|
HC PERC TRANSPORTAL W HEMO
|
Facility
|
OP
|
$6,570.00
|
|
|
Service Code
|
CPT 75885
|
| Hospital Charge Code |
909081690
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$207.41 |
| Max. Negotiated Rate |
$6,700.73 |
| Rate for Payer: Adventist Health Commercial |
$1,314.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,106.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,721.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,765.97
|
| Rate for Payer: Blue Shield of California Commercial |
$4,191.66
|
| Rate for Payer: Cash Price |
$2,956.50
|
| Rate for Payer: Cash Price |
$2,956.50
|
| Rate for Payer: Cigna of CA HMO |
$4,204.80
|
| Rate for Payer: Cigna of CA PPO |
$4,861.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,599.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$5,584.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,942.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$207.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,171.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$234.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,576.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,256.00
|
| Rate for Payer: Networks By Design Commercial |
$4,270.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,584.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,942.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,942.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC PERC TRANSPORTAL W/O HEMO
|
Facility
|
OP
|
$3,021.00
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
909081691
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$604.20 |
| Max. Negotiated Rate |
$6,700.73 |
| Rate for Payer: Adventist Health Commercial |
$604.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,123.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,721.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,271.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,927.40
|
| Rate for Payer: Cash Price |
$1,359.45
|
| Rate for Payer: Cash Price |
$1,359.45
|
| Rate for Payer: Cigna of CA HMO |
$1,933.44
|
| Rate for Payer: Cigna of CA PPO |
$2,235.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,114.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$2,567.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,812.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,918.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$725.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$2,416.80
|
| Rate for Payer: Networks By Design Commercial |
$1,963.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,567.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,812.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,812.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC PERC TRANSPORTAL W/O HEMO
|
Facility
|
IP
|
$3,021.00
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
909081691
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$604.20 |
| Max. Negotiated Rate |
$2,567.85 |
| Rate for Payer: Adventist Health Commercial |
$604.20
|
| Rate for Payer: Cash Price |
$1,359.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,114.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,208.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,208.40
|
| Rate for Payer: Galaxy Health WC |
$2,567.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,812.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,918.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,782.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$725.04
|
| Rate for Payer: Multiplan Commercial |
$2,416.80
|
| Rate for Payer: Networks By Design Commercial |
$1,963.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,567.85
|
|
|
HC PERC TRLUML ANGP NAT/RECR COA
|
Facility
|
IP
|
$25,990.00
|
|
|
Service Code
|
CPT 33897
|
| Hospital Charge Code |
909033897
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,198.00 |
| Max. Negotiated Rate |
$22,091.50 |
| Rate for Payer: Adventist Health Commercial |
$5,198.00
|
| Rate for Payer: Cash Price |
$11,695.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,193.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,396.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,396.00
|
| Rate for Payer: Galaxy Health WC |
$22,091.50
|
| Rate for Payer: Global Benefits Group Commercial |
$15,594.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,503.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,334.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,237.60
|
| Rate for Payer: Multiplan Commercial |
$20,792.00
|
| Rate for Payer: Networks By Design Commercial |
$16,893.50
|
| Rate for Payer: Prime Health Services Commercial |
$22,091.50
|
|
|
HC PERC TRLUML ANGP NAT/RECR COA
|
Facility
|
OP
|
$25,990.00
|
|
|
Service Code
|
CPT 33897
|
| Hospital Charge Code |
909033897
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$803.09 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$5,198.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,091.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,294.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19,492.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,759.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$11,695.50
|
| Rate for Payer: Cash Price |
$11,695.50
|
| Rate for Payer: Cash Price |
$11,695.50
|
| Rate for Payer: Cigna of CA HMO |
$16,633.60
|
| Rate for Payer: Cigna of CA PPO |
