|
HC RN ASSESSMENT 30 MIN
|
Facility
|
OP
|
$92.00
|
|
| Hospital Charge Code |
912904301
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$78.20 |
| Rate for Payer: Adventist Health Commercial |
$18.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$78.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$50.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$69.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.50
|
| Rate for Payer: Cash Price |
$50.60
|
| Rate for Payer: Cigna of CA HMO |
$58.88
|
| Rate for Payer: Cigna of CA PPO |
$68.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$78.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$78.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$78.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.80
|
| Rate for Payer: EPIC Health Plan Senior |
$36.80
|
| Rate for Payer: Galaxy Health WC |
$78.20
|
| Rate for Payer: Global Benefits Group Commercial |
$55.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$61.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$56.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.40
|
| Rate for Payer: Multiplan Commercial |
$73.60
|
| Rate for Payer: Networks By Design Commercial |
$59.80
|
| Rate for Payer: Prime Health Services Commercial |
$78.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$55.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$46.00
|
| Rate for Payer: United Healthcare All Other HMO |
$46.00
|
| Rate for Payer: United Healthcare HMO Rider |
$46.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$78.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$78.20
|
| Rate for Payer: Vantage Medical Group Senior |
$78.20
|
|
|
HC RN COMP CHART REVIEW
|
Facility
|
OP
|
$213.00
|
|
| Hospital Charge Code |
912900113
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$139.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.80
|
| Rate for Payer: Cash Price |
$117.15
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$181.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$149.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.10
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$106.50
|
| Rate for Payer: United Healthcare All Other HMO |
$106.50
|
| Rate for Payer: United Healthcare HMO Rider |
$106.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$181.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.05
|
| Rate for Payer: Vantage Medical Group Senior |
$181.05
|
|
|
HC RN COMP CHART REVIEW
|
Facility
|
IP
|
$213.00
|
|
| Hospital Charge Code |
912900113
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$181.05 |
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Cash Price |
$117.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.12
|
| Rate for Payer: Multiplan Commercial |
$170.40
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC RN CONF COORDINATOR
|
Facility
|
IP
|
$219.00
|
|
| Hospital Charge Code |
912900109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$186.15 |
| Rate for Payer: Adventist Health Commercial |
$43.80
|
| Rate for Payer: Cash Price |
$120.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.60
|
| Rate for Payer: EPIC Health Plan Senior |
$87.60
|
| Rate for Payer: Galaxy Health WC |
$186.15
|
| Rate for Payer: Global Benefits Group Commercial |
$131.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.56
|
| Rate for Payer: Multiplan Commercial |
$175.20
|
| Rate for Payer: Networks By Design Commercial |
$142.35
|
| Rate for Payer: Prime Health Services Commercial |
$186.15
|
|
|
HC RN CONF COORDINATOR
|
Facility
|
OP
|
$219.00
|
|
| Hospital Charge Code |
912900109
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$186.15 |
| Rate for Payer: Adventist Health Commercial |
$43.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$143.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$186.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$164.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$134.49
|
| Rate for Payer: Cash Price |
$120.45
|
| Rate for Payer: Cigna of CA HMO |
$140.16
|
| Rate for Payer: Cigna of CA PPO |
$162.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$186.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$186.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$186.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.60
|
| Rate for Payer: EPIC Health Plan Senior |
$87.60
|
| Rate for Payer: Galaxy Health WC |
$186.15
|
| Rate for Payer: Global Benefits Group Commercial |
$131.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$146.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$153.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$153.30
|
| Rate for Payer: Multiplan Commercial |
$175.20
|
| Rate for Payer: Networks By Design Commercial |
$142.35
|
| Rate for Payer: Prime Health Services Commercial |
$186.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.50
|
| Rate for Payer: United Healthcare All Other HMO |
$109.50
|
| Rate for Payer: United Healthcare HMO Rider |
$109.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$186.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.15
|
| Rate for Payer: Vantage Medical Group Senior |
$186.15
|
|
|
HC RN GROUP TEACHING
|
Facility
|
OP
|
$33.00
|
|
| Hospital Charge Code |
912900004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$28.05 |
| Rate for Payer: Adventist Health Commercial |
$6.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.27
|
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: Cigna of CA HMO |
$21.12
|
| Rate for Payer: Cigna of CA PPO |
