|
HC REPLC SOCKT BELOW E/W DISA
|
Facility
|
OP
|
$2,875.00
|
|
|
Service Code
|
CPT L6883
|
| Hospital Charge Code |
915356883
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$690.00 |
| Max. Negotiated Rate |
$2,443.75 |
| Rate for Payer: Adventist Health Commercial |
$1,178.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,443.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,581.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,156.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,740.24
|
| Rate for Payer: Blue Shield of California Commercial |
$2,210.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1,457.62
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Cigna of CA HMO |
$2,012.50
|
| Rate for Payer: Cigna of CA PPO |
$2,012.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,443.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,443.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,443.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,012.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,150.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,150.00
|
| Rate for Payer: Galaxy Health WC |
$2,443.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,725.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,852.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,825.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,095.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,696.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$690.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,012.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,012.50
|
| Rate for Payer: Multiplan Commercial |
$2,300.00
|
| Rate for Payer: Networks By Design Commercial |
$1,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,443.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,725.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,725.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.99
|
| Rate for Payer: United Healthcare All Other HMO |
$1,050.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,027.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$941.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,443.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,443.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,443.75
|
|
|
HC REPLC SOCKT BELOW E/W DISA
|
Facility
|
IP
|
$2,875.00
|
|
|
Service Code
|
CPT L6883
|
| Hospital Charge Code |
915356883
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$575.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$575.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Cash Price |
$1,293.75
|
| Rate for Payer: Cigna of CA HMO |
$2,012.50
|
| Rate for Payer: Cigna of CA PPO |
$2,012.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,012.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,150.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,150.00
|
| Rate for Payer: Galaxy Health WC |
$2,443.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,725.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,825.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,696.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$690.00
|
| Rate for Payer: Multiplan Commercial |
$2,300.00
|
| Rate for Payer: Networks By Design Commercial |
$1,868.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,443.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.99
|
| Rate for Payer: United Healthcare All Other HMO |
$1,050.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,027.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$941.56
|
|
|
HC REPLC SOCKT SHLDR DIS/INTERC
|
Facility
|
IP
|
$7,105.00
|
|
|
Service Code
|
CPT L6885
|
| Hospital Charge Code |
915356885
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,421.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Networks By Design Commercial |
$4,618.25
|
| Rate for Payer: Adventist Health Commercial |
$1,421.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cigna of CA HMO |
$4,973.50
|
| Rate for Payer: Cigna of CA PPO |
$4,973.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,973.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,842.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,842.00
|
| Rate for Payer: Galaxy Health WC |
$6,039.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,263.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,511.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,191.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.20
|
| Rate for Payer: Multiplan Commercial |
$5,684.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,039.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,666.51
|
| Rate for Payer: United Healthcare All Other HMO |
$2,595.46
|
| Rate for Payer: United Healthcare HMO Rider |
$2,539.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,326.89
|
|
|
HC REPLC SOCKT SHLDR DIS/INTERC
|
Facility
|
OP
|
$7,105.00
|
|
|
Service Code
|
CPT L6885
|
| Hospital Charge Code |
905356885
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,705.20 |
| Max. Negotiated Rate |
$6,039.25 |
| Rate for Payer: Adventist Health Commercial |
$2,913.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,039.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,907.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,328.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,300.66
|
| Rate for Payer: Blue Shield of California Commercial |
$5,463.74
|
| Rate for Payer: Blue Shield of California Commercial |
$3,602.24
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cigna of CA HMO |
$4,973.50
|
| Rate for Payer: Cigna of CA PPO |
$4,973.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,039.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,039.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,039.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,973.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,842.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,842.00
|
| Rate for Payer: Galaxy Health WC |
$6,039.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,263.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,577.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,511.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,176.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,191.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,973.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,973.50
|
| Rate for Payer: Multiplan Commercial |
$5,684.00
|
| Rate for Payer: Networks By Design Commercial |
$3,552.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,039.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,263.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,263.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,666.51
|
| Rate for Payer: United Healthcare All Other HMO |
$2,595.46
|
| Rate for Payer: United Healthcare HMO Rider |