$19,232.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,091.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,091.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,091.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,193.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,396.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,396.00
|
| Rate for Payer: Galaxy Health WC |
$22,091.50
|
| Rate for Payer: Global Benefits Group Commercial |
$15,594.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$803.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,503.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$908.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,334.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,237.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,193.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,193.00
|
| Rate for Payer: Multiplan Commercial |
$20,792.00
|
| Rate for Payer: Networks By Design Commercial |
$16,893.50
|
| Rate for Payer: Prime Health Services Commercial |
$22,091.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,594.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,995.00
|
| 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 |
$22,091.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,091.50
|
| Rate for Payer: Vantage Medical Group Senior |
$22,091.50
|
|
|
HC PERC TRNSLUMNL CORO LITHOTRIPSY
|
Facility
|
IP
|
$14,005.00
|
|
|
Service Code
|
CPT 92972
|
| Hospital Charge Code |
906811715
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,801.00 |
| Max. Negotiated Rate |
$11,904.25 |
| Rate for Payer: Adventist Health Commercial |
$2,801.00
|
| Rate for Payer: Cash Price |
$6,302.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,803.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,602.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,602.00
|
| Rate for Payer: Galaxy Health WC |
$11,904.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,403.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,893.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,262.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,361.20
|
| Rate for Payer: Multiplan Commercial |
$11,204.00
|
| Rate for Payer: Networks By Design Commercial |
$9,103.25
|
| Rate for Payer: Prime Health Services Commercial |
$11,904.25
|
|
|
HC PERC TRNSLUMNL CORO LITHOTRIPSY
|
Facility
|
OP
|
$14,005.00
|
|
|
Service Code
|
CPT 92972
|
| Hospital Charge Code |
906811715
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$164.51 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,801.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,904.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,702.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,503.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,987.01
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Cash Price |
$6,302.25
|
| Rate for Payer: Cash Price |
$6,302.25
|
| Rate for Payer: Cash Price |
$6,302.25
|
| Rate for Payer: Cigna of CA HMO |
$8,963.20
|
| Rate for Payer: Cigna of CA PPO |
$10,363.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,904.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,904.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,904.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,803.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,602.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,602.00
|
| Rate for Payer: Galaxy Health WC |
$11,904.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,403.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$164.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,893.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$186.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,262.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,361.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,803.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,803.50
|
| Rate for Payer: Multiplan Commercial |
$11,204.00
|
| Rate for Payer: Networks By Design Commercial |
$9,103.25
|
| Rate for Payer: Prime Health Services Commercial |
$11,904.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,403.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,002.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,002.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,002.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,002.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,904.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,904.25
|
| Rate for Payer: Vantage Medical Group Senior |
$11,904.25
|
|
|
HC PERC TRT FX GREAT TOE, W/MANIP
|
Facility
|
OP
|
$16,804.00
|
|
|
Service Code
|
CPT 28496
|
| Hospital Charge Code |
900501250
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$302.04 |
| Max. Negotiated Rate |
$14,283.40 |
| Rate for Payer: Adventist Health Commercial |
$3,360.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$7,561.80
|
| Rate for Payer: Cash Price |
$7,561.80
|
| Rate for Payer: Cash Price |
$7,561.80
|
| Rate for Payer: Cigna of CA HMO |
$10,754.56
|
| Rate for Payer: Cigna of CA PPO |
$12,434.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,762.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$14,283.40
|
| Rate for Payer: Global Benefits Group Commercial |
$10,082.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,670.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$302.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,032.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$13,443.20
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$10,922.60
|
| Rate for Payer: Prime Health Services Commercial |
$14,283.40
