.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,413.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$568.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$568.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,290.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,685.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,300.00
|
| Rate for Payer: Multiplan Commercial |
$5,619.20
|
| Rate for Payer: Networks By Design Commercial |
$4,565.60
|
| Rate for Payer: Networks By Design Commercial |
$3,493.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,568.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,970.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,214.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,214.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ABDOMEN W/O CONTRAST
|
Facility
|
IP
|
$6,385.00
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
908801300
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,277.00 |
| Max. Negotiated Rate |
$5,427.25 |
| Rate for Payer: Adventist Health Commercial |
$1,277.00
|
| Rate for Payer: Cash Price |
$2,873.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,469.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,554.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,554.00
|
| Rate for Payer: Galaxy Health WC |
$5,427.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,831.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,054.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,767.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,532.40
|
| Rate for Payer: Multiplan Commercial |
$5,108.00
|
| Rate for Payer: Networks By Design Commercial |
$4,150.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,427.25
|
|
|
HC MRI ABDOMEN W/O CONTRAST
|
Facility
|
OP
|
$4,687.00
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
908801300
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$3,983.95 |
| Rate for Payer: Adventist Health Commercial |
$937.40
|
| Rate for Payer: Adventist Health Commercial |
$1,277.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,007.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,097.25
|
| Rate for Payer: Blue Shield of California Commercial |
$2,688.09
|
| Rate for Payer: Blue Shield of California Commercial |
$1,973.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2,990.31
|
| Rate for Payer: Blue Shield of California Commercial |
$4,073.63
|
| Rate for Payer: Cash Price |
$2,109.15
|
| Rate for Payer: Cash Price |
$2,109.15
|
| Rate for Payer: Cash Price |
$2,873.25
|
| Rate for Payer: Cash Price |
$2,109.15
|
| Rate for Payer: Cash Price |
$2,873.25
|
| Rate for Payer: Cash Price |
$2,873.25
|
| Rate for Payer: Cigna of CA HMO |
$2,999.68
|
| Rate for Payer: Cigna of CA HMO |
$4,086.40
|
| Rate for Payer: Cigna of CA PPO |
$3,468.38
|
| Rate for Payer: Cigna of CA PPO |
$4,724.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,469.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,280.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$5,427.25
|
| Rate for Payer: Galaxy Health WC |
$3,983.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,812.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,831.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$320.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$320.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,054.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,976.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$362.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$362.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,124.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,532.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$3,749.60
|
| Rate for Payer: Multiplan Commercial |
$5,108.00
|
| Rate for Payer: Networks By Design Commercial |
$4,150.25
|
| Rate for Payer: Networks By Design Commercial |
$3,046.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,983.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,427.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,831.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,812.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,812.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,831.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI ABDOMEN W WO CONTRAST
|
Facility
|
OP
|
$6,180.00
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
908801302
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$5,253.00 |
| Rate for Payer: Adventist Health Commercial |
$1,236.00
|
| Rate for Payer: Adventist Health Commercial |
$1,713.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,965.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,498.09
|
| Rate for Payer: Blue Shield of California Commercial |
$3,607.13
|
| Rate for Payer: Blue Shield of California Commercial |
$2,601.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,942.84
|
| Rate for Payer: Blue Shield of California Commercial |
$5,466.38
|
| Rate for Payer: Cash Price |
$2,781.00
|
| Rate for Payer: Cash Price |
$2,781.00
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Cash Price |
$2,781.00
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Cigna of CA HMO |
$3,955.20
|
| Rate for Payer: Cigna of CA HMO |
$5,483.52
|
| Rate for Payer: Cigna of CA PPO |
$4,573.20
|
| Rate for Payer: Cigna of CA PPO |
$6,340.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,997.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,326.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$7,282.80
|
| Rate for Payer: Galaxy Health WC |
$5,253.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,708.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,140.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$560.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$560.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,440.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,924.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$633.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$633.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,483.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,056.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,944.00
|
| Rate for Payer: Multiplan Commercial |
$6,854.40
|
| Rate for Payer: Networks By Design Commercial |
$5,569.20
|
| Rate for Payer: Networks By Design Commercial |
$4,017.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,253.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,282.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,140.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,708.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,708.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,140.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ABDOMEN W WO CONTRAST