$2,539.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,326.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,039.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,039.25
|
| Rate for Payer: Vantage Medical Group Senior |
$6,039.25
|
|
|
HC REPLC SOCKT SHLDR DIS/INTERC
|
Facility
|
OP
|
$7,105.00
|
|
|
Service Code
|
CPT L6885
|
| Hospital Charge Code |
915356885
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,705.20 |
| Max. Negotiated Rate |
$6,039.25 |
| Rate for Payer: Adventist Health Commercial |
$2,913.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,039.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,907.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,328.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,300.66
|
| Rate for Payer: Blue Shield of California Commercial |
$5,463.74
|
| Rate for Payer: Blue Shield of California Commercial |
$3,602.24
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cigna of CA HMO |
$4,973.50
|
| Rate for Payer: Cigna of CA PPO |
$4,973.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,039.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,039.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,039.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,973.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,842.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,842.00
|
| Rate for Payer: Galaxy Health WC |
$6,039.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,263.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,577.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,511.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,176.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,191.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,973.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,973.50
|
| Rate for Payer: Multiplan Commercial |
$5,684.00
|
| Rate for Payer: Networks By Design Commercial |
$3,552.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,039.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,263.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,263.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,666.51
|
| Rate for Payer: United Healthcare All Other HMO |
$2,595.46
|
| Rate for Payer: United Healthcare HMO Rider |
$2,539.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,326.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,039.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,039.25
|
| Rate for Payer: Vantage Medical Group Senior |
$6,039.25
|
|
|
HC REPLC SOCKT SHLDR DIS/INTERC
|
Facility
|
IP
|
$7,105.00
|
|
|
Service Code
|
CPT L6885
|
| Hospital Charge Code |
905356885
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,421.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$1,421.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cash Price |
$3,197.25
|
| Rate for Payer: Cigna of CA HMO |
$4,973.50
|
| Rate for Payer: Cigna of CA PPO |
$4,973.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,973.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,842.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,842.00
|
| Rate for Payer: Galaxy Health WC |
$6,039.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,263.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,511.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,191.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,705.20
|
| Rate for Payer: Multiplan Commercial |
$5,684.00
|
| Rate for Payer: Networks By Design Commercial |
$4,618.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,039.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,666.51
|
| Rate for Payer: United Healthcare All Other HMO |
$2,595.46
|
| Rate for Payer: United Healthcare HMO Rider |
$2,539.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,326.89
|
|
|
HC REPLC TUN CNTRL INSRT CATH W/O
|
Facility
|
IP
|
$10,386.00
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
909080019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,077.20 |
| Max. Negotiated Rate |
$8,828.10 |
| Rate for Payer: Adventist Health Commercial |
$2,077.20
|
| Rate for Payer: Cash Price |
$4,673.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,270.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,154.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,154.40
|
| Rate for Payer: Galaxy Health WC |
$8,828.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,231.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,595.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,127.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,492.64
|
| Rate for Payer: Multiplan Commercial |
$8,308.80
|
| Rate for Payer: Networks By Design Commercial |
$6,750.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,828.10
|
|
|
HC REPLC TUN CNTRL INSRT CATH W/O
|
Facility
|
OP
|
$10,386.00
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
909080019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$293.97 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,077.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$4,673.70
|
| Rate for Payer: Cash Price |
$4,673.70
|
| Rate for Payer: Cash Price |
$4,673.70
|
| Rate for Payer: Cigna of CA HMO |
$6,647.04
|
| Rate for Payer: Cigna of CA PPO |
$7,685.64
|
| 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 |
$7,270.20
|
| 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 |
$8,828.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,231.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$293.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,595.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$332.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,492.64
|
| 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 |
$8,308.80
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,750.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,828.10
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,231.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,193.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| 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 REP LEG TENDON PRIMARY EA
|
Facility
|
IP
|
$8,701.00
|
|
|
Service Code
|
CPT 27664
|
| Hospital Charge Code |
900501603
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,740.20 |
| Max. Negotiated Rate |
$7,395.85 |
| Rate for Payer: Adventist Health Commercial |
$1,740.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,411.41
|
| Rate for Payer: Blue Shield of California Commercial |
$6,691.07
|
| Rate for Payer: Cash Price |
$3,915.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,090.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,480.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,480.40
|
| Rate for Payer: Galaxy Health WC |
$7,395.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,220.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,525.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,133.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,088.24