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,082.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,402.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,402.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,402.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,402.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC PERC TRT FX GREAT TOE, W/MANIP
|
Facility
|
IP
|
$16,804.00
|
|
|
Service Code
|
CPT 28496
|
| Hospital Charge Code |
900501250
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,360.80 |
| Max. Negotiated Rate |
$14,283.40 |
| Rate for Payer: Adventist Health Commercial |
$3,360.80
|
| Rate for Payer: Cash Price |
$7,561.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,762.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,721.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,721.60
|
| Rate for Payer: Galaxy Health WC |
$14,283.40
|
| Rate for Payer: Global Benefits Group Commercial |
$10,082.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,670.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,914.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,032.96
|
| Rate for Payer: Multiplan Commercial |
$13,443.20
|
| Rate for Payer: Networks By Design Commercial |
$10,922.60
|
| Rate for Payer: Prime Health Services Commercial |
$14,283.40
|
|
|
HC PERC T-TUBE CATH COOK MSPT1400
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$52.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cigna of CA HMO |
$184.10
|
| Rate for Payer: Cigna of CA PPO |
$184.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$184.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.20
|
| Rate for Payer: EPIC Health Plan Senior |
$105.20
|
| Rate for Payer: Galaxy Health WC |
$223.55
|
| Rate for Payer: Global Benefits Group Commercial |
$157.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$167.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$155.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.12
|
| Rate for Payer: Multiplan Commercial |
$210.40
|
| Rate for Payer: Networks By Design Commercial |
$131.50
|
| Rate for Payer: Prime Health Services Commercial |
$223.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.70
|
| Rate for Payer: United Healthcare All Other HMO |
$96.07
|
| Rate for Payer: United Healthcare HMO Rider |
$94.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86.13
|
|
|
HC PERC T-TUBE CATH COOK MSPT1400
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909001040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$52.60 |
| Max. Negotiated Rate |
$223.55 |
| Rate for Payer: Adventist Health Commercial |
$52.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$223.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$144.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$197.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.19
|
| Rate for Payer: Blue Shield of California Commercial |
$133.34
|
| Rate for Payer: Blue Shield of California Commercial |
$202.25
|
| Rate for Payer: Cash Price |
$118.35
|
| Rate for Payer: Cigna of CA HMO |
$184.10
|
| Rate for Payer: Cigna of CA PPO |
$184.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$223.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$223.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$223.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$184.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.20
|
| Rate for Payer: EPIC Health Plan Senior |
$105.20
|
| Rate for Payer: Galaxy Health WC |
$223.55
|
| Rate for Payer: Global Benefits Group Commercial |
$157.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$167.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$95.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$155.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.10
|
| Rate for Payer: Multiplan Commercial |
$210.40
|
| Rate for Payer: Networks By Design Commercial |
$131.50
|
| Rate for Payer: Prime Health Services Commercial |
$223.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$157.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$157.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.70
|
| Rate for Payer: United Healthcare All Other HMO |
$96.07
|
| Rate for Payer: United Healthcare HMO Rider |
$94.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$223.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$223.55
|
| Rate for Payer: Vantage Medical Group Senior |
$223.55
|
|
|
HC PERCU INJ-ABLATIVE AGENT LIVER
|
Facility
|
IP
|
$1,075.00
|
|
|
Service Code
|
CPT 47399
|
| Hospital Charge Code |
909081849
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.00 |
| Max. Negotiated Rate |
$913.75 |
| Rate for Payer: Adventist Health Commercial |
$215.00
|
| Rate for Payer: Cash Price |
$483.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$752.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$430.00
|
| Rate for Payer: EPIC Health Plan Senior |
$430.00
|
| Rate for Payer: Galaxy Health WC |
$913.75
|
| Rate for Payer: Global Benefits Group Commercial |
$645.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$682.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$634.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$258.00
|
| Rate for Payer: Multiplan Commercial |
$860.00
|
| Rate for Payer: Networks By Design Commercial |
$698.75
|
| Rate for Payer: Prime Health Services Commercial |
$913.75
|
|
|
HC PERCU INJ-ABLATIVE AGENT LIVER
|
Facility
|
OP
|
$1,075.00
|
|
|
Service Code
|
CPT 47399
|
| Hospital Charge Code |
909081849
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.00 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$215.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$689.83