|
Facility
|
IP
|
$8,568.00
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
908801302
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,713.60 |
| Max. Negotiated Rate |
$7,282.80 |
| Rate for Payer: Adventist Health Commercial |
$1,713.60
|
| Rate for Payer: Cash Price |
$3,855.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,997.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,427.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,427.20
|
| Rate for Payer: Galaxy Health WC |
$7,282.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,140.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,440.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,055.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,056.32
|
| Rate for Payer: Multiplan Commercial |
$6,854.40
|
| Rate for Payer: Networks By Design Commercial |
$5,569.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,282.80
|
|
|
HC MRI ANGIO HEAD WITH CONTRAST
|
Facility
|
OP
|
$5,853.00
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
908801084
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$374.27 |
| Max. Negotiated Rate |
$4,975.05 |
| Rate for Payer: Adventist Health Commercial |
$1,170.60
|
| Rate for Payer: Adventist Health Commercial |
$1,182.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,755.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,794.37
|
| Rate for Payer: Blue Shield of California Commercial |
$2,489.37
|
| Rate for Payer: Blue Shield of California Commercial |
$2,464.11
|
| Rate for Payer: Blue Shield of California Commercial |
$3,734.21
|
| Rate for Payer: Blue Shield of California Commercial |
$3,772.49
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,660.85
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,660.85
|
| Rate for Payer: Cash Price |
$2,660.85
|
| Rate for Payer: Cigna of CA HMO |
$3,745.92
|
| Rate for Payer: Cigna of CA HMO |
$3,784.32
|
| Rate for Payer: Cigna of CA PPO |
$4,331.22
|
| Rate for Payer: Cigna of CA PPO |
$4,375.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,139.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,097.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$5,026.05
|
| Rate for Payer: Galaxy Health WC |
$4,975.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,511.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,547.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$374.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$374.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,754.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,716.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$423.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$423.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,404.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,419.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,682.40
|
| Rate for Payer: Multiplan Commercial |
$4,730.40
|
| Rate for Payer: Networks By Design Commercial |
$3,843.45
|
| Rate for Payer: Networks By Design Commercial |
$3,804.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,975.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,026.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,547.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,511.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,511.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,547.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ANGIO HEAD WITH CONTRAST
|
Facility
|
IP
|
$5,913.00
|
|
|
Service Code
|
CPT 70545
|
| Hospital Charge Code |
908801084
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,182.60 |
| Max. Negotiated Rate |
$5,026.05 |
| Rate for Payer: Adventist Health Commercial |
$1,182.60
|
| Rate for Payer: Cash Price |
$2,660.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,139.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,365.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,365.20
|
| Rate for Payer: Galaxy Health WC |
$5,026.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,547.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,754.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,488.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,419.12
|
| Rate for Payer: Multiplan Commercial |
$4,730.40
|
| Rate for Payer: Networks By Design Commercial |
$3,843.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,026.05
|
|
|
HC MRI ANGIO HEAD WO CNTRAST
|
Facility
|
OP
|
$5,226.00
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
908801083
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$4,442.10 |
| Rate for Payer: Adventist Health Commercial |
$1,045.20
|
| Rate for Payer: Adventist Health Commercial |
$1,126.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,353.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,614.05
|
| Rate for Payer: Blue Shield of California Commercial |
$2,371.07
|
| Rate for Payer: Blue Shield of California Commercial |
$2,200.15
|
| Rate for Payer: Blue Shield of California Commercial |
$3,334.19
|
| Rate for Payer: Blue Shield of California Commercial |
$3,593.22
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Cigna of CA HMO |
$3,344.64
|
| Rate for Payer: Cigna of CA HMO |
$3,604.48
|
| Rate for Payer: Cigna of CA PPO |
$3,867.24
|
| Rate for Payer: Cigna of CA PPO |
$4,167.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,942.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,658.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$4,787.20
|
| Rate for Payer: Galaxy Health WC |
$4,442.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,379.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$354.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$354.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,576.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,318.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,254.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,351.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$4,180.80
|
| Rate for Payer: Multiplan Commercial |
$4,505.60
|
| Rate for Payer: Networks By Design Commercial |
$3,660.80
|
| Rate for Payer: Networks By Design Commercial |
$3,396.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,442.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,787.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,379.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,135.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,135.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,379.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI ANGIO HEAD WO CNTRAST
|
Facility
|
IP
|
$5,632.00
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
908801015
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,126.40 |
| Max. Negotiated Rate |