|
| Rate for Payer: Multiplan Commercial |
$6,960.80
|
| Rate for Payer: Networks By Design Commercial |
$5,655.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,395.85
|
|
|
HC REP LEG TENDON PRIMARY EA
|
Facility
|
OP
|
$8,701.00
|
|
|
Service Code
|
CPT 27664
|
| Hospital Charge Code |
900501603
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$462.61 |
| Max. Negotiated Rate |
$15,398.95 |
| Rate for Payer: Adventist Health Commercial |
$1,740.20
|
| 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 |
$6,716.00
|
| Rate for Payer: Cash Price |
$3,915.45
|
| Rate for Payer: Cash Price |
$3,915.45
|
| Rate for Payer: Cash Price |
$3,915.45
|
| Rate for Payer: Cigna of CA HMO |
$5,568.64
|
| Rate for Payer: Cigna of CA PPO |
$6,438.74
|
| 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 |
$6,090.70
|
| 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 |
$7,395.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,220.60
|
| 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 |
$5,525.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$462.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,032.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,088.24
|
| 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 |
$6,960.80
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Networks By Design Commercial |
$5,655.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,395.85
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,220.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,350.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,350.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,350.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,350.50
|
| 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 REP OF NAIL BED
|
Facility
|
OP
|
$2,031.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$191.69 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$832.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$832.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,045.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$950.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$913.95
|
| Rate for Payer: Cash Price |
$913.95
|
| Rate for Payer: Cash Price |
$913.95
|
| Rate for Payer: Cigna of CA HMO |
$1,299.84
|
| Rate for Payer: Cigna of CA PPO |
$1,502.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,045.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$950.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,421.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,568.44
|
| Rate for Payer: EPIC Health Plan Senior |
$1,045.63
|
| Rate for Payer: Galaxy Health WC |
$1,726.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,218.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,558.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$950.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,289.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,021.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,273.76
|
| Rate for Payer: Multiplan Commercial |
$1,624.80
|
| Rate for Payer: Multiplan WC |
$1,239.24
|
| Rate for Payer: Networks By Design Commercial |
$1,320.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,726.35
|
| Rate for Payer: Prime Health Services WC |
$1,226.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,218.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,218.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$950.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,045.63
|
| Rate for Payer: Vantage Medical Group Senior |
$950.57
|
|
|
HC REP OF NAIL BED
|
Facility
|
IP
|
$2,031.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$406.20 |
| Max. Negotiated Rate |
$1,726.35 |
| Rate for Payer: Adventist Health Commercial |
$406.20
|
| Rate for Payer: Cash Price |
$913.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,421.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$812.40
|
| Rate for Payer: EPIC Health Plan Senior |
$812.40
|
| Rate for Payer: Galaxy Health WC |
$1,726.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,218.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,289.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,198.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.44
|
| Rate for Payer: Multiplan Commercial |
$1,624.80
|
| Rate for Payer: Networks By Design Commercial |
$1,320.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,726.35
|
|
|
HC REP OF NAIL BED
|
Facility
|
IP
|
$2,031.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$406.20 |
| Max. Negotiated Rate |
$1,726.35 |
| Rate for Payer: Adventist Health Commercial |
$406.20
|
| Rate for Payer: Cash Price |
$913.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,421.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$812.40
|
| Rate for Payer: EPIC Health Plan Senior |
$812.40
|
| Rate for Payer: Galaxy Health WC |
$1,726.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,218.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,289.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,198.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.44
|
| Rate for Payer: Multiplan Commercial |
$1,624.80
|
| Rate for Payer: Networks By Design Commercial |
$1,320.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,726.35
|
|
|
HC REP OF NAIL BED
|
Facility
|
OP
|
$2,031.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$191.69 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$406.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,045.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$950.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$913.95
|
| Rate for Payer: Cash Price |
$913.95
|
| Rate for Payer: Cash Price |
$913.95
|
| Rate for Payer: Cigna of CA HMO |
$1,299.84
|
| Rate for Payer: Cigna of CA PPO |
$1,502.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,045.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$950.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,421.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,568.44
|
| Rate for Payer: EPIC Health Plan Senior |
$1,045.63
|
| Rate for Payer: Galaxy Health WC |
$1,726.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,218.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,558.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$950.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,289.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,021.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$487.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,273.76
|
| Rate for Payer: Multiplan Commercial |
$1,624.80
|
| Rate for Payer: Multiplan WC |
$1,239.24
|
| Rate for Payer: Networks By Design Commercial |
$1,320.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,726.35
|
