|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$786.60 |
| Max. Negotiated Rate |
$3,539.70 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,753.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,573.20
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,497.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,320.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
901200036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$806.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Cigna of CA HMO |
$2,517.12
|
| Rate for Payer: Cigna of CA PPO |
$2,910.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,753.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,497.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$806.82
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
| Rate for Payer: Prime Health Services Medicare |
$855.23
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$887.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,359.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,966.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Cigna of CA HMO |
$2,517.12
|
| Rate for Payer: Cigna of CA PPO |
$2,910.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,753.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,497.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$867.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$806.82
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
| Rate for Payer: Prime Health Services Medicare |
$855.23
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$887.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,359.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,966.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,966.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,966.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,966.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$806.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Cigna of CA HMO |
$2,517.12
|
| Rate for Payer: Cigna of CA PPO |
$2,910.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,753.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,497.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$806.82
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
| Rate for Payer: Prime Health Services Medicare |
$855.23
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$887.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,359.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,966.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$786.60 |
| Max. Negotiated Rate |
$3,539.70 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,753.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,573.20
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,497.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,320.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$786.60 |
| Max. Negotiated Rate |
$3,539.70 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Cash Price |
$1,769.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,753.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,573.20
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,497.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,320.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
|
|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
|
OP
|
$3,537.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$137.03 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$707.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,006.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,945.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,652.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,591.65
|
| Rate for Payer: Cash Price |
$1,591.65
|
| Rate for Payer: Cash Price |
$1,591.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,829.60
|
| Rate for Payer: Cigna of CA HMO |
$2,263.68
|
| Rate for Payer: Cigna of CA PPO |
$2,617.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,006.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,006.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,006.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,475.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,414.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,414.80
|
| Rate for Payer: Galaxy Health WC |
$3,006.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,122.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,183.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$137.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,245.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$151.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,086.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$707.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,475.90
|
| Rate for Payer: Multiplan Commercial |
$2,652.75
|
| Rate for Payer: Networks By Design Commercial |
$2,299.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,006.45
|
| Rate for Payer: Riverside University Health System MISP |
$1,414.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,122.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,768.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,006.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,006.45
|
| Rate for Payer: Vantage Medical Group Senior |
$3,006.45
|
|
|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
|
IP
|
$3,537.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$707.40 |
| Max. Negotiated Rate |
$3,183.30 |
| Rate for Payer: Adventist Health Commercial |
$707.40
|
| Rate for Payer: Cash Price |
$1,591.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,829.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,475.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,414.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,414.80
|
| Rate for Payer: Galaxy Health WC |
$3,006.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,122.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,183.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,245.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,086.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$707.40
|
| Rate for Payer: Multiplan Commercial |
$2,652.75
|
| Rate for Payer: Networks By Design Commercial |
$2,299.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,006.45
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
|
IP
|
$1,133.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$226.60 |
| Max. Negotiated Rate |
$1,019.70 |
| Rate for Payer: Adventist Health Commercial |
$226.60
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Central Health Plan Commercial |
$906.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$793.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$453.20
|
| Rate for Payer: EPIC Health Plan Senior |
$453.20
|
| Rate for Payer: Galaxy Health WC |
$963.05
|
| Rate for Payer: Global Benefits Group Commercial |
$679.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,019.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$719.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$668.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.60
|
| Rate for Payer: Multiplan Commercial |
$849.75
|
| Rate for Payer: Networks By Design Commercial |
$736.45
|
| Rate for Payer: Prime Health Services Commercial |
$963.05
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
|
OP
|
$1,133.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$48.23 |
| Max. Negotiated Rate |
$1,019.70 |
| Rate for Payer: Adventist Health Commercial |
$226.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$146.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.13
|
| Rate for Payer: Blue Shield of California Commercial |
$713.79
|
| Rate for Payer: Blue Shield of California EPN |
$449.80
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Cash Price |
$509.85
|
| Rate for Payer: Central Health Plan Commercial |
$906.40
|
| Rate for Payer: Cigna of CA HMO |
$725.12
|
