|
HC ROOM NON HEART TX
|
Facility
|
IP
|
$31,528.00
|
|
| Hospital Charge Code |
902341258
|
|
Hospital Revenue Code
|
209
|
| Min. Negotiated Rate |
$4,650.00 |
| Max. Negotiated Rate |
$26,798.80 |
| Rate for Payer: Adventist Health Commercial |
$6,305.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,039.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,560.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,310.00
|
| Rate for Payer: Cash Price |
$14,187.60
|
| Rate for Payer: Cash Price |
$14,187.60
|
| Rate for Payer: Cash Price |
$14,187.60
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22,069.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,611.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12,611.20
|
| Rate for Payer: Galaxy Health WC |
$26,798.80
|
| Rate for Payer: Global Benefits Group Commercial |
$18,916.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,650.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20,020.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,601.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,566.72
|
| Rate for Payer: Multiplan Commercial |
$25,222.40
|
| Rate for Payer: Prime Health Services Commercial |
$26,798.80
|
|
|
HC ROOM NON HEART TX 1:1
|
Facility
|
IP
|
$30,610.00
|
|
| Hospital Charge Code |
992341258
|
|
Hospital Revenue Code
|
209
|
| Min. Negotiated Rate |
$4,650.00 |
| Max. Negotiated Rate |
$26,018.50 |
| Rate for Payer: Adventist Health Commercial |
$6,122.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,039.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,560.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,310.00
|
| Rate for Payer: Cash Price |
$13,774.50
|
| Rate for Payer: Cash Price |
$13,774.50
|
| Rate for Payer: Cash Price |
$13,774.50
|
| Rate for Payer: Cigna of CA HMO |
$5,390.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,427.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,244.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,244.00
|
| Rate for Payer: Galaxy Health WC |
$26,018.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,366.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,650.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,437.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,059.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,346.40
|
| Rate for Payer: Multiplan Commercial |
$24,488.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,018.50
|
|
|
HC ROOM NURSERY
|
Facility
|
IP
|
$2,787.00
|
|
| Hospital Charge Code |
902300020
|
|
Hospital Revenue Code
|
170
|
| Min. Negotiated Rate |
$557.40 |
| Max. Negotiated Rate |
$2,368.95 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,610.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,466.00
|
| Rate for Payer: Blue Shield of California Commercial |
$968.00
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cigna of CA HMO |
$945.00
|
| Rate for Payer: Cigna of CA PPO |
$1,155.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$953.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$668.88
|
| Rate for Payer: Multiplan Commercial |
$2,229.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
|
|
HC ROOM NURSERY LEVEL II
|
Facility
|
IP
|
$8,353.00
|
|
| Hospital Charge Code |
902300028
|
|
Hospital Revenue Code
|
172
|
| Min. Negotiated Rate |
$1,670.60 |
| Max. Negotiated Rate |
$9,933.00 |
| Rate for Payer: Adventist Health Commercial |
$1,670.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,449.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,556.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,933.00
|
| Rate for Payer: Cash Price |
$3,758.85
|
| Rate for Payer: Cash Price |
$3,758.85
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,847.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,341.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,341.20
|
| Rate for Payer: Galaxy Health WC |
$7,100.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,011.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,004.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,304.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,928.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,004.72
|
| Rate for Payer: Multiplan Commercial |
$6,682.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,100.05
|
|
|
HC ROOM NURSERY LEVEL II ISO
|
Facility
|
IP
|
$9,816.00
|
|
| Hospital Charge Code |
902300029
|
|
Hospital Revenue Code
|
172
|
| Min. Negotiated Rate |
$1,963.20 |
| Max. Negotiated Rate |
$9,933.00 |
| Rate for Payer: Adventist Health Commercial |
$1,963.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,449.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,556.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,933.00
|
| Rate for Payer: Cash Price |
$4,417.20
|
| Rate for Payer: Cash Price |
$4,417.20
|
| Rate for Payer: Cigna of CA HMO |
$5,850.00
|
| Rate for Payer: Cigna of CA PPO |
$6,940.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,871.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,926.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,926.40
|
| Rate for Payer: Galaxy Health WC |
$8,343.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5,889.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,004.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,233.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,791.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,355.84
|
| Rate for Payer: Multiplan Commercial |
$7,852.80
|
| Rate for Payer: Prime Health Services Commercial |
$8,343.60
|
|
|
HC ROOM OB
|
Facility
|
IP
|
$6,615.00
|
|
| Hospital Charge Code |
902300003
