|
HC PHYSICIAN CASE CONF COORD
|
Facility
|
OP
|
$233.00
|
|
| Hospital Charge Code |
908602547
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$198.05 |
| Rate for Payer: Adventist Health Commercial |
$46.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$198.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$174.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.09
|
| Rate for Payer: Cash Price |
$128.15
|
| Rate for Payer: Cigna of CA HMO |
$149.12
|
| Rate for Payer: Cigna of CA PPO |
$172.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$198.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$198.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.20
|
| Rate for Payer: EPIC Health Plan Senior |
$93.20
|
| Rate for Payer: Galaxy Health WC |
$198.05
|
| Rate for Payer: Global Benefits Group Commercial |
$139.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$155.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.10
|
| Rate for Payer: Multiplan Commercial |
$186.40
|
| Rate for Payer: Networks By Design Commercial |
$151.45
|
| Rate for Payer: Prime Health Services Commercial |
$198.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$139.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$139.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.50
|
| Rate for Payer: United Healthcare All Other HMO |
$116.50
|
| Rate for Payer: United Healthcare HMO Rider |
$116.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$198.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$198.05
|
| Rate for Payer: Vantage Medical Group Senior |
$198.05
|
|
|
HC PHYSICIAN CASE CONF COORD
|
Facility
|
IP
|
$233.00
|
|
| Hospital Charge Code |
908602547
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$198.05 |
| Rate for Payer: Adventist Health Commercial |
$46.60
|
| Rate for Payer: Cash Price |
$128.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.20
|
| Rate for Payer: EPIC Health Plan Senior |
$93.20
|
| Rate for Payer: Galaxy Health WC |
$198.05
|
| Rate for Payer: Global Benefits Group Commercial |
$139.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$155.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.92
|
| Rate for Payer: Multiplan Commercial |
$186.40
|
| Rate for Payer: Networks By Design Commercial |
$151.45
|
| Rate for Payer: Prime Health Services Commercial |
$198.05
|
|
|
HC PHYSICIAN CASE CONF COORD
|
Facility
|
OP
|
$233.00
|
|
| Hospital Charge Code |
908600147
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.60 |
| Max. Negotiated Rate |
$198.05 |
| Rate for Payer: Adventist Health Commercial |
$46.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$198.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$174.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.09
|
| Rate for Payer: Cash Price |
$128.15
|
| Rate for Payer: Cigna of CA HMO |
$149.12
|
| Rate for Payer: Cigna of CA PPO |
$172.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$198.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$198.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$198.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.20
|
| Rate for Payer: EPIC Health Plan Senior |
$93.20
|
| Rate for Payer: Galaxy Health WC |
$198.05
|
| Rate for Payer: Global Benefits Group Commercial |
$139.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$155.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$88.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$144.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$163.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$163.10
|
| Rate for Payer: Multiplan Commercial |
$186.40
|
| Rate for Payer: Networks By Design Commercial |
$151.45
|
| Rate for Payer: Prime Health Services Commercial |
$198.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$139.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$139.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.50
|
| Rate for Payer: United Healthcare All Other HMO |
$116.50
|
| Rate for Payer: United Healthcare HMO Rider |
$116.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$198.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$198.05
|
| Rate for Payer: Vantage Medical Group Senior |
$198.05
|
|
|
HC PHYSICIAN CONF PARTICIP 30 MIN
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
CPT 99367
|
| Hospital Charge Code |
908600144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.57
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Cigna of CA HMO |
$62.08
|
| Rate for Payer: Cigna of CA PPO |
$71.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$82.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38.80
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67.90
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.50
|
| Rate for Payer: United Healthcare All Other HMO |
$48.50
|
| Rate for Payer: United Healthcare HMO Rider |
$48.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$82.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.45
|
| Rate for Payer: Vantage Medical Group Senior |
$82.45
|
|
|
HC PHYSICIAN CONF PARTICIP 30 MIN