$24.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.20
|
| Rate for Payer: EPIC Health Plan Senior |
$13.20
|
| Rate for Payer: Galaxy Health WC |
$28.05
|
| Rate for Payer: Global Benefits Group Commercial |
$19.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.10
|
| Rate for Payer: Multiplan Commercial |
$26.40
|
| Rate for Payer: Networks By Design Commercial |
$21.45
|
| Rate for Payer: Prime Health Services Commercial |
$28.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.50
|
| Rate for Payer: United Healthcare All Other HMO |
$16.50
|
| Rate for Payer: United Healthcare HMO Rider |
$16.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.05
|
| Rate for Payer: Vantage Medical Group Senior |
$28.05
|
|
|
HC RN GROUP TEACHING
|
Facility
|
IP
|
$33.00
|
|
| Hospital Charge Code |
912900004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$28.05 |
| Rate for Payer: Adventist Health Commercial |
$6.60
|
| Rate for Payer: Cash Price |
$18.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.20
|
| Rate for Payer: EPIC Health Plan Senior |
$13.20
|
| Rate for Payer: Galaxy Health WC |
$28.05
|
| Rate for Payer: Global Benefits Group Commercial |
$19.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.92
|
| Rate for Payer: Multiplan Commercial |
$26.40
|
| Rate for Payer: Networks By Design Commercial |
$21.45
|
| Rate for Payer: Prime Health Services Commercial |
$28.05
|
|
|
HC RN PER CHART REVIEW
|
Facility
|
OP
|
$86.00
|
|
| Hospital Charge Code |
912900112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$73.10 |
| Rate for Payer: Adventist Health Commercial |
$17.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$56.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$73.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$47.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.81
|
| Rate for Payer: Cash Price |
$47.30
|
| Rate for Payer: Cigna of CA HMO |
$55.04
|
| Rate for Payer: Cigna of CA PPO |
$63.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$73.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.40
|
| Rate for Payer: EPIC Health Plan Senior |
$34.40
|
| Rate for Payer: Galaxy Health WC |
$73.10
|
| Rate for Payer: Global Benefits Group Commercial |
$51.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$60.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: Networks By Design Commercial |
$55.90
|
| Rate for Payer: Prime Health Services Commercial |
$73.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.00
|
| Rate for Payer: United Healthcare All Other HMO |
$43.00
|
| Rate for Payer: United Healthcare HMO Rider |
$43.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$73.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.10
|
| Rate for Payer: Vantage Medical Group Senior |
$73.10
|
|
|
HC RN PER CHART REVIEW
|
Facility
|
IP
|
$86.00
|
|
| Hospital Charge Code |
912900112
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$73.10 |
| Rate for Payer: Adventist Health Commercial |
$17.20
|
| Rate for Payer: Cash Price |
$47.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.40
|
| Rate for Payer: EPIC Health Plan Senior |
$34.40
|
| Rate for Payer: Galaxy Health WC |
$73.10
|
| Rate for Payer: Global Benefits Group Commercial |
$51.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$57.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$53.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.64
|
| Rate for Payer: Multiplan Commercial |
$68.80
|
| Rate for Payer: Networks By Design Commercial |
$55.90
|
| Rate for Payer: Prime Health Services Commercial |
$73.10
|
|
|
HC RN PHONE CONSULT 15 MIN
|
Facility
|
IP
|
$23.00
|
|
| Hospital Charge Code |
912900008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Cash Price |
$12.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC RN PHONE CONSULT 15 MIN
|
Facility
|
OP
|
$23.00
|
|
| Hospital Charge Code |
912900008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Adventist Health Commercial |
$4.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.12
|
| Rate for Payer: Cash Price |
$12.65
|
| Rate for Payer: Cigna of CA HMO |
$14.72
|
| Rate for Payer: Cigna of CA PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.10
|
| Rate for Payer: Multiplan Commercial |
$18.40
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19.55
|
|
|
HC RN SW CONF PARTIC COORD
|
Facility
|
IP
|
$245.00
|
|
| Hospital Charge Code |
915500045
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$208.25 |
| Rate for Payer: Adventist Health Commercial |
$49.00
|
| Rate for Payer: Cash Price |
$134.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.00
|
| Rate for Payer: EPIC Health Plan Senior |
$98.00
|
| Rate for Payer: Galaxy Health WC |
$208.25
|
| Rate for Payer: Global Benefits Group Commercial |
$147.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$163.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$151.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.80
|
| Rate for Payer: Multiplan Commercial |
$196.00
|
| Rate for Payer: Networks By Design Commercial |
$159.25
|
| Rate for Payer: Prime Health Services Commercial |
$208.25
|
|
|
HC RN SW CONF PARTIC COORD
|
Facility
|
OP
|
$245.00
|
|
| Hospital Charge Code |
915500045
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$208.25 |
| Rate for Payer: Adventist Health Commercial |
$49.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$160.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$208.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$134.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$183.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.45