$4,787.20 |
| Rate for Payer: Adventist Health Commercial |
$1,126.40
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,252.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,252.80
|
| Rate for Payer: Galaxy Health WC |
$4,787.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,379.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,576.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,322.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,351.68
|
| Rate for Payer: Multiplan Commercial |
$4,505.60
|
| Rate for Payer: Networks By Design Commercial |
$3,660.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,787.20
|
|
|
HC MRI ANGIO HEAD WO CNTRAST
|
Facility
|
IP
|
$5,632.00
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
908801083
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$1,126.40 |
| Max. Negotiated Rate |
$4,787.20 |
| Rate for Payer: Adventist Health Commercial |
$1,126.40
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,942.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,252.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,252.80
|
| Rate for Payer: Galaxy Health WC |
$4,787.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,379.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,576.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,322.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,351.68
|
| Rate for Payer: Multiplan Commercial |
$4,505.60
|
| Rate for Payer: Networks By Design Commercial |
$3,660.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,787.20
|
|
|
HC MRI ANGIO HEAD WO CNTRAST
|
Facility
|
OP
|
$5,226.00
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
908801015
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$4,442.10 |
| Rate for Payer: Adventist Health Commercial |
$1,045.20
|
| Rate for Payer: Adventist Health Commercial |
$1,126.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,353.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,614.05
|
| Rate for Payer: Blue Shield of California Commercial |
$2,371.07
|
| Rate for Payer: Blue Shield of California Commercial |
$2,200.15
|
| Rate for Payer: Blue Shield of California Commercial |
$3,334.19
|
| Rate for Payer: Blue Shield of California Commercial |
$3,593.22
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Cash Price |
$2,351.70
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Cash Price |
$2,534.40
|
| Rate for Payer: Cigna of CA HMO |
$3,344.64
|
| Rate for Payer: Cigna of CA HMO |
$3,604.48
|
| Rate for Payer: Cigna of CA PPO |
$3,867.24
|
| Rate for Payer: Cigna of CA PPO |
$4,167.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,942.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,658.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$4,787.20
|
| Rate for Payer: Galaxy Health WC |
$4,442.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,135.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,379.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$354.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$354.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,576.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,318.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,254.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,351.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$4,180.80
|
| Rate for Payer: Multiplan Commercial |
$4,505.60
|
| Rate for Payer: Networks By Design Commercial |
$3,660.80
|
| Rate for Payer: Networks By Design Commercial |
$3,396.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,442.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,787.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,379.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,135.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,135.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,379.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC MRI ANGIO HEAD W WO CONTRAST
|
Facility
|
OP
|
$6,270.00
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
908801085
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$5,329.50 |
| Rate for Payer: Adventist Health Commercial |
$1,254.00
|
| Rate for Payer: Adventist Health Commercial |
$1,476.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,023.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,736.39
|
| Rate for Payer: Blue Shield of California Commercial |
$3,107.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,639.67
|
| Rate for Payer: Blue Shield of California Commercial |
$4,000.26
|
| Rate for Payer: Blue Shield of California Commercial |
$4,709.08
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Cash Price |
$3,321.45
|
| Rate for Payer: Cash Price |
$2,821.50
|
| Rate for Payer: Cash Price |
$3,321.45
|
| Rate for Payer: Cash Price |
$3,321.45
|
| Rate for Payer: Cigna of CA HMO |
$4,012.80
|
| Rate for Payer: Cigna of CA HMO |
$4,723.84
|
| Rate for Payer: Cigna of CA PPO |
$4,639.80
|
| Rate for Payer: Cigna of CA PPO |
$5,461.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,166.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,389.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$6,273.85
|
| Rate for Payer: Galaxy Health WC |
$5,329.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,762.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,428.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$544.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$544.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,686.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,981.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$615.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$615.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,504.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,771.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$5,016.00
|
| Rate for Payer: Multiplan Commercial |
$5,904.80
|
| Rate for Payer: Networks By Design Commercial |
$4,797.65
|
| Rate for Payer: Networks By Design Commercial |
$4,075.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,329.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,273.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,428.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,762.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,762.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,428.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare HMO Rider |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,367.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ANGIO HEAD W WO CONTRAST
|
Facility
|
IP
|
$7,381.00
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
908801085
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,476.20 |
| Max. Negotiated Rate |
$6,273.85 |