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$483.75
|
| Rate for Payer: Cash Price |
$483.75
|
| Rate for Payer: Cash Price |
$483.75
|
| Rate for Payer: Cigna of CA HMO |
$688.00
|
| Rate for Payer: Cigna of CA PPO |
$795.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$752.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$913.75
|
| Rate for Payer: Global Benefits Group Commercial |
$645.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$682.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$258.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$860.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$698.75
|
| Rate for Payer: Prime Health Services Commercial |
$913.75
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$645.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$537.50
|
| 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: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC PERCU RFA BONE INCLUDES CT GUI
|
Facility
|
IP
|
$18,138.00
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
909081838
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,627.60 |
| Max. Negotiated Rate |
$15,417.30 |
| Rate for Payer: Adventist Health Commercial |
$3,627.60
|
| Rate for Payer: Cash Price |
$8,162.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,696.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,255.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,255.20
|
| Rate for Payer: Galaxy Health WC |
$15,417.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10,882.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,517.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,701.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,353.12
|
| Rate for Payer: Multiplan Commercial |
$14,510.40
|
| Rate for Payer: Networks By Design Commercial |
$11,789.70
|
| Rate for Payer: Prime Health Services Commercial |
$15,417.30
|
|
|
HC PERCU RFA BONE INCLUDES CT GUI
|
Facility
|
OP
|
$18,138.00
|
|
|
Service Code
|
CPT 20982
|
| Hospital Charge Code |
909081838
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,627.60 |
| Max. Negotiated Rate |
$37,209.84 |
| Rate for Payer: Adventist Health Commercial |
$3,627.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33,827.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,806.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,551.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,743.74
|
| Rate for Payer: Blue Shield of California Commercial |
$8,695.24
|
| Rate for Payer: Cash Price |
$8,162.10
|
| Rate for Payer: Cash Price |
$8,162.10
|
| Rate for Payer: Cash Price |
$8,162.10
|
| Rate for Payer: Cigna of CA HMO |
$11,608.32
|
| Rate for Payer: Cigna of CA PPO |
$13,422.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33,827.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,806.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,551.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,696.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,209.84
|
| Rate for Payer: EPIC Health Plan Senior |
$24,806.56
|
| Rate for Payer: Galaxy Health WC |
$15,417.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10,882.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$36,984.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,178.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,551.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,517.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,988.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31,571.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,353.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,414.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,218.90
|
| Rate for Payer: Multiplan Commercial |
$14,510.40
|
| Rate for Payer: Multiplan WC |
$26,048.55
|
| Rate for Payer: Networks By Design Commercial |
$11,789.70
|
| Rate for Payer: Prime Health Services Commercial |
$15,417.30
|
| Rate for Payer: Prime Health Services WC |
$25,782.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,882.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,069.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,551.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33,827.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,806.56
|
| Rate for Payer: Vantage Medical Group Senior |
$22,551.42
|
|
|
HC PERCU-STAY
|
Facility
|
IP
|
$19.00
|
|
| Hospital Charge Code |
909001085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$16.15 |
| Rate for Payer: Adventist Health Commercial |
$3.80
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7.60
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.56
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
|
|
HC PERCU-STAY
|
Facility
|
OP
|
$19.00
|
|
| Hospital Charge Code |
909001085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$16.15 |
| Rate for Payer: Adventist Health Commercial |
$3.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.19
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cigna of CA HMO |
$12.16
|
| Rate for Payer: Cigna of CA PPO |
$14.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7.60
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.30
|
| Rate for Payer: Multiplan Commercial |
$15.20
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9.50
|
| Rate for Payer: United Healthcare HMO Rider |
$9.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.15
|
| Rate for Payer: Vantage Medical Group Senior |
$16.15
|
|
|
HC PERCUTANE DISTAL PHAL FRAC EA
|
Facility
|
OP
|
$16,804.00
|
|
|
Service Code
|
CPT 26756
|
| Hospital Charge Code |
