|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$319.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$290.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$269.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC RMVL OF SKIN TAGS 1-15 LESIONS
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 11200
|
| Hospital Charge Code |
900501378
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$388.45 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$205.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$319.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$290.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$269.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.68
|
| Rate for Payer: Multiplan Commercial |
$365.60
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC RMVL PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
IP
|
$9,938.00
|
|
|
Service Code
|
CPT 0922T
|
| Hospital Charge Code |
906811510
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,987.60 |
| Max. Negotiated Rate |
$8,447.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.20
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,863.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.12
|
| Rate for Payer: Multiplan Commercial |
$7,950.40
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
|
|
HC RMVL PERM CCM DFIB SYS DUAL LEADS
|
Facility
|
OP
|
$9,938.00
|
|
|
Service Code
|
CPT 0922T
|
| Hospital Charge Code |
906811510
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$8,447.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,518.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cigna of CA HMO |
$6,360.32
|
| Rate for Payer: Cigna of CA PPO |
$7,354.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,607.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,056.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,950.40
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,962.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC RMVL PERM CCM DFIB SYS PG ONLY
|
Facility
|
OP
|
$9,938.00
|
|
|
Service Code
|
CPT 0919T
|
| Hospital Charge Code |
906811507
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$8,447.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,518.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cigna of CA HMO |
$6,360.32
|
| Rate for Payer: Cigna of CA PPO |
$7,354.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,607.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,056.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,950.40
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,962.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC RMVL PERM CCM DFIB SYS PG ONLY
|
Facility
|
IP
|
$9,938.00
|
|
|
Service Code
|
CPT 0919T
|
| Hospital Charge Code |
906811507
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,987.60 |
| Max. Negotiated Rate |
$8,447.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.20
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,863.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.12
|
| Rate for Payer: Multiplan Commercial |
$7,950.40
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE DFB LEAD
|
Facility
|
IP
|
$9,938.00
|
|
|
Service Code
|
CPT 0921T
|
| Hospital Charge Code |
906811509
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,987.60 |
| Max. Negotiated Rate |
$8,447.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.20
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,863.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.12
|
| Rate for Payer: Multiplan Commercial |
$7,950.40
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE DFB LEAD
|
Facility
|
OP
|
$9,938.00
|
|
|
Service Code
|
CPT 0921T
|
| Hospital Charge Code |
906811509
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$8,447.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,518.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cigna of CA HMO |
$6,360.32
|
| Rate for Payer: Cigna of CA PPO |
$7,354.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,607.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,056.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,950.40
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,962.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE PAC LEAD
|
Facility
|
IP
|
$9,938.00
|
|
|
Service Code
|
CPT 0920T
|
| Hospital Charge Code |
906811508
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,987.60 |
| Max. Negotiated Rate |
$8,447.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.20
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,863.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.12
|
| Rate for Payer: Multiplan Commercial |
$7,950.40
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
|
|
HC RMVL PERM CCM DFIB SYS SINGLE PAC LEAD
|
Facility
|
OP
|
$9,938.00
|
|
|
Service Code
|
CPT 0920T
|
| Hospital Charge Code |
906811508
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$8,447.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,518.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,806.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cash Price |
$4,472.10
|
| Rate for Payer: Cigna of CA HMO |
$6,360.32
|
| Rate for Payer: Cigna of CA PPO |
$7,354.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,286.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,806.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,956.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,930.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5,286.98
|
| Rate for Payer: Galaxy Health WC |
$8,447.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,882.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,806.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,310.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,607.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,728.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,056.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,440.51
|
| Rate for Payer: Multiplan Commercial |
$7,950.40
|
| Rate for Payer: Networks By Design Commercial |
$6,459.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,447.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,962.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,806.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,209.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,286.98
|
| Rate for Payer: Vantage Medical Group Senior |
$4,806.35
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cigna of CA HMO |
$632.96
|
| Rate for Payer: Cigna of CA PPO |
$731.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$395.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.55
|