|
| Rate for Payer: Cash Price |
$134.75
|
| Rate for Payer: Cigna of CA HMO |
$156.80
|
| Rate for Payer: Cigna of CA PPO |
$181.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$208.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$208.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$208.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.00
|
| Rate for Payer: EPIC Health Plan Senior |
$98.00
|
| Rate for Payer: Galaxy Health WC |
$208.25
|
| Rate for Payer: Global Benefits Group Commercial |
$147.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$163.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$151.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$171.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$171.50
|
| Rate for Payer: Multiplan Commercial |
$196.00
|
| Rate for Payer: Networks By Design Commercial |
$159.25
|
| Rate for Payer: Prime Health Services Commercial |
$208.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$147.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$122.50
|
| Rate for Payer: United Healthcare All Other HMO |
$122.50
|
| Rate for Payer: United Healthcare HMO Rider |
$122.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$122.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$208.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$208.25
|
| Rate for Payer: Vantage Medical Group Senior |
$208.25
|
|
|
HC ROCKER BOTTOM CONTACT AFO
|
Facility
|
OP
|
$203.90
|
|
|
Service Code
|
CPT L2232
|
| Hospital Charge Code |
905352232
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.94 |
| Max. Negotiated Rate |
$173.31 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$173.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$112.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$152.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.10
|
| Rate for Payer: Blue Shield of California Commercial |
$150.48
|
| Rate for Payer: Blue Shield of California EPN |
$99.10
|
| Rate for Payer: Cash Price |
$112.15
|
| Rate for Payer: Cash Price |
$112.15
|
| Rate for Payer: Cigna of CA HMO |
$142.73
|
| Rate for Payer: Cigna of CA PPO |
$142.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$173.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$173.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$173.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.56
|
| Rate for Payer: EPIC Health Plan Senior |
$81.56
|
| Rate for Payer: Galaxy Health WC |
$173.31
|
| Rate for Payer: Global Benefits Group Commercial |
$122.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$105.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$126.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$142.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142.73
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$101.95
|
| Rate for Payer: Prime Health Services Commercial |
$173.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$122.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$122.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.52
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$72.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$173.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$173.31
|
| Rate for Payer: Vantage Medical Group Senior |
$173.31
|
|
|
HC ROCKER BOTTOM CONTACT AFO
|
Facility
|
OP
|
$203.90
|
|
|
Service Code
|
CPT L2232
|
| Hospital Charge Code |
915352232
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.94 |
| Max. Negotiated Rate |
$173.31 |
| Rate for Payer: Adventist Health Commercial |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$173.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$112.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$152.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.10
|
| Rate for Payer: Blue Shield of California Commercial |
$150.48
|
| Rate for Payer: Blue Shield of California EPN |
$99.10
|
| Rate for Payer: Cash Price |
$112.15
|
| Rate for Payer: Cash Price |
$112.15
|
| Rate for Payer: Cigna of CA HMO |
$142.73
|
| Rate for Payer: Cigna of CA PPO |
$142.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$173.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$173.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$173.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.56
|
| Rate for Payer: EPIC Health Plan Senior |
$81.56
|
| Rate for Payer: Galaxy Health WC |
$173.31
|
| Rate for Payer: Global Benefits Group Commercial |
$122.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$105.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$118.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$126.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$142.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142.73
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$101.95
|
| Rate for Payer: Prime Health Services Commercial |
$173.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$122.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$122.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.52
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$72.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$173.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$173.31
|
| Rate for Payer: Vantage Medical Group Senior |
$173.31
|
|
|
HC ROCKER BOTTOM CONTACT AFO
|
Facility
|
IP
|
$203.90
|
|
|
Service Code
|
CPT L2232
|
| Hospital Charge Code |
905352232
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.78 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$40.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$112.15
