|
HC PANCREATIC PSDOCYST EXT DRN
|
Facility
|
OP
|
$507.00
|
|
|
Service Code
|
CPT 48510
|
| Hospital Charge Code |
909000155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$101.40 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$101.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$430.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$278.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$380.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$278.85
|
| Rate for Payer: Cash Price |
$278.85
|
| Rate for Payer: Cash Price |
$278.85
|
| Rate for Payer: Cigna of CA HMO |
$324.48
|
| Rate for Payer: Cigna of CA PPO |
$375.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$430.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$430.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$430.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$202.80
|
| Rate for Payer: EPIC Health Plan Senior |
$202.80
|
| Rate for Payer: Galaxy Health WC |
$430.95
|
| Rate for Payer: Global Benefits Group Commercial |
$304.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$213.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$338.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$313.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$354.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$354.90
|
| Rate for Payer: Multiplan Commercial |
$405.60
|
| Rate for Payer: Networks By Design Commercial |
$329.55
|
| Rate for Payer: Prime Health Services Commercial |
$430.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$304.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$430.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$430.95
|
| Rate for Payer: Vantage Medical Group Senior |
$430.95
|
|
|
HC PANTIES
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380015
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.16 |
| Max. Negotiated Rate |
$28.90 |
| Rate for Payer: Adventist Health Commercial |
$13.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.69
|
| Rate for Payer: Blue Shield of California Commercial |
$25.09
|
| Rate for Payer: Blue Shield of California EPN |
$16.52
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cigna of CA HMO |
$23.80
|
| Rate for Payer: Cigna of CA PPO |
$23.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.80
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Networks By Design Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.76
|
| Rate for Payer: United Healthcare All Other HMO |
$12.42
|
| Rate for Payer: United Healthcare HMO Rider |
$12.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.90
|
| Rate for Payer: Vantage Medical Group Senior |
$28.90
|
|
|
HC PANTIES
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380015
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cigna of CA HMO |
$23.80
|
| Rate for Payer: Cigna of CA PPO |
$23.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Networks By Design Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.76
|
| Rate for Payer: United Healthcare All Other HMO |
$12.42
|
| Rate for Payer: United Healthcare HMO Rider |
$12.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.13
|
|
|
HC PANTIES
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
915380015
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.16 |
| Max. Negotiated Rate |
$28.90 |
| Rate for Payer: Adventist Health Commercial |
$13.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.69
|
| Rate for Payer: Blue Shield of California Commercial |
$25.09
|
| Rate for Payer: Blue Shield of California EPN |
$16.52
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cigna of CA HMO |
$23.80
|
| Rate for Payer: Cigna of CA PPO |
$23.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.80
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Networks By Design Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.76
|
| Rate for Payer: United Healthcare All Other HMO |
$12.42
|
| Rate for Payer: United Healthcare HMO Rider |
$12.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.90
|
| Rate for Payer: Vantage Medical Group Senior |
$28.90
|
|
|
HC PANTIES
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT L8499
|
| Hospital Charge Code |
905380015
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$6.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Cigna of CA HMO |
$23.80
|
| Rate for Payer: Cigna of CA PPO |
$23.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.60
|
| Rate for Payer: EPIC Health Plan Senior |
$13.60
|
| Rate for Payer: Galaxy Health WC |
$28.90
|
| Rate for Payer: Global Benefits Group Commercial |
$20.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.16
|
| Rate for Payer: Multiplan Commercial |
$27.20
|
| Rate for Payer: Networks By Design Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Commercial |
$28.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.76
|
| Rate for Payer: United Healthcare All Other HMO |
$12.42
|
| Rate for Payer: United Healthcare HMO Rider |
$12.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.13
|
|
|
HC PAPOOSE INFANT SPINAL IMOBLIZR
|
Facility
|
IP
|
$1,038.86
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901606308
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$207.77 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$207.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$571.37
|
| Rate for Payer: Cash Price |
$571.37
|
| Rate for Payer: Cigna of CA HMO |
$727.20
|
| Rate for Payer: Cigna of CA PPO |