| Rate for Payer: EPIC Health Plan Senior |
$395.70
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$589.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$359.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$628.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$453.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$494.50
|
| Rate for Payer: United Healthcare All Other HMO |
$494.50
|
| Rate for Payer: United Healthcare HMO Rider |
$494.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$494.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$359.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Vantage Medical Group Senior |
$359.73
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$405.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$298.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Cigna of CA HMO |
$632.96
|
| Rate for Payer: Cigna of CA PPO |
$731.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$395.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.55
|
| Rate for Payer: EPIC Health Plan Senior |
$395.70
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$589.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$359.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$628.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$453.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$593.40
|
| 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 |
$359.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Vantage Medical Group Senior |
$359.73
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$840.65 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$628.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
|
|
HC RMVL REPAIR FULL ARM/LEG CAST
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT 29705
|
| Hospital Charge Code |
900501111
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$840.65 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Cash Price |
$445.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$692.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$628.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$583.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
|
|
HC RMVL SUBQ CARDIAC RHYTHM MNTR
|
Facility
|
IP
|
$3,421.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
906813407
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$684.20 |
| Max. Negotiated Rate |
$2,907.85 |
| Rate for Payer: Adventist Health Commercial |
$684.20
|
| Rate for Payer: Cash Price |
$1,539.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,394.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,368.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,368.40
|
| Rate for Payer: Galaxy Health WC |
$2,907.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,052.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,172.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,018.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$821.04
|
| Rate for Payer: Multiplan Commercial |
$2,736.80
|
| Rate for Payer: Networks By Design Commercial |
$2,223.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,907.85
|
|
|
HC RMVL SUBQ CARDIAC RHYTHM MNTR
|
Facility
|
OP
|
$3,421.00
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
906813407
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$684.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,638.65
|
| Rate for Payer: Blue Shield of California Commercial |
$5,508.41
|
| Rate for Payer: Cash Price |
$1,539.45
|
| Rate for Payer: Cash Price |
$1,539.45
|
| Rate for Payer: Cash Price |
$1,539.45
|
| Rate for Payer: Cigna of CA HMO |
$2,189.44
|
| Rate for Payer: Cigna of CA PPO |
$2,531.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,394.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,907.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,052.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$38.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,172.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$821.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,147.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,736.80
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,223.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,907.85
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,052.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,710.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC RMV SELF-CONTD PENIS PROS
|
Facility
|
IP
|
$6,927.00
|
|
|
Service Code
|
CPT 54415
|
| Hospital Charge Code |
900501733
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,385.40 |
| Max. Negotiated Rate |
$5,887.95 |
| Rate for Payer: Adventist Health Commercial |
$1,385.40
|
| Rate for Payer: Cash Price |
$3,117.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,848.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,770.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,770.80
|
| Rate for Payer: Galaxy Health WC |
$5,887.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,156.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,398.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,086.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,662.48
|
| Rate for Payer: Multiplan Commercial |
$5,541.60
|
| Rate for Payer: Networks By Design Commercial |
$4,502.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,887.95
|
|
|
HC RMV SELF-CONTD PENIS PROS
|
Facility
|
OP
|
$6,927.00
|
|
|
Service Code
|
CPT 54415
|
| Hospital Charge Code |
900501733
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$821.26 |
| Max. Negotiated Rate |
$9,104.00 |
| Rate for Payer: Adventist Health Commercial |
$1,385.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,987.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,533.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Cash Price |
$3,117.15
|
| Rate for Payer: Cash Price |
$3,117.15
|
| Rate for Payer: Cash Price |
$3,117.15
|
| Rate for Payer: Cigna of CA HMO |
$4,433.28
|
| Rate for Payer: Cigna of CA PPO |
$5,125.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,987.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,533.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,848.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,480.62
|
| Rate for Payer: EPIC Health Plan Senior |
$4,987.08
|
| Rate for Payer: Galaxy Health WC |
$5,887.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,156.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,435.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,533.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,398.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$821.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,873.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,662.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,712.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,075.17