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
CPT 99367
|
| Hospital Charge Code |
908600144
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$82.45 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38.80
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
|
|
HC PHYSICIAN CONF PARTICIP 30 MIN
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
CPT 99367
|
| Hospital Charge Code |
908600144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$82.45 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38.80
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
|
|
HC PHYSICIAN CONF PARTICIP 30 MIN
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
CPT 99367
|
| Hospital Charge Code |
908600144
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.57
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Cigna of CA HMO |
$62.08
|
| Rate for Payer: Cigna of CA PPO |
$71.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$82.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38.80
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$67.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$67.90
|
| Rate for Payer: Multiplan Commercial |
$77.60
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.50
|
| Rate for Payer: United Healthcare All Other HMO |
$48.50
|
| Rate for Payer: United Healthcare HMO Rider |
$48.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$82.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.45
|
| Rate for Payer: Vantage Medical Group Senior |
$82.45
|
|
|
HC PHYSICIAN GRP TEACH SUPPORT
|
Facility
|
OP
|
$89.00
|
|
| Hospital Charge Code |
912174313
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$75.65 |
| Rate for Payer: Adventist Health Commercial |
$17.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$48.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.65
|
| Rate for Payer: Cash Price |
$48.95
|
| Rate for Payer: Cigna of CA HMO |
$56.96
|
| Rate for Payer: Cigna of CA PPO |
$65.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.60
|
| Rate for Payer: EPIC Health Plan Senior |
$35.60
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62.30
|
| Rate for Payer: Multiplan Commercial |
$71.20
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.50
|
| Rate for Payer: United Healthcare All Other HMO |
$44.50
|
| Rate for Payer: United Healthcare HMO Rider |
$44.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.65
|
| Rate for Payer: Vantage Medical Group Senior |
$75.65
|
|
|
HC PHYSICIAN GRP TEACH SUPPORT
|
Facility
|
IP
|
$85.00
|
|
| Hospital Charge Code |
908600165
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$72.25 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Cash Price |
$46.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: EPIC Health Plan Senior |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
|
|
HC PHYSICIAN GRP TEACH SUPPORT
|
Facility
|
OP
|
$85.00
|
|
| Hospital Charge Code |
908600165
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$72.25 |
| Rate for Payer: Dignity Health Medi-Cal |
$72.25
|
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.20
|
| Rate for Payer: Cash Price |
$46.75
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$72.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.00
|
| Rate for Payer: EPIC Health Plan Senior |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59.50
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.50
|
| Rate for Payer: United Healthcare All Other HMO |
$42.50
|
| Rate for Payer: United Healthcare HMO Rider |
$42.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.25
|
| Rate for Payer: Vantage Medical Group Senior |
$72.25
|
|
|
HC PHYSICIAN GRP TEACH SUPPORT
|
Facility
|
IP
|
$89.00
|
|
| Hospital Charge Code |
912174313
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$75.65 |
| Rate for Payer: Adventist Health Commercial |
$17.80
|
| Rate for Payer: Cash Price |
$48.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.60
|
| Rate for Payer: EPIC Health Plan Senior |
$35.60
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.36
|
| Rate for Payer: Multiplan Commercial |
$71.20
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
|
|
HC PHYSICIAN PERIODIC CHART REV
|
Facility
|
IP
|
$139.00
|
|
| Hospital Charge Code |
908600145
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$118.15 |
| Rate for Payer: Adventist Health Commercial |
$27.80
|
| Rate for Payer: Cash Price |
$76.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.60
|
| Rate for Payer: EPIC Health Plan Senior |
$55.60
|
| Rate for Payer: Galaxy Health WC |
$118.15
|
| Rate for Payer: Global Benefits Group Commercial |
$83.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.36
|
| Rate for Payer: Multiplan Commercial |
$111.20
|
| Rate for Payer: Networks By Design Commercial |
$90.35
|
| Rate for Payer: Prime Health Services Commercial |
$118.15
|
|
|
HC PHYSICIAN PERIODIC CHART REV
|
Facility
|
OP
|
$139.00
|
|
| Hospital Charge Code |
908600145
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$118.15 |