| Rate for Payer: Cigna of CA PPO |
$838.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$793.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$963.05
|
| Rate for Payer: Global Benefits Group Commercial |
$679.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,019.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$719.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$849.75
|
| Rate for Payer: Networks By Design Commercial |
$736.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$963.05
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$679.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$679.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
|
OP
|
$1,241.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.03 |
| Max. Negotiated Rate |
$1,116.90 |
| Rate for Payer: Adventist Health Commercial |
$248.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$172.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$153.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$213.80
|
| Rate for Payer: Blue Shield of California Commercial |
$781.83
|
| Rate for Payer: Blue Shield of California EPN |
$492.68
|
| Rate for Payer: Cash Price |
$558.45
|
| Rate for Payer: Cash Price |
$558.45
|
| Rate for Payer: Central Health Plan Commercial |
$992.80
|
| Rate for Payer: Cigna of CA HMO |
$794.24
|
| Rate for Payer: Cigna of CA PPO |
$918.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$868.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$1,054.85
|
| Rate for Payer: Global Benefits Group Commercial |
$744.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,116.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$788.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$58.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$930.75
|
| Rate for Payer: Networks By Design Commercial |
$806.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,054.85
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$744.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$744.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
|
IP
|
$1,241.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$248.20 |
| Max. Negotiated Rate |
$1,116.90 |
| Rate for Payer: Adventist Health Commercial |
$248.20
|
| Rate for Payer: Cash Price |
$558.45
|
| Rate for Payer: Central Health Plan Commercial |
$992.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$868.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$496.40
|
| Rate for Payer: EPIC Health Plan Senior |
$496.40
|
| Rate for Payer: Galaxy Health WC |
$1,054.85
|
| Rate for Payer: Global Benefits Group Commercial |
$744.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,116.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$788.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$732.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.20
|
| Rate for Payer: Multiplan Commercial |
$930.75
|
| Rate for Payer: Networks By Design Commercial |
$806.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,054.85
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
|
IP
|
$1,672.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$334.40 |
| Max. Negotiated Rate |
$1,504.80 |
| Rate for Payer: Adventist Health Commercial |
$334.40
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,337.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,170.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$668.80
|
| Rate for Payer: EPIC Health Plan Senior |
$668.80
|
| Rate for Payer: Galaxy Health WC |
$1,421.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,504.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,061.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$986.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.40
|
| Rate for Payer: Multiplan Commercial |
$1,254.00
|
| Rate for Payer: Networks By Design Commercial |
$1,086.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,421.20
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
|
OP
|
$1,672.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$60.39 |
| Max. Negotiated Rate |
$1,504.80 |
| Rate for Payer: Adventist Health Commercial |
$334.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$215.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$189.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$264.05
|
| Rate for Payer: Blue Shield of California Commercial |
$1,053.36
|
| Rate for Payer: Blue Shield of California EPN |
$663.78
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Cash Price |
$752.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,337.60
|
| Rate for Payer: Cigna of CA HMO |
$1,070.08
|
| Rate for Payer: Cigna of CA PPO |
$1,237.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,170.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$1,421.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,504.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$60.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,061.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$1,254.00
|
| Rate for Payer: Networks By Design Commercial |
$1,086.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,421.20
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,003.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,003.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC THORACOSCOPY SX W PLEURODESIS
|
Facility
|
OP
|
$27,088.00
|
|
|
Service Code
|
CPT 32650
|
| Hospital Charge Code |
909010013
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$671.73 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,417.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,024.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,898.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,316.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$12,189.60
|
| Rate for Payer: Cash Price |
$12,189.60
|
| Rate for Payer: Cash Price |
$12,189.60
|
| Rate for Payer: Central Health Plan Commercial |
$21,670.40
|
| Rate for Payer: Cigna of CA HMO |
$17,336.32
|
| Rate for Payer: Cigna of CA PPO |
$20,045.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,024.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,024.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,024.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,961.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,835.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,835.20
|
| Rate for Payer: Galaxy Health WC |
$23,024.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16,252.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,379.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$671.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,200.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$742.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,981.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,417.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,961.60
|
| Rate for Payer: Multiplan Commercial |
$20,316.00
|
| Rate for Payer: Networks By Design Commercial |
$17,607.20
|
| Rate for Payer: Prime Health Services Commercial |
$23,024.80
|
| Rate for Payer: Riverside University Health System MISP |
$10,835.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,252.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,544.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23,024.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,024.80
|
| Rate for Payer: Vantage Medical Group Senior |
$23,024.80
|
|
|
HC THORACOSCOPY SX W PLEURODESIS
|
Facility
|
IP
|
$27,088.00
|
|
|
Service Code
|
CPT 32650
|
| Hospital Charge Code |
909010013
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,417.60 |
| Max. Negotiated Rate |
$24,379.20 |
| Rate for Payer: Adventist Health Commercial |
$5,417.60
|
| Rate for Payer: Cash Price |
$12,189.60
|
| Rate for Payer: Central Health Plan Commercial |
$21,670.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,961.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,835.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,835.20