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$1,323.00 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: EPIC Health Plan Commercial |
$2,646.00
|
| Rate for Payer: Adventist Health Commercial |
$1,323.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,841.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,105.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,217.00
|
| Rate for Payer: Cash Price |
$2,976.75
|
| Rate for Payer: Cash Price |
$2,976.75
|
| Rate for Payer: Cash Price |
$2,976.75
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,630.50
|
| Rate for Payer: EPIC Health Plan Senior |
$2,646.00
|
| Rate for Payer: Galaxy Health WC |
$5,622.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,969.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,200.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,902.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,587.60
|
| Rate for Payer: Multiplan Commercial |
$5,292.00
|
| Rate for Payer: Networks By Design Commercial |
$4,299.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,622.75
|
|
|
HC ROOM OB HIGH RISK
|
Facility
|
IP
|
$8,256.00
|
|
| Hospital Charge Code |
902300004
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$1,651.20 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,651.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,841.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,105.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,217.00
|
| Rate for Payer: Cash Price |
$3,715.20
|
| Rate for Payer: Cash Price |
$3,715.20
|
| Rate for Payer: Cash Price |
$3,715.20
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,779.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,302.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,302.40
|
| Rate for Payer: Galaxy Health WC |
$7,017.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,953.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,242.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,871.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,981.44
|
| Rate for Payer: Multiplan Commercial |
$6,604.80
|
| Rate for Payer: Networks By Design Commercial |
$5,366.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,017.60
|
|
|
HC ROOM OB HIGH RISK ISOLATION
|
Facility
|
IP
|
$9,828.00
|
|
| Hospital Charge Code |
902300012
|
|
Hospital Revenue Code
|
164
|
| Min. Negotiated Rate |
$1,965.60 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,965.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,661.00
|
| Rate for Payer: Cash Price |
$4,422.60
|
| Rate for Payer: Cash Price |
$4,422.60
|
| Rate for Payer: Cash Price |
$4,422.60
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,879.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,931.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,931.20
|
| Rate for Payer: Galaxy Health WC |
$8,353.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,896.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,240.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,798.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,358.72
|
| Rate for Payer: Multiplan Commercial |
$7,862.40
|
| Rate for Payer: Networks By Design Commercial |
$6,388.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,353.80
|
|
|
HC ROOM OB ISOLATION
|
Facility
|
IP
|
$7,417.00
|
|
| Hospital Charge Code |
902300013
|
|
Hospital Revenue Code
|
164
|
| Min. Negotiated Rate |
$1,483.40 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,483.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,661.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,717.00
|
| Rate for Payer: Cash Price |
$3,337.65
|
| Rate for Payer: Cash Price |
$3,337.65
|
| Rate for Payer: Cash Price |
$3,337.65
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,191.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,966.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,966.80
|
| Rate for Payer: Galaxy Health WC |
$6,304.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,450.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,709.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,376.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,780.08
|
| Rate for Payer: Multiplan Commercial |
$5,933.60
|
| Rate for Payer: Networks By Design Commercial |
$4,821.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,304.45
|
|
|
HC ROOM OBSERVATION
|
Facility
|
OP
|
$468.00
|
|
|
Service Code
|
CPT G0378
|
| Hospital Charge Code |
900200058
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$9,601.00 |
| Rate for Payer: Adventist Health Commercial |
$93.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,437.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$397.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$351.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,810.00
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Cigna of CA HMO |
$299.52
|
| Rate for Payer: Cigna of CA PPO |
$346.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$397.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$397.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$397.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$327.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.20
|
| Rate for Payer: EPIC Health Plan Senior |
$187.20
|
| Rate for Payer: Galaxy Health WC |
$397.80
|
| Rate for Payer: Global Benefits Group Commercial |
$280.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$297.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$276.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$327.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$327.60
|
| Rate for Payer: Multiplan Commercial |
$374.40
|
| Rate for Payer: Networks By Design Commercial |
$304.20
|