$727.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$415.54
|
| Rate for Payer: EPIC Health Plan Senior |
$415.54
|
| Rate for Payer: Galaxy Health WC |
$883.03
|
| Rate for Payer: Global Benefits Group Commercial |
$623.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$692.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$395.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$643.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.33
|
| Rate for Payer: Multiplan Commercial |
$831.09
|
| Rate for Payer: Networks By Design Commercial |
$519.43
|
| Rate for Payer: Prime Health Services Commercial |
$883.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$389.88
|
| Rate for Payer: United Healthcare All Other HMO |
$379.50
|
| Rate for Payer: United Healthcare HMO Rider |
$371.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$340.23
|
|
|
HC PAPOOSE INFANT SPINAL IMOBLIZR
|
Facility
|
OP
|
$1,038.86
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901606308
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$249.33 |
| Max. Negotiated Rate |
$883.03 |
| Rate for Payer: Adventist Health Commercial |
$425.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$883.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$571.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$779.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$601.71
|
| Rate for Payer: Blue Shield of California Commercial |
$766.68
|
| Rate for Payer: Blue Shield of California EPN |
$504.89
|
| Rate for Payer: Cash Price |
$571.37
|
| Rate for Payer: Cash Price |
$571.37
|
| Rate for Payer: Cigna of CA HMO |
$727.20
|
| Rate for Payer: Cigna of CA PPO |
$727.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$883.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$883.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$883.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$415.54
|
| Rate for Payer: EPIC Health Plan Senior |
$415.54
|
| Rate for Payer: Galaxy Health WC |
$883.03
|
| Rate for Payer: Global Benefits Group Commercial |
$623.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$307.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$692.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$643.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$727.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$727.20
|
| Rate for Payer: Multiplan Commercial |
$831.09
|
| Rate for Payer: Networks By Design Commercial |
$519.43
|
| Rate for Payer: Prime Health Services Commercial |
$883.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$623.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$623.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$389.88
|
| Rate for Payer: United Healthcare All Other HMO |
$379.50
|
| Rate for Payer: United Healthcare HMO Rider |
$371.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$340.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$883.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$883.03
|
| Rate for Payer: Vantage Medical Group Senior |
$883.03
|
|
|
HC PAP S EAR-THIN PREP PG
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
903800211
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$139.64 |
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.64
|
| Rate for Payer: Blue Shield of California Commercial |
$39.47
|
| Rate for Payer: Blue Shield of California EPN |
$26.08
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: Cigna of CA HMO |
$37.76
|
| Rate for Payer: Cigna of CA PPO |
$43.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.35
|
| Rate for Payer: EPIC Health Plan Senior |
$20.26
|
| Rate for Payer: Galaxy Health WC |
$50.15
|
| Rate for Payer: Global Benefits Group Commercial |
$35.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$30.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.15
|
| Rate for Payer: Multiplan Commercial |
$47.20
|
| Rate for Payer: Networks By Design Commercial |
$38.35
|
| Rate for Payer: Prime Health Services Commercial |
$50.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.41
|
| Rate for Payer: United Healthcare All Other HMO |
$16.41
|
| Rate for Payer: United Healthcare HMO Rider |
$16.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.41
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.29
|
| Rate for Payer: Vantage Medical Group Senior |
$20.26
|
|
|
HC PAP S EAR-THIN PREP PG
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 88142
|
| Hospital Charge Code |
903800211
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$50.15 |
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.60
|
| Rate for Payer: EPIC Health Plan Senior |
$23.60
|
| Rate for Payer: Galaxy Health WC |
$50.15
|
| Rate for Payer: Global Benefits Group Commercial |
$35.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.16
|
| Rate for Payer: Multiplan Commercial |
$47.20
|
| Rate for Payer: Networks By Design Commercial |
$38.35
|
| Rate for Payer: Prime Health Services Commercial |
$50.15
|
|
|
HC PAP SMEAR-CONVENTIONAL PG
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 88164
|
| Hospital Charge Code |
903800212
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$51.07 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.07
|
| Rate for Payer: Blue Shield of California Commercial |
$16.73
|
| Rate for Payer: Blue Shield of California EPN |
$11.05
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.56
|
| Rate for Payer: EPIC Health Plan Senior |
$18.19