| Rate for Payer: Prime Health Services WC |
$1,226.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,218.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,015.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,015.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,015.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,015.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$950.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,045.63
|
| Rate for Payer: Vantage Medical Group Senior |
$950.57
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
IP
|
$3,241.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.20 |
| Max. Negotiated Rate |
$2,754.85 |
| Rate for Payer: Adventist Health Commercial |
$648.20
|
| Rate for Payer: Cash Price |
$1,458.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,268.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,296.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,296.40
|
| Rate for Payer: Galaxy Health WC |
$2,754.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,944.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,058.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,912.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$777.84
|
| Rate for Payer: Multiplan Commercial |
$2,592.80
|
| Rate for Payer: Networks By Design Commercial |
$2,106.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,754.85
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
OP
|
$3,241.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$648.20 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Adventist Health Commercial |
$648.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$1,458.45
|
| Rate for Payer: Cash Price |
$1,458.45
|
| Rate for Payer: Cash Price |
$1,458.45
|
| Rate for Payer: Cigna of CA HMO |
$2,074.24
|
| Rate for Payer: Cigna of CA PPO |
$2,398.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,268.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$2,754.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,944.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,058.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$867.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$777.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,016.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,592.80
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,106.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,754.85
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,944.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,620.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,620.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,620.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,620.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
IP
|
$3,241.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$648.20 |
| Max. Negotiated Rate |
$2,754.85 |
| Rate for Payer: Adventist Health Commercial |
$648.20
|
| Rate for Payer: Cash Price |
$1,458.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,268.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,296.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,296.40
|
| Rate for Payer: Galaxy Health WC |
$2,754.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,944.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,058.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,912.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$777.84
|
| Rate for Payer: Multiplan Commercial |
$2,592.80
|
| Rate for Payer: Networks By Design Commercial |
$2,106.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,754.85
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
OP
|
$3,241.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$648.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,079.75
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$1,458.45
|
| Rate for Payer: Cash Price |
$1,458.45
|
| Rate for Payer: Cash Price |
$1,458.45
|
| Rate for Payer: Cigna of CA HMO |
$2,074.24
|
| Rate for Payer: Cigna of CA PPO |
$2,398.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,268.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$2,754.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,944.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,058.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$777.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,016.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,592.80
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,106.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,754.85
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,944.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,620.50
|
| 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 |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
IP
|
$4,199.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$839.80 |
| Max. Negotiated Rate |
$3,569.15 |
| Rate for Payer: Galaxy Health WC |
$3,569.15
|
| Rate for Payer: Adventist Health Commercial |
$839.80
|
| Rate for Payer: Cash Price |
$1,889.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,939.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,679.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,679.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,519.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,666.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,477.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,007.76
|
| Rate for Payer: Multiplan Commercial |
$3,359.20
|
| Rate for Payer: Networks By Design Commercial |
$2,729.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,569.15
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
OP
|
$4,199.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$75.06 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$839.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,889.55
|
| Rate for Payer: Cash Price |
$1,889.55
|
| Rate for Payer: Cash Price |
$1,889.55
|
| Rate for Payer: Cigna of CA HMO |
$2,687.36
|
| Rate for Payer: Cigna of CA PPO |
$3,107.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,939.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| Rate for Payer: Galaxy Health WC |
$3,569.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,519.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$75.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,666.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$84.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,007.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,551.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,713.00
|
| Rate for Payer: Multiplan Commercial |
$3,359.20
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$2,729.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,569.15
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,519.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,099.50
|