| Rate for Payer: Adventist Health Commercial |
$27.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$104.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.36
|
| Rate for Payer: Cash Price |
$76.45
|
| Rate for Payer: Cigna of CA HMO |
$88.96
|
| Rate for Payer: Cigna of CA PPO |
$102.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$118.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$118.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.60
|
| Rate for Payer: EPIC Health Plan Senior |
$55.60
|
| Rate for Payer: Galaxy Health WC |
$118.15
|
| Rate for Payer: Global Benefits Group Commercial |
$83.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$97.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$97.30
|
| Rate for Payer: Multiplan Commercial |
$111.20
|
| Rate for Payer: Networks By Design Commercial |
$90.35
|
| Rate for Payer: Prime Health Services Commercial |
$118.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$83.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$83.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.50
|
| Rate for Payer: United Healthcare All Other HMO |
$69.50
|
| Rate for Payer: United Healthcare HMO Rider |
$69.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$118.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$118.15
|
| Rate for Payer: Vantage Medical Group Senior |
$118.15
|
|
|
HC PHYSICIAN PHONE CONSULT 30 MIN
|
Facility
|
IP
|
$138.00
|
|
| Hospital Charge Code |
908600142
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Cash Price |
$75.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: EPIC Health Plan Senior |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.12
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
|
|
HC PHYSICIAN PHONE CONSULT 30 MIN
|
Facility
|
OP
|
$138.00
|
|
| Hospital Charge Code |
908600142
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.75
|
| Rate for Payer: Cash Price |
$75.90
|
| Rate for Payer: Cigna of CA HMO |
$88.32
|
| Rate for Payer: Cigna of CA PPO |
$102.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$117.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: EPIC Health Plan Senior |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.60
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.00
|
| Rate for Payer: United Healthcare All Other HMO |
$69.00
|
| Rate for Payer: United Healthcare HMO Rider |
$69.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$117.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.30
|
| Rate for Payer: Vantage Medical Group Senior |
$117.30
|
|
|
HC PHYSICIAN PHONE CONSULT 30 MIN
|
Facility
|
OP
|
$138.00
|
|
| Hospital Charge Code |
912175432
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.75
|
| Rate for Payer: Cash Price |
$75.90
|
| Rate for Payer: Cigna of CA HMO |
$88.32
|
| Rate for Payer: Cigna of CA PPO |
$102.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$117.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: EPIC Health Plan Senior |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.60
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.00
|
| Rate for Payer: United Healthcare All Other HMO |
$69.00
|
| Rate for Payer: United Healthcare HMO Rider |
$69.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$117.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.30
|
| Rate for Payer: Vantage Medical Group Senior |
$117.30
|
|
|
HC PHYSICIAN PHONE CONSULT 30 MIN
|
Facility
|
IP
|
$138.00
|
|
| Hospital Charge Code |
912175432
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$117.30 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Cash Price |
$75.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: EPIC Health Plan Senior |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.12
|
| Rate for Payer: Multiplan Commercial |
$110.40
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
|
|
HC PHYSIOLOGIC EXERCISE STUDY
|
Facility
|
IP
|
$882.00
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
906811411
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$749.70 |
| Rate for Payer: Adventist Health Commercial |
$176.40
|
| Rate for Payer: Cash Price |
$485.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$352.80
|
| Rate for Payer: EPIC Health Plan Senior |
$352.80
|
| Rate for Payer: Galaxy Health WC |
$749.70
|
| Rate for Payer: Global Benefits Group Commercial |
$529.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$588.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$336.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$545.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$211.68
|
| Rate for Payer: Multiplan Commercial |
$705.60
|
| Rate for Payer: Networks By Design Commercial |
$573.30
|
| Rate for Payer: Prime Health Services Commercial |
$749.70
|
|
|
HC PHYSIOLOGIC EXERCISE STUDY
|
Facility
|
OP
|
$882.00
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
906811411
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$176.40 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$176.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$749.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$485.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$661.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$541.64