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.37
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.90
|
| Rate for Payer: United Healthcare All Other HMO |
$12.90
|
| Rate for Payer: United Healthcare HMO Rider |
$12.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.90
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.01
|
| Rate for Payer: Vantage Medical Group Senior |
$18.19
|
|
|
HC PAP SMEAR-CONVENTIONAL PG
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 88164
|
| Hospital Charge Code |
903800212
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$21.25 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC PARACENTESIS EYE RML BLOOD
|
Facility
|
IP
|
$5,924.00
|
|
|
Service Code
|
CPT 65815
|
| Hospital Charge Code |
950442303
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,184.80 |
| Max. Negotiated Rate |
$5,035.40 |
| Rate for Payer: Adventist Health Commercial |
$1,184.80
|
| Rate for Payer: Cash Price |
$3,258.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,369.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,369.60
|
| Rate for Payer: Galaxy Health WC |
$5,035.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,554.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,951.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,257.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,666.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,421.76
|
| Rate for Payer: Multiplan Commercial |
$4,739.20
|
| Rate for Payer: Networks By Design Commercial |
$3,850.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,035.40
|
|
|
HC PARACENTESIS EYE RML BLOOD
|
Facility
|
OP
|
$5,924.00
|
|
|
Service Code
|
CPT 65815
|
| Hospital Charge Code |
950442303
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$432.92 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Adventist Health Commercial |
$1,184.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,897.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Cash Price |
$3,258.20
|
| Rate for Payer: Cash Price |
$3,258.20
|
| Rate for Payer: Cash Price |
$3,258.20
|
| Rate for Payer: Cigna of CA HMO |
$3,791.36
|
| Rate for Payer: Cigna of CA PPO |
$4,383.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,187.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,897.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,912.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,897.90
|
| Rate for Payer: Galaxy Health WC |
$5,035.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,554.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,752.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,897.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,951.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$432.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,897.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,421.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,651.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,883.19
|
| Rate for Payer: Multiplan Commercial |
$4,739.20
|
| Rate for Payer: Multiplan WC |
$4,617.28
|
| Rate for Payer: Networks By Design Commercial |
$3,850.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,035.40
|
| Rate for Payer: Prime Health Services WC |
$4,570.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,554.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,962.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,962.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,962.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,962.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,897.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,346.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,187.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,897.90
|
|
|
HC PARANASAL SINUS LTD
|
Facility
|
OP
|
$684.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
909001142
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$36.32 |
| Max. Negotiated Rate |
$581.40 |
| Rate for Payer: Adventist Health Commercial |
$136.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$448.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$174.89
|
| Rate for Payer: Blue Shield of California Commercial |
$418.61
|
| Rate for Payer: Blue Shield of California EPN |
$276.34
|
| Rate for Payer: Cash Price |
$376.20
|
| Rate for Payer: Cash Price |
$376.20
|
| Rate for Payer: Cigna of CA HMO |
$437.76
|
| Rate for Payer: Cigna of CA PPO |
$506.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$581.40
|
| Rate for Payer: Global Benefits Group Commercial |
$410.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$456.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$547.20
|
| Rate for Payer: Networks By Design Commercial |
$444.60
|
| Rate for Payer: Prime Health Services Commercial |
$581.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$410.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$410.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC PARANASAL SINUS LTD
|
Facility
|
IP
|
$684.00
|
|
|
Service Code
|
CPT 70210
|
| Hospital Charge Code |
909001142
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$136.80 |
| Max. Negotiated Rate |
$581.40 |
| Rate for Payer: Adventist Health Commercial |
$136.80
|
| Rate for Payer: Cash Price |
$376.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$273.60
|
| Rate for Payer: Galaxy Health WC |
$581.40
|
| Rate for Payer: Global Benefits Group Commercial |