| Rate for Payer: Prime Health Services Commercial |
$397.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$280.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,601.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,518.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,779.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$397.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$397.80
|
| Rate for Payer: Vantage Medical Group Senior |
$397.80
|
|
|
HC ROOM OBSERVATION
|
Facility
|
IP
|
$287.00
|
|
|
Service Code
|
CPT G0378
|
| Hospital Charge Code |
902350001
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$57.40 |
| Max. Negotiated Rate |
$243.95 |
| Rate for Payer: Adventist Health Commercial |
$57.40
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$200.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$186.55
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
|
|
HC ROOM OBSERVATION
|
Facility
|
OP
|
$287.00
|
|
|
Service Code
|
CPT G0378
|
| Hospital Charge Code |
902350001
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$57.40 |
| Max. Negotiated Rate |
$9,601.00 |
| Rate for Payer: Adventist Health Commercial |
$57.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,437.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$157.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$215.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,810.00
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cigna of CA HMO |
$183.68
|
| Rate for Payer: Cigna of CA PPO |
$212.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$243.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$243.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$243.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$200.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$114.80
|
| Rate for Payer: Galaxy Health WC |
$243.95
|
| Rate for Payer: Global Benefits Group Commercial |
$172.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$200.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$200.90
|
| Rate for Payer: Multiplan Commercial |
$229.60
|
| Rate for Payer: Networks By Design Commercial |
$186.55
|
| Rate for Payer: Prime Health Services Commercial |
$243.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,601.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,518.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,779.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$243.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$243.95
|
| Rate for Payer: Vantage Medical Group Senior |
$243.95
|
|
|
HC ROOM OBSERVATION
|
Facility
|
IP
|
$468.00
|
|
|
Service Code
|
CPT G0378
|
| Hospital Charge Code |
900200058
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$397.80 |
| Rate for Payer: Adventist Health Commercial |
$93.60
|
| Rate for Payer: Cash Price |
$210.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$327.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.20
|
| Rate for Payer: EPIC Health Plan Senior |
$187.20
|
| Rate for Payer: Galaxy Health WC |
$397.80
|
| Rate for Payer: Global Benefits Group Commercial |
$280.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$297.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$276.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.32
|
| Rate for Payer: Multiplan Commercial |
$374.40
|
| Rate for Payer: Networks By Design Commercial |
$304.20
|
| Rate for Payer: Prime Health Services Commercial |
$397.80
|
|
|
HC ROOM OB TRAUMA
|
Facility
|
IP
|
$6,356.00
|
|
| Hospital Charge Code |
902300005
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$1,271.20 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,271.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,841.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,105.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,217.00
|
| Rate for Payer: Cash Price |
$2,860.20
|
| Rate for Payer: Cash Price |
$2,860.20
|
| Rate for Payer: Cash Price |
$2,860.20
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,449.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,542.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,542.40
|
| Rate for Payer: Galaxy Health WC |
$5,402.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,813.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,036.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,750.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,525.44
|
| Rate for Payer: Multiplan Commercial |
$5,084.80
|
| Rate for Payer: Networks By Design Commercial |
$4,131.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,402.60
|
|
|
HC ROOM OB TRAUMA ISO
|
Facility
|
IP
|
$8,236.00
|
|
| Hospital Charge Code |
902300014
|
|
Hospital Revenue Code
|
164
|
| Min. Negotiated Rate |
$1,647.20 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,647.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,661.00
|
| Rate for Payer: Cash Price |
$3,706.20
|
| Rate for Payer: Cash Price |
$3,706.20
|
| Rate for Payer: Cash Price |
$3,706.20
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,765.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,294.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,294.40
|
| Rate for Payer: Galaxy Health WC |
$7,000.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,941.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,229.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,859.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,976.64
|
| Rate for Payer: Multiplan Commercial |
$6,588.80
|
| Rate for Payer: Networks By Design Commercial |
$5,353.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,000.60
|
|
|
HC ROOM OP EXTENDED RECOVERY
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 99236
