|
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 |
$136.68
|
| Rate for Payer: Cash Price |
$95.85
|
| 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: 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 Medi-Cal |
$77.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| 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 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 |
$140.53
|
| Rate for Payer: Cash Price |
$98.55
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$153.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$139.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.21
|
| 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 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 |
$98.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$153.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$139.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.21
|
| 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 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 |
$21.18
|
| Rate for Payer: Cash Price |
$14.85
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$20.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.47
|
| 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 |
$14.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$20.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.47
|
| 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 |
$55.19
|
| Rate for Payer: Cash Price |
$38.70
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$54.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.74
|
| 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 |
$38.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$54.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.74
|
| 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
|
OP
|
$23.00
|
|
| Hospital Charge Code |
912900008
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$19.55 |
| Rate for Payer: Vantage Medical Group Senior |
$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 |
$14.76
|
| Rate for Payer: Cash Price |
$10.35
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$14.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.57
|
| 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
|
|
|
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 |
$10.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$14.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.57
|
| 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 RNPIGG
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913709
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$18.70 |
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8.80
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
|
|
HC RNPIGG
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913709
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$157.18 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Adventist Health Commercial |
$4.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.18
|
| Rate for Payer: Blue Shield of California Commercial |
$10.14
|
| Rate for Payer: Blue Shield of California Commercial |
$12.55
|
| Rate for Payer: Blue Shield of California Commercial |
$15.33
|
| Rate for Payer: Blue Shield of California Commercial |
$8.30
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: Multiplan Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
|
|
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 |
$110.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$171.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$155.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$144.55
|
| 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 |
$157.22
|
| Rate for Payer: Cash Price |
$110.25
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$171.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$155.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$88.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$144.55
|
| 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 ROBOTIC SURGERY LEVEL I 1ST ADDL 30 MIN
|
Facility
|
OP
|
$3,184.00
|
|
| Hospital Charge Code |
900700495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: United Healthcare HMO Rider |
$1,592.00
|
| Rate for Payer: Adventist Health Commercial |
$636.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,751.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,388.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,043.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Cigna of CA HMO |
$2,037.76
|
| Rate for Payer: Cigna of CA PPO |
$2,356.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,706.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,706.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,228.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.60
|
| Rate for Payer: Galaxy Health WC |
$2,706.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,910.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,021.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,155.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,878.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,228.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,228.80
|
| Rate for Payer: Multiplan Commercial |
$2,547.20
|
| Rate for Payer: Networks By Design Commercial |
$2,069.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,706.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,910.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,592.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,592.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,592.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,706.40
|
| Rate for Payer: Vantage Medical Group Senior |
$2,706.40
|
|
|
HC ROBOTIC SURGERY LEVEL I 1ST ADDL 30 MIN
|
Facility
|
IP
|
$3,184.00
|
|
| Hospital Charge Code |
900700495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$2,706.40 |
| Rate for Payer: Adventist Health Commercial |
$636.80
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,228.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.60
|
| Rate for Payer: Galaxy Health WC |
$2,706.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,910.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,021.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,878.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.16
|
| Rate for Payer: Multiplan Commercial |
$2,547.20
|
| Rate for Payer: Networks By Design Commercial |
$2,069.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,706.40
|
|
|
HC ROBOTIC SURGERY LEVEL I 1ST HR
|
Facility
|
OP
|
$26,251.00
|
|
| Hospital Charge Code |
900700496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,753.44 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$5,250.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,313.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,438.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19,688.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,845.27
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$11,812.95
|
| Rate for Payer: Cash Price |
$11,812.95
|
| Rate for Payer: Cigna of CA HMO |
$16,800.64
|
| Rate for Payer: Cigna of CA PPO |
$19,425.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,313.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,313.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,313.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,375.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,500.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,500.40
|
| Rate for Payer: Galaxy Health WC |
$22,313.35
|
| Rate for Payer: Global Benefits Group Commercial |
$15,750.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,669.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,529.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,488.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,300.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,375.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,375.70
|
| Rate for Payer: Multiplan Commercial |
$21,000.80
|
| Rate for Payer: Networks By Design Commercial |
$17,063.15
|
| Rate for Payer: Prime Health Services Commercial |
$22,313.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,750.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,125.50
|
| Rate for Payer: United Healthcare All Other HMO |
$13,125.50
|
| Rate for Payer: United Healthcare HMO Rider |
$13,125.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,125.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,313.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,313.35
|
| Rate for Payer: Vantage Medical Group Senior |
$22,313.35
|
|
|
HC ROBOTIC SURGERY LEVEL I 1ST HR
|
Facility
|
IP
|
$26,251.00
|
|
| Hospital Charge Code |
900700496
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,250.20 |
| Max. Negotiated Rate |
$22,313.35 |
| Rate for Payer: Adventist Health Commercial |
$5,250.20
|
| Rate for Payer: Cash Price |
$11,812.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,375.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,500.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,500.40
|
| Rate for Payer: Galaxy Health WC |
$22,313.35
|
| Rate for Payer: Global Benefits Group Commercial |
$15,750.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16,669.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,488.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,300.24
|
| Rate for Payer: Multiplan Commercial |
$21,000.80
|
| Rate for Payer: Networks By Design Commercial |
$17,063.15
|
| Rate for Payer: Prime Health Services Commercial |
$22,313.35
|
|
|
HC ROBOTIC SURGERY LEVEL I EA SUBS 30 MIN
|
Facility
|
OP
|
$3,184.00
|
|
| Hospital Charge Code |
900700497
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Cigna of CA HMO |
$2,037.76
|
| Rate for Payer: Cigna of CA PPO |
$2,356.16
|
| Rate for Payer: Adventist Health Commercial |