$410.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$456.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$260.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$423.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.16
|
| Rate for Payer: Multiplan Commercial |
$547.20
|
| Rate for Payer: Networks By Design Commercial |
$444.60
|
| Rate for Payer: Prime Health Services Commercial |
$581.40
|
|
|
HC PARASITE SCREEN
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87272
|
| Hospital Charge Code |
900911729
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$266.05 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$172.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$193.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.12
|
| Rate for Payer: Multiplan Commercial |
$250.40
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC PARASITE SCREEN
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 87272
|
| Hospital Charge Code |
900911729
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$266.05 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$205.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.77
|
| Rate for Payer: Blue Shield of California Commercial |
$209.40
|
| Rate for Payer: Blue Shield of California EPN |
$138.35
|
| Rate for Payer: Cash Price |
$172.15
|
| Rate for Payer: Cash Price |
$172.15
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.17
|
| Rate for Payer: EPIC Health Plan Senior |
$11.98
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.05
|
| Rate for Payer: Multiplan Commercial |
$250.40
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$187.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.70
|
| Rate for Payer: United Healthcare All Other HMO |
$9.70
|
| Rate for Payer: United Healthcare HMO Rider |
$9.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
|
HC PARASPINAL UPRIGHTS ADD LE
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT L2670
|
| Hospital Charge Code |
905352670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$57.84 |
| Max. Negotiated Rate |
$204.85 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.59
|
| Rate for Payer: Blue Shield of California Commercial |
$177.86
|
| Rate for Payer: Blue Shield of California EPN |
$117.13
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cigna of CA HMO |
$168.70
|
| Rate for Payer: Cigna of CA PPO |
$168.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$149.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$168.70
|
| Rate for Payer: Multiplan Commercial |
$192.80
|
| Rate for Payer: Networks By Design Commercial |
$120.50
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.45
|
| Rate for Payer: United Healthcare All Other HMO |
$88.04
|
| Rate for Payer: United Healthcare HMO Rider |
$86.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$78.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.85
|
| Rate for Payer: Vantage Medical Group Senior |
$204.85
|
|
|
HC PARASPINAL UPRIGHTS ADD LE
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT L2670
|
| Hospital Charge Code |
915352670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$57.84 |
| Max. Negotiated Rate |
$204.85 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.59
|
| Rate for Payer: Blue Shield of California Commercial |
$177.86
|
| Rate for Payer: Blue Shield of California EPN |
$117.13
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cigna of CA HMO |
$168.70
|
| Rate for Payer: Cigna of CA PPO |
$168.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$149.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$168.70
|
| Rate for Payer: Multiplan Commercial |
$192.80
|
| Rate for Payer: Networks By Design Commercial |
$120.50
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.45
|
| Rate for Payer: United Healthcare All Other HMO |
$88.04
|
| Rate for Payer: United Healthcare HMO Rider |
$86.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$78.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.85
|
| Rate for Payer: Vantage Medical Group Senior |
$204.85
|
|
|
HC PARASPINAL UPRIGHTS ADD LE
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT L2670
|
| Hospital Charge Code |
915352670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cigna of CA HMO |
$168.70
|
| Rate for Payer: Cigna of CA PPO |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.84
|
| Rate for Payer: Multiplan Commercial |
$192.80
|
| Rate for Payer: Networks By Design Commercial |
$120.50
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.45
|
| Rate for Payer: United Healthcare All Other HMO |
$88.04
|
| Rate for Payer: United Healthcare HMO Rider |
$86.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$78.93
|
|
|
HC PARASPINAL UPRIGHTS ADD LE
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT L2670
|
| Hospital Charge Code |
905352670
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cigna of CA HMO |
$168.70
|
| Rate for Payer: Cigna of CA PPO |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.84
|
| Rate for Payer: Multiplan Commercial |
$192.80
|
| Rate for Payer: Networks By Design Commercial |
$120.50
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.45
|
| Rate for Payer: United Healthcare All Other HMO |
$88.04
|
| Rate for Payer: United Healthcare HMO Rider |
$86.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$78.93
|
|
|
HC PARATHYROID
|
Facility
|
OP
|
$1,334.00
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
909301309
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$266.80 |