|
| Rate for Payer: Multiplan Commercial |
$5,541.60
|
| Rate for Payer: Multiplan WC |
$6,982.34
|
| Rate for Payer: Networks By Design Commercial |
$4,502.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,887.95
|
| Rate for Payer: Prime Health Services WC |
$6,911.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,156.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,463.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,463.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,463.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,463.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,533.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,987.08
|
| Rate for Payer: Vantage Medical Group Senior |
$4,533.71
|
|
|
HC RMV SUPER/DEEP WIRE/PIN/SCREW
|
Facility
|
IP
|
$7,966.00
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
950510037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,593.20 |
| Max. Negotiated Rate |
$6,771.10 |
| Rate for Payer: Adventist Health Commercial |
$1,593.20
|
| Rate for Payer: Cash Price |
$3,584.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,576.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,186.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,186.40
|
| Rate for Payer: Galaxy Health WC |
$6,771.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,779.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,058.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,699.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,911.84
|
| Rate for Payer: Multiplan Commercial |
$6,372.80
|
| Rate for Payer: Networks By Design Commercial |
$5,177.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,771.10
|
|
|
HC RMV SUPER/DEEP WIRE/PIN/SCREW
|
Facility
|
IP
|
$7,966.00
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
950510037
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,593.20 |
| Max. Negotiated Rate |
$6,771.10 |
| Rate for Payer: Galaxy Health WC |
$6,771.10
|
| Rate for Payer: Adventist Health Commercial |
$1,593.20
|
| Rate for Payer: Cash Price |
$3,584.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,576.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,186.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,186.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,779.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,058.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,699.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,911.84
|
| Rate for Payer: Multiplan Commercial |
$6,372.80
|
| Rate for Payer: Networks By Design Commercial |
$5,177.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,771.10
|
|
|
HC RMV SUPER/DEEP WIRE/PIN/SCREW
|
Facility
|
OP
|
$7,966.00
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
950510037
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$255.19 |
| Max. Negotiated Rate |
$8,240.00 |
| Rate for Payer: Adventist Health Commercial |
$1,593.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,705.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$3,584.70
|
| Rate for Payer: Cash Price |
$3,584.70
|
| Rate for Payer: Cash Price |
$3,584.70
|
| Rate for Payer: Cigna of CA HMO |
$5,098.24
|
| Rate for Payer: Cigna of CA PPO |
$5,894.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,576.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$6,771.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,779.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$255.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,058.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$288.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,911.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$6,372.80
|
| Rate for Payer: Networks By Design Commercial |
$5,177.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,771.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,779.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,779.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,983.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,983.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,983.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,983.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC RMV SUPER/DEEP WIRE/PIN/SCREW
|
Facility
|
OP
|
$7,966.00
|
|
|
Service Code
|
CPT 20680
|
| Hospital Charge Code |
950510037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$288.61 |
| Max. Negotiated Rate |
$8,240.00 |
| Rate for Payer: Adventist Health Commercial |
$1,593.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$3,584.70
|
| Rate for Payer: Cash Price |
$3,584.70
|
| Rate for Payer: Cash Price |
$3,584.70
|
| Rate for Payer: Cigna of CA HMO |
$5,098.24
|
| Rate for Payer: Cigna of CA PPO |
$5,894.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,576.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$6,771.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,779.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,058.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$288.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,016.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,911.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,707.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$6,372.80
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$5,177.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,771.10
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,779.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,983.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,983.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,983.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,983.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC RN ASSESSMENT 30 MIN
|
Facility
|
IP
|
$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: Cash Price |
$41.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$64.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.08
|
| 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
|
|
|
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 |
$59.04
|
| Rate for Payer: Cash Price |
$41.40
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$64.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$58.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.28
|
| 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
|
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 |
$95.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| 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
|
|