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$485.10
|
| Rate for Payer: Cash Price |
$485.10
|
| Rate for Payer: Cash Price |
$485.10
|
| Rate for Payer: Cigna of CA HMO |
$573.30
|
| Rate for Payer: Cigna of CA PPO |
$652.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$749.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$749.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$749.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$352.80
|
| Rate for Payer: EPIC Health Plan Senior |
$352.80
|
| Rate for Payer: Galaxy Health WC |
$749.70
|
| Rate for Payer: Global Benefits Group Commercial |
$529.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$377.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$588.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$545.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$211.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$617.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$617.40
|
| Rate for Payer: Multiplan Commercial |
$705.60
|
| Rate for Payer: Networks By Design Commercial |
$573.30
|
| Rate for Payer: Prime Health Services Commercial |
$749.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$529.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$749.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$749.70
|
| Rate for Payer: Vantage Medical Group Senior |
$749.70
|
|
|
HC PICC CATH KIT 3FR SL 55CM
|
Facility
|
OP
|
$901.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.32 |
| Max. Negotiated Rate |
$766.36 |
| Rate for Payer: Adventist Health Commercial |
$180.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$766.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$495.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$676.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$522.21
|
| Rate for Payer: Blue Shield of California Commercial |
$665.38
|
| Rate for Payer: Blue Shield of California EPN |
$438.18
|
| Rate for Payer: Cash Price |
$495.88
|
| Rate for Payer: Cigna of CA HMO |
$631.12
|
| Rate for Payer: Cigna of CA PPO |
$631.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$766.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$766.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$766.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.64
|
| Rate for Payer: EPIC Health Plan Senior |
$360.64
|
| Rate for Payer: Galaxy Health WC |
$766.36
|
| Rate for Payer: Global Benefits Group Commercial |
$540.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$601.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$343.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$558.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$631.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$631.12
|
| Rate for Payer: Multiplan Commercial |
$721.28
|
| Rate for Payer: Networks By Design Commercial |
$450.80
|
| Rate for Payer: Prime Health Services Commercial |
$766.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$540.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$540.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$338.37
|
| Rate for Payer: United Healthcare All Other HMO |
$329.35
|
| Rate for Payer: United Healthcare HMO Rider |
$322.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$295.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$766.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$766.36
|
| Rate for Payer: Vantage Medical Group Senior |
$766.36
|
|
|
HC PICC CATH KIT 3FR SL 55CM
|
Facility
|
IP
|
$901.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.32 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$180.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$495.88
|
| Rate for Payer: Cash Price |
$495.88
|
| Rate for Payer: Cigna of CA HMO |
$631.12
|
| Rate for Payer: Cigna of CA PPO |
$631.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.64
|
| Rate for Payer: EPIC Health Plan Senior |
$360.64
|
| Rate for Payer: Galaxy Health WC |
$766.36
|
| Rate for Payer: Global Benefits Group Commercial |
$540.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$601.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$343.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$558.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.38
|
| Rate for Payer: Multiplan Commercial |
$721.28
|
| Rate for Payer: Networks By Design Commercial |
$450.80
|
| Rate for Payer: Prime Health Services Commercial |
$766.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$338.37
|
| Rate for Payer: United Healthcare All Other HMO |
$329.35
|
| Rate for Payer: United Healthcare HMO Rider |
$322.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$295.27
|
|
|
HC PICC KIT DUAL LUMEN
|
Facility
|
IP
|
$408.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081719
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$81.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cigna of CA HMO |
$285.60
|