| Max. Negotiated Rate |
$1,133.90 |
| Rate for Payer: Adventist Health Commercial |
$266.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$874.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$819.21
|
| Rate for Payer: Blue Shield of California Commercial |
$816.41
|
| Rate for Payer: Blue Shield of California EPN |
$538.94
|
| Rate for Payer: Cash Price |
$733.70
|
| Rate for Payer: Cash Price |
$733.70
|
| Rate for Payer: Cigna of CA HMO |
$853.76
|
| Rate for Payer: Cigna of CA PPO |
$987.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$510.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.27
|
| Rate for Payer: EPIC Health Plan Senior |
$510.57
|
| Rate for Payer: Galaxy Health WC |
$1,133.90
|
| Rate for Payer: Global Benefits Group Commercial |
$800.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$837.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$523.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$889.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$592.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$510.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$643.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$684.16
|
| Rate for Payer: Multiplan Commercial |
$1,067.20
|
| Rate for Payer: Networks By Design Commercial |
$867.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,133.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$800.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$800.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$824.42
|
| Rate for Payer: United Healthcare All Other HMO |
$824.42
|
| Rate for Payer: United Healthcare HMO Rider |
$824.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$824.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$510.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.63
|
| Rate for Payer: Vantage Medical Group Senior |
$510.57
|
|
|
HC PARATHYROID
|
Facility
|
IP
|
$1,334.00
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
909301309
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$266.80 |
| Max. Negotiated Rate |
$1,133.90 |
| Rate for Payer: Adventist Health Commercial |
$266.80
|
| Rate for Payer: Cash Price |
$733.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$533.60
|
| Rate for Payer: EPIC Health Plan Senior |
$533.60
|
| Rate for Payer: Galaxy Health WC |
$1,133.90
|
| Rate for Payer: Global Benefits Group Commercial |
$800.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$889.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$508.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$825.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.16
|
| Rate for Payer: Multiplan Commercial |
$1,067.20
|
| Rate for Payer: Networks By Design Commercial |
$867.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,133.90
|
|
|
HC PARAVALVULAR LEAK TRICUSPID
|
Facility
|
OP
|
$25,018.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906819771
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$198.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$5,003.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,363.55
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$13,759.90
|
| Rate for Payer: Cash Price |
$13,759.90
|
| Rate for Payer: Cash Price |
$13,759.90
|
| Rate for Payer: Cigna of CA HMO |
$16,261.70
|
| Rate for Payer: Cigna of CA PPO |
$18,513.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$218.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.38
|
| Rate for Payer: EPIC Health Plan Senior |
$198.80
|
| Rate for Payer: Galaxy Health WC |
$21,265.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,010.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$326.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$198.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,687.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$198.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,004.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$250.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.39
|
| Rate for Payer: Multiplan Commercial |
$20,014.40
|
| Rate for Payer: Networks By Design Commercial |
$16,261.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,265.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,010.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,010.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$198.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$218.68
|
| Rate for Payer: Vantage Medical Group Senior |
$198.80
|
|
|
HC PARAVALVULAR LEAK TRICUSPID
|
Facility
|
IP
|
$25,018.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906819771
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,003.60 |
| Max. Negotiated Rate |
$21,265.30 |
| Rate for Payer: EPIC Health Plan Senior |
$10,007.20
|
| Rate for Payer: Adventist Health Commercial |
$5,003.60
|
| Rate for Payer: Cash Price |
$13,759.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,007.20
|
| Rate for Payer: Galaxy Health WC |
$21,265.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,010.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,687.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,531.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,486.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,004.32
|
| Rate for Payer: Multiplan Commercial |
$20,014.40
|
| Rate for Payer: Networks By Design Commercial |
$16,261.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,265.30
|
|