|
| Rate for Payer: Cash Price |
$112.15
|
| Rate for Payer: Cigna of CA HMO |
$142.73
|
| Rate for Payer: Cigna of CA PPO |
$142.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.56
|
| Rate for Payer: EPIC Health Plan Senior |
$81.56
|
| Rate for Payer: Galaxy Health WC |
$173.31
|
| Rate for Payer: Global Benefits Group Commercial |
$122.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$126.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.94
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$101.95
|
| Rate for Payer: Prime Health Services Commercial |
$173.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.52
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$72.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.78
|
|
|
HC ROCKER BOTTOM CONTACT AFO
|
Facility
|
IP
|
$203.90
|
|
|
Service Code
|
CPT L2232
|
| Hospital Charge Code |
915352232
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.78 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$40.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$112.15
|
| Rate for Payer: Cash Price |
$112.15
|
| Rate for Payer: Cigna of CA HMO |
$142.73
|
| Rate for Payer: Cigna of CA PPO |
$142.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.56
|
| Rate for Payer: EPIC Health Plan Senior |
$81.56
|
| Rate for Payer: Galaxy Health WC |
$173.31
|
| Rate for Payer: Global Benefits Group Commercial |
$122.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$126.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.94
|
| Rate for Payer: Multiplan Commercial |
$163.12
|
| Rate for Payer: Networks By Design Commercial |
$101.95
|
| Rate for Payer: Prime Health Services Commercial |
$173.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.52
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$72.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.78
|
|
|
HC ROOM BOARDER BABY
|
Facility
|
IP
|
$4,026.00
|
|
| Hospital Charge Code |
902300021
|
|
Hospital Revenue Code
|
171
|
| Min. Negotiated Rate |
$805.20 |
| Max. Negotiated Rate |
$4,527.00 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,687.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,406.00
|
| Rate for Payer: Blue Shield of California EPN |
$929.00
|
| Rate for Payer: Cash Price |
$2,214.30
|
| Rate for Payer: Cash Price |
$2,214.30
|
| Rate for Payer: Cigna of CA HMO |
$945.00
|
| Rate for Payer: Cigna of CA PPO |
$1,155.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,610.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,610.40
|
| Rate for Payer: Galaxy Health WC |
$3,422.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,415.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,527.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,685.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,533.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,492.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$966.24
|
| Rate for Payer: Multiplan Commercial |
$3,220.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,422.10
|
|
|
HC ROOM DOU/INTERMEDIATE
|
Facility
|
IP
|
$6,879.00
|
|
| Hospital Charge Code |
992348107
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$1,375.80 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,375.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,691.00
|
| Rate for Payer: Blue Shield of California EPN |
$4,417.00
|
| Rate for Payer: Cash Price |
$3,783.45
|
| Rate for Payer: Cash Price |
$3,783.45
|
| Rate for Payer: Cash Price |
$3,783.45
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,751.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,751.60
|
| Rate for Payer: Galaxy Health WC |
$5,847.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,127.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,200.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,588.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,620.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,258.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,650.96
|
| Rate for Payer: Multiplan Commercial |
$5,503.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,847.15
|
|
|
HC ROOM DOU/INTERMEDIATE
|
Facility
|
IP
|
$7,085.00
|
|
| Hospital Charge Code |
902348107
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$1,417.00 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,417.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,691.00
|
| Rate for Payer: Blue Shield of California EPN |
$4,417.00
|
| Rate for Payer: Cash Price |
$3,896.75
|
| Rate for Payer: Cash Price |
$3,896.75
|
| Rate for Payer: Cash Price |
$3,896.75
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,834.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,834.00
|
| Rate for Payer: Galaxy Health WC |
$6,022.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,251.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,200.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,725.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,699.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,385.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,700.40
|
| Rate for Payer: Multiplan Commercial |
$5,668.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,022.25
|
|
|
HC ROOM DOU INTERM ISO
|
Facility
|
IP
|
$8,236.00
|
|
| Hospital Charge Code |
902300010
|
|
Hospital Revenue Code
|
164
|
| Min. Negotiated Rate |
$1,647.20 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,647.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,425.00
|