|
| Hospital Charge Code |
902360000
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$1,327.38 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,327.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$107.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$69.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$95.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.50
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Cigna of CA HMO |
$81.28
|
| Rate for Payer: Cigna of CA PPO |
$93.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$107.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$107.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$107.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.80
|
| Rate for Payer: EPIC Health Plan Senior |
$50.80
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$209.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$88.90
|
| Rate for Payer: Multiplan Commercial |
$101.60
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.50
|
| Rate for Payer: United Healthcare All Other HMO |
$63.50
|
| Rate for Payer: United Healthcare HMO Rider |
$63.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$107.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$107.95
|
| Rate for Payer: Vantage Medical Group Senior |
$107.95
|
|
|
HC ROOM OP EXTENDED RECOVERY
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 99236
|
| Hospital Charge Code |
902360000
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$107.95 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.80
|
| Rate for Payer: EPIC Health Plan Senior |
$50.80
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.48
|
| Rate for Payer: Multiplan Commercial |
$101.60
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
|
|
HC ROOM OP EXTENDED RECOVERY
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
CPT 99220
|
| Hospital Charge Code |
902350000
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$107.95 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$107.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$69.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$95.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.50
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Cigna of CA HMO |
$81.28
|
| Rate for Payer: Cigna of CA PPO |
$93.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$107.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$107.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$107.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.80
|
| Rate for Payer: EPIC Health Plan Senior |
$50.80
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$46.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$88.90
|
| Rate for Payer: Multiplan Commercial |
$101.60
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.50
|
| Rate for Payer: United Healthcare All Other HMO |
$63.50
|
| Rate for Payer: United Healthcare HMO Rider |
$63.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$107.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$107.95
|
| Rate for Payer: Vantage Medical Group Senior |
$107.95
|
|
|
HC ROOM OP EXTENDED RECOVERY
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
CPT 99220
|
| Hospital Charge Code |
902350000
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$107.95 |
| Rate for Payer: Adventist Health Commercial |
$25.40
|
| Rate for Payer: Cash Price |
$57.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.80
|
| Rate for Payer: EPIC Health Plan Senior |
$50.80
|
| Rate for Payer: Galaxy Health WC |
$107.95
|
| Rate for Payer: Global Benefits Group Commercial |
$76.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.48
|
| Rate for Payer: Multiplan Commercial |
$101.60
|
| Rate for Payer: Networks By Design Commercial |
$82.55
|
| Rate for Payer: Prime Health Services Commercial |
$107.95
|
|
|
HC ROOM PEDS ACUTE
|
Facility
|
IP
|
$6,615.00
|
|
| Hospital Charge Code |
902300006
|
|
Hospital Revenue Code
|
123
|
| Min. Negotiated Rate |
$1,323.00 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,323.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,841.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,661.00
|
| Rate for Payer: Cash Price |
$2,976.75
|
| Rate for Payer: Cash Price |
$2,976.75
|
| Rate for Payer: Cash Price |
$2,976.75
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,630.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,646.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,646.00
|
| Rate for Payer: Galaxy Health WC |
$5,622.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,969.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,200.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,902.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,587.60
|
| Rate for Payer: Multiplan Commercial |
$5,292.00
|
| Rate for Payer: Networks By Design Commercial |
$4,299.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,622.75
|
|
|
HC ROOM PEDS ACUTE ISOLATION
|
Facility
|
IP
|
$8,236.00
|
|
| Hospital Charge Code |
902300015
|
|
Hospital Revenue Code
|
164
|
| Min. Negotiated Rate |
$1,647.20 |
| Max. Negotiated Rate |
$8,400.00 |
| Rate for Payer: Adventist Health Commercial |
$1,647.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,661.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,717.00
|
| Rate for Payer: Cash Price |
$3,706.20
|
| Rate for Payer: Cash Price |
$3,706.20
|
| Rate for Payer: Cash Price |
$3,706.20
|
| Rate for Payer: Cigna of CA HMO |
$5,225.00
|
| Rate for Payer: Cigna of CA PPO |
$8,400.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,765.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,294.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,294.40