| Rate for Payer: Cigna of CA PPO |
$285.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.20
|
| Rate for Payer: EPIC Health Plan Senior |
$163.20
|
| Rate for Payer: Galaxy Health WC |
$346.80
|
| Rate for Payer: Global Benefits Group Commercial |
$244.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.92
|
| Rate for Payer: Multiplan Commercial |
$326.40
|
| Rate for Payer: Networks By Design Commercial |
$204.00
|
| Rate for Payer: Prime Health Services Commercial |
$346.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$153.12
|
| Rate for Payer: United Healthcare All Other HMO |
$149.04
|
| Rate for Payer: United Healthcare HMO Rider |
$145.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$133.62
|
|
|
HC PICC KIT DUAL LUMEN
|
Facility
|
OP
|
$408.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081719
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$81.60 |
| Max. Negotiated Rate |
$346.80 |
| Rate for Payer: Adventist Health Commercial |
$81.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$346.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.31
|
| Rate for Payer: Blue Shield of California Commercial |
$301.10
|
| Rate for Payer: Blue Shield of California EPN |
$198.29
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cigna of CA HMO |
$285.60
|
| Rate for Payer: Cigna of CA PPO |
$285.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$346.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$346.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$346.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$163.20
|
| Rate for Payer: EPIC Health Plan Senior |
$163.20
|
| Rate for Payer: Galaxy Health WC |
$346.80
|
| Rate for Payer: Global Benefits Group Commercial |
$244.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$272.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.60
|
| Rate for Payer: Multiplan Commercial |
$326.40
|
| Rate for Payer: Networks By Design Commercial |
$204.00
|
| Rate for Payer: Prime Health Services Commercial |
$346.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$244.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$244.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$153.12
|
| Rate for Payer: United Healthcare All Other HMO |
$149.04
|
| Rate for Payer: United Healthcare HMO Rider |
$145.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$133.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$346.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$346.80
|
| Rate for Payer: Vantage Medical Group Senior |
$346.80
|
|
|
HC PICC KIT SINGLE LUMEN
|
Facility
|
IP
|
$302.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.40 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$60.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$166.10
|
| Rate for Payer: Cash Price |
$166.10
|
| Rate for Payer: Cigna of CA HMO |
$211.40
|
| Rate for Payer: Cigna of CA PPO |
$211.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.80
|
| Rate for Payer: EPIC Health Plan Senior |
$120.80
|
| Rate for Payer: Galaxy Health WC |
$256.70
|
| Rate for Payer: Global Benefits Group Commercial |
$181.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.48
|
| Rate for Payer: Multiplan Commercial |
$241.60
|
| Rate for Payer: Networks By Design Commercial |
$151.00
|
| Rate for Payer: Prime Health Services Commercial |
$256.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.34
|
| Rate for Payer: United Healthcare All Other HMO |
$110.32
|
| Rate for Payer: United Healthcare HMO Rider |
$107.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.91
|
|
|
HC PICC KIT SINGLE LUMEN
|
Facility
|
OP
|
$302.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909081718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.40 |
| Max. Negotiated Rate |
$256.70 |
| Rate for Payer: Adventist Health Commercial |
$60.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$166.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$174.92
|
| Rate for Payer: Blue Shield of California Commercial |
$222.88
|
| Rate for Payer: Blue Shield of California EPN |
$146.77
|
| Rate for Payer: Cash Price |
$166.10
|
| Rate for Payer: Cigna of CA HMO |
$211.40
|
| Rate for Payer: Cigna of CA PPO |
$211.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$256.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.80
|
| Rate for Payer: EPIC Health Plan Senior |
$120.80
|
| Rate for Payer: Galaxy Health WC |
$256.70
|
| Rate for Payer: Global Benefits Group Commercial |
$181.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$211.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$211.40
|
| Rate for Payer: Multiplan Commercial |
$241.60
|
| Rate for Payer: Networks By Design Commercial |
$151.00
|
| Rate for Payer: Prime Health Services Commercial |
$256.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.34
|
| Rate for Payer: United Healthcare All Other HMO |
$110.32
|
| Rate for Payer: United Healthcare HMO Rider |
$107.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$256.70
|
| Rate for Payer: Vantage Medical Group Senior |
$256.70
|
|