| Rate for Payer: Blue Shield of California EPN |
$3,562.00
|
| Rate for Payer: Cash Price |
$4,529.80
|
| Rate for Payer: Cash Price |
$4,529.80
|
| Rate for Payer: Cash Price |
$4,529.80
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,294.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,294.40
|
| Rate for Payer: Galaxy Health WC |
$7,000.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,941.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,970.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,493.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,137.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,098.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,976.64
|
| Rate for Payer: Multiplan Commercial |
$6,588.80
|
| Rate for Payer: Networks By Design Commercial |
$5,353.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,000.60
|
|
|
HC ROOM HEART TRANSPLANT
|
Facility
|
IP
|
$31,528.00
|
|
| Hospital Charge Code |
902341218
|
|
Hospital Revenue Code
|
213
|
| Min. Negotiated Rate |
$3,562.00 |
| Max. Negotiated Rate |
$26,798.80 |
| Rate for Payer: Adventist Health Commercial |
$6,305.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,521.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,425.00
|
| Rate for Payer: Blue Shield of California EPN |
$3,562.00
|
| Rate for Payer: Cash Price |
$17,340.40
|
| Rate for Payer: Cash Price |
$17,340.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,611.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12,611.20
|
| Rate for Payer: Galaxy Health WC |
$26,798.80
|
| Rate for Payer: Global Benefits Group Commercial |
$18,916.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,650.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,029.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,012.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,515.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,566.72
|
| Rate for Payer: Multiplan Commercial |
$25,222.40
|
| Rate for Payer: Prime Health Services Commercial |
$26,798.80
|
|
|
HC ROOM HEART TRANSPLANT 1:1
|
Facility
|
IP
|
$30,610.00
|
|
| Hospital Charge Code |
992341218
|
|
Hospital Revenue Code
|
213
|
| Min. Negotiated Rate |
$3,562.00 |
| Max. Negotiated Rate |
$26,018.50 |
| Rate for Payer: Adventist Health Commercial |
$6,122.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,521.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,425.00
|
| Rate for Payer: Blue Shield of California EPN |
$3,562.00
|
| Rate for Payer: Cash Price |
$16,835.50
|
| Rate for Payer: Cash Price |
$16,835.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,244.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,244.00
|
| Rate for Payer: Galaxy Health WC |
$26,018.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,366.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,650.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,416.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,662.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,947.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,346.40
|
| Rate for Payer: Multiplan Commercial |
$24,488.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,018.50
|
|
|
HC ROOM ICU
|
Facility
|
IP
|
$20,211.00
|
|
| Hospital Charge Code |
902314214
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$4,042.20 |
| Max. Negotiated Rate |
$17,179.35 |
| Rate for Payer: Adventist Health Commercial |
$4,042.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,521.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,170.00
|
| Rate for Payer: Blue Shield of California EPN |
$6,053.00
|
| Rate for Payer: Cash Price |
$11,116.05
|
| Rate for Payer: Cash Price |
$11,116.05
|
| Rate for Payer: Cash Price |
$11,116.05
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,084.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,084.40
|
| Rate for Payer: Galaxy Health WC |
$17,179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$12,126.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,650.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,480.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,700.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,510.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,850.64
|
| Rate for Payer: Multiplan Commercial |
$16,168.80
|
| Rate for Payer: Prime Health Services Commercial |
$17,179.35
|
|
|
HC ROOM ICU 1:1
|
Facility
|
IP
|
$20,211.00
|
|
| Hospital Charge Code |
992314214
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$4,042.20 |
| Max. Negotiated Rate |
$17,179.35 |
| Rate for Payer: Adventist Health Commercial |
$4,042.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,521.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,170.00
|
| Rate for Payer: Blue Shield of California EPN |
$6,053.00
|
| Rate for Payer: Cash Price |
$11,116.05
|
| Rate for Payer: Cash Price |
$11,116.05
|
| Rate for Payer: Cash Price |
$11,116.05
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,084.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,084.40
|
| Rate for Payer: Galaxy Health WC |
$17,179.35
|
| Rate for Payer: Global Benefits Group Commercial |
$12,126.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,650.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,480.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,700.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,510.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,850.64
|
| Rate for Payer: Multiplan Commercial |
$16,168.80
|
| Rate for Payer: Prime Health Services Commercial |
$17,179.35
|
|