$636.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,751.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,388.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,043.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,706.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,706.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,228.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.60
|
| Rate for Payer: Galaxy Health WC |
$2,706.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,910.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,021.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,155.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,878.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,228.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,228.80
|
| Rate for Payer: Multiplan Commercial |
$2,547.20
|
| Rate for Payer: Networks By Design Commercial |
$2,069.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,706.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,910.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,592.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,592.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,592.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,592.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,706.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,706.40
|
| Rate for Payer: Vantage Medical Group Senior |
$2,706.40
|
|
|
HC ROBOTIC SURGERY LEVEL I EA SUBS 30 MIN
|
Facility
|
IP
|
$3,184.00
|
|
| Hospital Charge Code |
900700497
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.80 |
| Max. Negotiated Rate |
$2,706.40 |
| Rate for Payer: Adventist Health Commercial |
$636.80
|
| Rate for Payer: Cash Price |
$1,432.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,228.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,273.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,273.60
|
| Rate for Payer: Galaxy Health WC |
$2,706.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,910.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,021.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,878.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$764.16
|
| Rate for Payer: Multiplan Commercial |
$2,547.20
|
| Rate for Payer: Networks By Design Commercial |
$2,069.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,706.40
|
|
|
HC ROBOTIC SURGERY LEVEL II 1ST ADDL 30 MIN
|
Facility
|
OP
|
$4,303.00
|
|
| Hospital Charge Code |
900700498
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.60 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,366.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,227.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,761.24
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Cigna of CA HMO |
$2,753.92
|
| Rate for Payer: Cigna of CA PPO |
$3,184.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,657.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,657.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,721.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,721.20
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,561.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,538.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,032.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,012.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,012.10
|
| Rate for Payer: Multiplan Commercial |
$3,442.40
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,581.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,151.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,151.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,151.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,151.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,657.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,657.55
|
|
|
HC ROBOTIC SURGERY LEVEL II 1ST ADDL 30 MIN
|
Facility
|
IP
|
$4,303.00
|
|
| Hospital Charge Code |
900700498
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.60 |
| Max. Negotiated Rate |
$3,657.55 |
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,721.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,721.20
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,538.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,032.72
|
| Rate for Payer: Multiplan Commercial |
$3,442.40
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
|
|
HC ROBOTIC SURGERY LEVEL II 1ST HR
|
Facility
|
IP
|
$35,444.00
|
|
| Hospital Charge Code |
900700499
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,088.80 |
| Max. Negotiated Rate |
$30,127.40 |
| Rate for Payer: Adventist Health Commercial |
$7,088.80
|
| Rate for Payer: Cash Price |
$15,949.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24,810.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,177.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,177.60
|
| Rate for Payer: Galaxy Health WC |
$30,127.40
|
| Rate for Payer: Global Benefits Group Commercial |
$21,266.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22,506.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,911.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,506.56
|
| Rate for Payer: Multiplan Commercial |
$28,355.20
|
| Rate for Payer: Networks By Design Commercial |
$23,038.60
|
| Rate for Payer: Prime Health Services Commercial |
$30,127.40
|
|
|
HC ROBOTIC SURGERY LEVEL II 1ST HR
|
Facility
|
OP
|
$35,444.00
|
|
| Hospital Charge Code |
900700499
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,753.44 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$7,088.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30,127.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19,494.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26,583.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,744.41
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$15,949.80
|
| Rate for Payer: Cash Price |
$15,949.80
|
| Rate for Payer: Cigna of CA HMO |
$22,684.16
|
| Rate for Payer: Cigna of CA PPO |
$26,228.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30,127.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$30,127.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30,127.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24,810.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,177.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,177.60
|
| Rate for Payer: Galaxy Health WC |
$30,127.40
|
| Rate for Payer: Global Benefits Group Commercial |
$21,266.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22,506.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12,866.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,911.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,506.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,810.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,810.80
|
| Rate for Payer: Multiplan Commercial |
$28,355.20
|
| Rate for Payer: Networks By Design Commercial |
$23,038.60
|
| Rate for Payer: Prime Health Services Commercial |
$30,127.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,266.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,722.00
|
| Rate for Payer: United Healthcare All Other HMO |
$17,722.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,722.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,722.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30,127.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30,127.40
|
| Rate for Payer: Vantage Medical Group Senior |
$30,127.40
|
|
|
HC ROBOTIC SURGERY LEVEL II EA SUBS 30 MIN
|
Facility
|
OP
|
$4,303.00
|
|
| Hospital Charge Code |
900700500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.60 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,366.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,227.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,761.24
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Cigna of CA HMO |
$2,753.92
|
| Rate for Payer: Cigna of CA PPO |
$3,184.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,657.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,657.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,721.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,721.20
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,561.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,538.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,032.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,012.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,012.10
|
| Rate for Payer: Multiplan Commercial |
$3,442.40
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,581.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,151.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,151.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,151.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,151.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,657.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,657.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,657.55
|
|
|
HC ROBOTIC SURGERY LEVEL II EA SUBS 30 MIN
|
Facility
|
IP
|
$4,303.00
|
|
| Hospital Charge Code |
900700500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$860.60 |
| Max. Negotiated Rate |
$3,657.55 |
| Rate for Payer: Adventist Health Commercial |
$860.60
|
| Rate for Payer: Cash Price |
$1,936.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,012.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,721.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,721.20
|
| Rate for Payer: Galaxy Health WC |
$3,657.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,581.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,732.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,538.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,032.72
|
| Rate for Payer: Multiplan Commercial |
$3,442.40
|
| Rate for Payer: Networks By Design Commercial |
$2,796.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,657.55
|
|