| Rate for Payer: Adventist Health Commercial |
$1,476.20
|
| Rate for Payer: Cash Price |
$3,321.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,166.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,952.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,952.40
|
| Rate for Payer: Galaxy Health WC |
$6,273.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,428.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,686.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,354.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,771.44
|
| Rate for Payer: Multiplan Commercial |
$5,904.80
|
| Rate for Payer: Networks By Design Commercial |
$4,797.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,273.85
|
|
|
HC MRI ANGIO NECK W CONTRAST
|
Facility
|
IP
|
$5,564.00
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
908801087
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,112.80 |
| Max. Negotiated Rate |
$4,729.40 |
| Rate for Payer: Adventist Health Commercial |
$1,112.80
|
| Rate for Payer: Cash Price |
$2,503.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,894.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,225.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,225.60
|
| Rate for Payer: Galaxy Health WC |
$4,729.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,338.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,533.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,282.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,335.36
|
| Rate for Payer: Multiplan Commercial |
$4,451.20
|
| Rate for Payer: Networks By Design Commercial |
$3,616.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,729.40
|
|
|
HC MRI ANGIO NECK W CONTRAST
|
Facility
|
OP
|
$5,564.00
|
|
|
Service Code
|
CPT 70548
|
| Hospital Charge Code |
908801087
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$404.17 |
| Max. Negotiated Rate |
$4,729.40 |
| Rate for Payer: Adventist Health Commercial |
$1,112.80
|
| Rate for Payer: Adventist Health Commercial |
$1,170.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,570.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,755.87
|
| Rate for Payer: Blue Shield of California Commercial |
$2,464.11
|
| Rate for Payer: Blue Shield of California Commercial |
$2,342.44
|
| Rate for Payer: Blue Shield of California Commercial |
$3,549.83
|
| Rate for Payer: Blue Shield of California Commercial |
$3,734.21
|
| Rate for Payer: Cash Price |
$2,503.80
|
| Rate for Payer: Cash Price |
$2,503.80
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,503.80
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cash Price |
$2,633.85
|
| Rate for Payer: Cigna of CA HMO |
$3,560.96
|
| Rate for Payer: Cigna of CA HMO |
$3,745.92
|
| Rate for Payer: Cigna of CA PPO |
$4,117.36
|
| Rate for Payer: Cigna of CA PPO |
$4,331.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,097.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,894.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$4,975.05
|
| Rate for Payer: Galaxy Health WC |
$4,729.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,338.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,511.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$404.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$404.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,716.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,533.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$457.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$457.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,335.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,404.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$4,451.20
|
| Rate for Payer: Multiplan Commercial |
$4,682.40
|
| Rate for Payer: Networks By Design Commercial |
$3,804.45
|
| Rate for Payer: Networks By Design Commercial |
$3,616.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,729.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,975.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,511.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,338.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,338.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,511.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare All Other HMO |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare HMO Rider |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,115.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC MRI ANGIO NECK WO CONTRAST
|
Facility
|
OP
|
$5,375.00
|
|
|
Service Code
|
CPT 70547
|
| Hospital Charge Code |
908801086
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$4,568.75 |
| Rate for Payer: Adventist Health Commercial |
$1,075.00
|
| Rate for Payer: Adventist Health Commercial |
$1,130.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,449.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,626.25
|
| Rate for Payer: Blue Shield of California Commercial |
$2,379.07
|
| Rate for Payer: Blue Shield of California Commercial |
$2,262.88
|
| Rate for Payer: Blue Shield of California Commercial |
$3,429.25
|
| Rate for Payer: Blue Shield of California Commercial |
$3,605.34
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cash Price |
$2,418.75
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cash Price |
$2,542.95
|
| Rate for Payer: Cigna of CA HMO |
$3,440.00
|
| Rate for Payer: Cigna of CA HMO |
$3,616.64
|
| Rate for Payer: Cigna of CA PPO |
$3,977.50
|
| Rate for Payer: Cigna of CA PPO |
$4,181.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,955.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,762.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$4,803.35
|
| Rate for Payer: Galaxy Health WC |
$4,568.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,225.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,390.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$355.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$355.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,588.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,413.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$402.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$402.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,290.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,356.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$4,300.00
|
| Rate for Payer: Multiplan Commercial |
$4,520.80
|
| Rate for Payer: Networks By Design Commercial |
$3,673.15
|
| Rate for Payer: Networks By Design Commercial |
$3,493.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,568.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,803.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,390.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,390.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