900501333
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$693.94 |
| Max. Negotiated Rate |
$14,283.40 |
| Rate for Payer: Adventist Health Commercial |
$3,360.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$7,561.80
|
| Rate for Payer: Cash Price |
$7,561.80
|
| Rate for Payer: Cash Price |
$7,561.80
|
| Rate for Payer: Cigna of CA HMO |
$10,754.56
|
| Rate for Payer: Cigna of CA PPO |
$12,434.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,762.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$14,283.40
|
| Rate for Payer: Global Benefits Group Commercial |
$10,082.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,670.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$693.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,032.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$13,443.20
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$10,922.60
|
| Rate for Payer: Prime Health Services Commercial |
$14,283.40
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,082.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,402.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,402.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,402.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,402.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC PERCUTANE DISTAL PHAL FRAC EA
|
Facility
|
IP
|
$16,804.00
|
|
|
Service Code
|
CPT 26756
|
| Hospital Charge Code |
900501333
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,360.80 |
| Max. Negotiated Rate |
$14,283.40 |
| Rate for Payer: Adventist Health Commercial |
$3,360.80
|
| Rate for Payer: Cash Price |
$7,561.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,762.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,721.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,721.60
|
| Rate for Payer: Galaxy Health WC |
$14,283.40
|
| Rate for Payer: Global Benefits Group Commercial |
$10,082.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,670.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,914.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,032.96
|
| Rate for Payer: Multiplan Commercial |
$13,443.20
|
| Rate for Payer: Networks By Design Commercial |
$10,922.60
|
| Rate for Payer: Prime Health Services Commercial |
$14,283.40
|
|
|
HC PERCUTANEOUS SHEATH INTRO 7FR
|
Facility
|
IP
|
$237.30
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901608009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.46 |
| Max. Negotiated Rate |
$201.71 |
| Rate for Payer: Adventist Health Commercial |
$47.46
|
| Rate for Payer: Cash Price |
$106.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$166.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.92
|
| Rate for Payer: EPIC Health Plan Senior |
$94.92
|
| Rate for Payer: Galaxy Health WC |
$201.71
|
| Rate for Payer: Global Benefits Group Commercial |
$142.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$150.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$140.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.95
|
| Rate for Payer: Multiplan Commercial |
$189.84
|
| Rate for Payer: Networks By Design Commercial |
$154.25
|
| Rate for Payer: Prime Health Services Commercial |
$201.71
|
|
|
HC PERCUTANEOUS SHEATH INTRO 7FR
|
Facility
|
OP
|
$237.30
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
901608009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.46 |
| Max. Negotiated Rate |
$266.83 |
| Rate for Payer: Adventist Health Commercial |
$47.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$266.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.28
|
| Rate for Payer: Cash Price |
$106.79
|
| Rate for Payer: Cash Price |
$106.79
|
| Rate for Payer: Cigna of CA HMO |
$151.87
|
| Rate for Payer: Cigna of CA PPO |
$175.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$201.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$201.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$166.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.92
|
| Rate for Payer: EPIC Health Plan Senior |
$94.92
|
| Rate for Payer: Galaxy Health WC |
$201.71
|
| Rate for Payer: Global Benefits Group Commercial |
$142.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$150.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$140.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$166.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$166.11
|
| Rate for Payer: Multiplan Commercial |
$189.84
|
| Rate for Payer: Networks By Design Commercial |
$154.25
|
| Rate for Payer: Prime Health Services Commercial |
$201.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$142.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$142.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$118.65
|
| Rate for Payer: United Healthcare All Other HMO |
$118.65
|
| Rate for Payer: United Healthcare HMO Rider |
$118.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$118.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$201.71
|
| Rate for Payer: Vantage Medical Group Senior |
$201.71
|
|
|
HC PERCUTANEOUS SKELETAL FIXATION
|
Facility
|
OP
|
$9,026.00
|
|
|
Service Code
|
CPT 24538
|
| Hospital Charge Code |
900501694
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$801.46 |
| Max. Negotiated Rate |
$15,398.95 |
| Rate for Payer: Adventist Health Commercial |
$1,805.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$4,061.70
|
| Rate for Payer: Cash Price |
$4,061.70
|
| Rate for Payer: Cash Price |
$4,061.70
|
| Rate for Payer: Cigna of CA HMO |
$5,776.64
|
| Rate for Payer: Cigna of CA PPO |