|
| Rate for Payer: Galaxy Health WC |
$7,000.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,941.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,970.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,229.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,859.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,976.64
|
| Rate for Payer: Multiplan Commercial |
$6,588.80
|
| Rate for Payer: Networks By Design Commercial |
$5,353.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,000.60
|
|
|
HC ROOM PEDS ACUTE REHAB
|
Facility
|
IP
|
$7,755.00
|
|
| Hospital Charge Code |
902300007
|
|
Hospital Revenue Code
|
128
|
| Min. Negotiated Rate |
$1,551.00 |
| Max. Negotiated Rate |
$6,591.75 |
| Rate for Payer: Adventist Health Commercial |
$1,551.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,692.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,952.00
|
| Rate for Payer: Cash Price |
$3,489.75
|
| Rate for Payer: Cash Price |
$3,489.75
|
| Rate for Payer: Cigna of CA HMO |
$1,890.00
|
| Rate for Payer: Cigna of CA PPO |
$2,370.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,428.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,102.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,102.00
|
| Rate for Payer: Galaxy Health WC |
$6,591.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,653.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,800.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,747.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,924.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,575.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,861.20
|
| Rate for Payer: Multiplan Commercial |
$6,204.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,591.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,356.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,145.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.00
|
|
|
HC ROOM PEDS ACUTE REHAB ISOLATION
|
Facility
|
IP
|
$7,975.00
|
|
| Hospital Charge Code |
902300016
|
|
Hospital Revenue Code
|
128
|
| Min. Negotiated Rate |
$1,595.00 |
| Max. Negotiated Rate |
$6,778.75 |
| Rate for Payer: Adventist Health Commercial |
$1,595.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,692.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,959.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,952.00
|
| Rate for Payer: Cash Price |
$3,588.75
|
| Rate for Payer: Cash Price |
$3,588.75
|
| Rate for Payer: Cigna of CA HMO |
$1,890.00
|
| Rate for Payer: Cigna of CA PPO |
$2,370.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,582.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,190.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,190.00
|
| Rate for Payer: Galaxy Health WC |
$6,778.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,785.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,800.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,747.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,064.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,705.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,914.00
|
| Rate for Payer: Multiplan Commercial |
$6,380.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,778.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,356.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,145.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,881.00
|
|
|
HC ROOM PEDS HEART TRANSPLANT
|
Facility
|
IP
|
$31,528.00
|
|
| Hospital Charge Code |
902341228
|
|
Hospital Revenue Code
|
213
|
| Min. Negotiated Rate |
$3,717.00 |
| Max. Negotiated Rate |
$26,798.80 |
| Rate for Payer: Adventist Health Commercial |
$6,305.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,039.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,661.00
|
| Rate for Payer: Cash Price |
$14,187.60
|
| Rate for Payer: Cash Price |
$14,187.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22,069.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,611.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12,611.20
|
| Rate for Payer: Galaxy Health WC |
$26,798.80
|
| Rate for Payer: Global Benefits Group Commercial |
$18,916.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,650.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20,020.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,601.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,566.72
|
| Rate for Payer: Multiplan Commercial |
$25,222.40
|
| Rate for Payer: Prime Health Services Commercial |
$26,798.80
|
|
|
HC ROOM PEDS HEART TRANSPLANT 1:1
|
Facility
|
IP
|
$30,610.00
|
|
| Hospital Charge Code |
992341228
|
|
Hospital Revenue Code
|
213
|
| Min. Negotiated Rate |
$3,717.00 |
| Max. Negotiated Rate |
$26,018.50 |
| Rate for Payer: Adventist Health Commercial |
$6,122.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,039.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,717.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,661.00
|
| Rate for Payer: Cash Price |
$13,774.50
|
| Rate for Payer: Cash Price |
$13,774.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,427.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,244.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,244.00
|
| Rate for Payer: Galaxy Health WC |
$26,018.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18,366.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,650.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,437.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,059.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,346.40
|
| Rate for Payer: Multiplan Commercial |
$24,488.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,018.50
|
|