| 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 |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
OP
|
$4,199.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$75.06 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Adventist Health Commercial |
$839.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,889.55
|
| Rate for Payer: Cash Price |
$1,889.55
|
| Rate for Payer: Cash Price |
$1,889.55
|
| Rate for Payer: Cigna of CA HMO |
$2,729.35
|
| Rate for Payer: Cigna of CA PPO |
$3,107.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,939.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| Rate for Payer: Galaxy Health WC |
$3,569.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,519.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$75.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,666.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$84.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,007.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,551.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,713.00
|
| Rate for Payer: Multiplan Commercial |
$3,359.20
|
| Rate for Payer: Networks By Design Commercial |
$2,729.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,569.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,519.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,519.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,099.50
|
| 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 |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
IP
|
$4,199.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$839.80 |
| Max. Negotiated Rate |
$3,569.15 |
| Rate for Payer: Adventist Health Commercial |
$839.80
|
| Rate for Payer: Cash Price |
$1,889.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,939.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,679.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,679.60
|
| Rate for Payer: Galaxy Health WC |
$3,569.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,519.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,666.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,477.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,007.76
|
| Rate for Payer: Multiplan Commercial |
$3,359.20
|
| Rate for Payer: Networks By Design Commercial |
$2,729.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,569.15
|
|
|
HC REPOSITION VAD DIFF SESSION
|
Facility
|
IP
|
$7,426.00
|
|
|
Service Code
|
CPT 33993
|
| Hospital Charge Code |
906811431
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,485.20 |
| Max. Negotiated Rate |
$6,312.10 |
| Rate for Payer: Adventist Health Commercial |
$1,485.20
|
| Rate for Payer: Cash Price |
$3,341.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,198.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,970.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,970.40
|
| Rate for Payer: Galaxy Health WC |
$6,312.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,455.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,715.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,381.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,782.24
|
| Rate for Payer: Multiplan Commercial |
$5,940.80
|
| Rate for Payer: Networks By Design Commercial |
$4,826.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,312.10
|
|
|
HC REPOSITION VAD DIFF SESSION
|
Facility
|
OP
|
$7,426.00
|
|
|
Service Code
|
CPT 33993
|
| Hospital Charge Code |
906811431
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$48.79 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,485.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,084.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,569.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,472.51
|
| Rate for Payer: Blue Shield of California Commercial |
$5,596.61
|
| Rate for Payer: Cash Price |
$3,341.70
|
| Rate for Payer: Cash Price |
$3,341.70
|
| Rate for Payer: Cash Price |
$3,341.70
|
| Rate for Payer: Cigna of CA HMO |
$4,826.90
|
| Rate for Payer: Cigna of CA PPO |
$5,495.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,312.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,312.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,198.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,970.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,970.40
|
| Rate for Payer: Galaxy Health WC |
$6,312.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,455.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$48.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,715.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,381.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,782.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,198.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,198.20
|
| Rate for Payer: Multiplan Commercial |
$5,940.80
|
| Rate for Payer: Networks By Design Commercial |
$4,826.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,312.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,455.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,455.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,713.00
|
| 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 |
$6,312.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,312.10
|
| Rate for Payer: Vantage Medical Group Senior |
$6,312.10
|
|
|
HC REP PRIM, RUPTRD ACHILLES TEND
|
Facility
|
OP
|
$11,311.00
|
|
|
Service Code
|
CPT 27650
|
| Hospital Charge Code |
900501585
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$881.39 |
| Max. Negotiated Rate |
$15,398.95 |
| Rate for Payer: Adventist Health Commercial |
$2,262.20
|
| 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 |
$8,240.00
|
| Rate for Payer: Cash Price |
$5,089.95
|
| Rate for Payer: Cash Price |
$5,089.95
|
| Rate for Payer: Cash Price |
$5,089.95
|
| Rate for Payer: Cigna of CA HMO |
$7,239.04
|
| Rate for Payer: Cigna of CA PPO |
$8,370.14
|
| 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 |
$7,917.70
|
| 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 |
$9,614.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6,786.60
|
| 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 |
$7,182.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$881.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,032.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,714.64
|
| 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 |
$9,048.80
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Networks By Design Commercial |
$7,352.15
|
| Rate for Payer: Prime Health Services Commercial |
$9,614.35
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,786.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,655.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,655.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,655.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,655.50
|
| 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
|
|