$6,679.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,318.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,398.95
|
| Rate for Payer: EPIC Health Plan Senior |
$10,265.97
|
| Rate for Payer: Galaxy Health WC |
$7,672.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,415.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,305.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,731.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$801.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,032.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,166.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,759.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,505.82
|
| Rate for Payer: Multiplan Commercial |
$7,220.80
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Networks By Design Commercial |
$5,866.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,672.10
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,415.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,513.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,513.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,513.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,513.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,332.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
HC PERCUTANEOUS SKELETAL FIXATION
|
Facility
|
IP
|
$9,026.00
|
|
|
Service Code
|
CPT 24538
|
| Hospital Charge Code |
900501694
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,805.20 |
| Max. Negotiated Rate |
$7,672.10 |
| Rate for Payer: Adventist Health Commercial |
$1,805.20
|
| Rate for Payer: Cash Price |
$4,061.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,318.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,610.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,610.40
|
| Rate for Payer: Galaxy Health WC |
$7,672.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,415.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,731.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,325.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,166.24
|
| Rate for Payer: Multiplan Commercial |
$7,220.80
|
| Rate for Payer: Networks By Design Commercial |
$5,866.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,672.10
|
|
|
HC PERCUTANEOUS TUBE DRN CATH CHANGE
|
Facility
|
OP
|
$1,851.00
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
909001855
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$113.79 |
| Max. Negotiated Rate |
$1,573.35 |
| Rate for Payer: Adventist Health Commercial |
$370.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$572.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,573.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,018.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,388.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$577.04
|
| Rate for Payer: Blue Shield of California Commercial |
$779.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1,180.94
|
| Rate for Payer: Cash Price |
$832.95
|
| Rate for Payer: Cash Price |
$832.95
|
| Rate for Payer: Cigna of CA HMO |
$1,184.64
|
| Rate for Payer: Cigna of CA PPO |
$1,369.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,573.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,573.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,573.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,295.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.40
|
| Rate for Payer: EPIC Health Plan Senior |
$740.40
|
| Rate for Payer: Galaxy Health WC |
$1,573.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,110.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$113.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,175.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$128.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,092.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$444.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,295.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,295.70
|
| Rate for Payer: Multiplan Commercial |
$1,480.80
|
| Rate for Payer: Networks By Design Commercial |
$1,203.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,573.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,110.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,110.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$925.50
|
| Rate for Payer: United Healthcare All Other HMO |
$925.50
|
| Rate for Payer: United Healthcare HMO Rider |
$925.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$925.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,573.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,573.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,573.35
|
|
|
HC PERCUTANEOUS TUBE DRN CATH CHANGE
|
Facility
|
IP
|
$1,851.00
|
|
|
Service Code
|
CPT 75984
|
| Hospital Charge Code |
909001855
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$370.20 |
| Max. Negotiated Rate |
$1,573.35 |
| Rate for Payer: Adventist Health Commercial |
$370.20
|
| Rate for Payer: Cash Price |
$832.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,295.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.40
|
| Rate for Payer: EPIC Health Plan Senior |
$740.40
|
| Rate for Payer: Galaxy Health WC |
$1,573.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,110.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,175.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,092.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$444.24
|
| Rate for Payer: Multiplan Commercial |
$1,480.80
|
| Rate for Payer: Networks By Design Commercial |
$1,203.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,573.35
|
|