|
| Rate for Payer: Galaxy Health WC |
$23,024.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16,252.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,379.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,200.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,981.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,417.60
|
| Rate for Payer: Multiplan Commercial |
$20,316.00
|
| Rate for Payer: Networks By Design Commercial |
$17,607.20
|
| Rate for Payer: Prime Health Services Commercial |
$23,024.80
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
|
IP
|
$6,936.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,387.20 |
| Max. Negotiated Rate |
$6,242.40 |
| Rate for Payer: Adventist Health Commercial |
$1,387.20
|
| Rate for Payer: Cash Price |
$3,121.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,548.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,855.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,774.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,774.40
|
| Rate for Payer: Galaxy Health WC |
$5,895.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,161.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,242.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,404.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,092.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,387.20
|
| Rate for Payer: Multiplan Commercial |
$5,202.00
|
| Rate for Payer: Networks By Design Commercial |
$4,508.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,895.60
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
|
OP
|
$6,936.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$192.11 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,387.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,895.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,814.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,202.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,121.20
|
| Rate for Payer: Cash Price |
$3,121.20
|
| Rate for Payer: Cash Price |
$3,121.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,548.80
|
| Rate for Payer: Cigna of CA HMO |
$4,439.04
|
| Rate for Payer: Cigna of CA PPO |
$5,132.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,895.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,895.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,895.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,855.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,774.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,774.40
|
| Rate for Payer: Galaxy Health WC |
$5,895.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,161.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,242.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$192.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,404.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$212.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,092.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,387.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,855.20
|
| Rate for Payer: Multiplan Commercial |
$5,202.00
|
| Rate for Payer: Networks By Design Commercial |
$4,508.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,895.60
|
| Rate for Payer: Riverside University Health System MISP |
$2,774.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,161.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,468.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,895.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,895.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,895.60
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
|
OP
|
$3,634.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$174.18 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$726.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,998.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,725.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,635.30
|
| Rate for Payer: Cash Price |
$1,635.30
|
| Rate for Payer: Cash Price |
$1,635.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,907.20
|
| Rate for Payer: Cigna of CA HMO |
$2,325.76
|
| Rate for Payer: Cigna of CA PPO |
$2,689.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,088.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,088.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,543.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,453.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,453.60
|
| Rate for Payer: Galaxy Health WC |
$3,088.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,180.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,270.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$174.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,307.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,144.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$726.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,543.80
|
| Rate for Payer: Multiplan Commercial |
$2,725.50
|
| Rate for Payer: Networks By Design Commercial |
$2,362.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,088.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,453.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,180.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,817.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,088.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3,088.90
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
|
IP
|
$3,634.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$726.80 |
| Max. Negotiated Rate |
$3,270.60 |
| Rate for Payer: Adventist Health Commercial |
$726.80
|
| Rate for Payer: Cash Price |
$1,635.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,907.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,543.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,453.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,453.60
|
| Rate for Payer: Galaxy Health WC |
$3,088.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,180.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,270.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,307.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,144.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$726.80
|
| Rate for Payer: Multiplan Commercial |
$2,725.50
|
| Rate for Payer: Networks By Design Commercial |
$2,362.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,088.90
|
|
|
HC THORA KIT PLEURAL SEAL
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
900831718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Blue Shield of California Commercial |
$237.39
|
| Rate for Payer: Blue Shield of California EPN |
$149.18
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Central Health Plan Commercial |
$236.80
|
| Rate for Payer: Cigna of CA HMO |
$207.20
|
| Rate for Payer: Cigna of CA PPO |
$207.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$118.40
|
| Rate for Payer: Galaxy Health WC |
$251.60
|
| Rate for Payer: Global Benefits Group Commercial |
$177.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$266.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.20
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: Networks By Design Commercial |
$148.00
|
| Rate for Payer: Prime Health Services Commercial |
$251.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.09
|
| Rate for Payer: United Healthcare All Other HMO |
$108.13
|
| Rate for Payer: United Healthcare HMO Rider |
$105.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.94
|
|
|
HC THORA KIT PLEURAL SEAL
|
Facility
|
OP
|
$296.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
900831718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$251.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$162.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$222.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.33
|
| Rate for Payer: Blue Shield of California Commercial |
$237.39
|
| Rate for Payer: Blue Shield of California EPN |
$149.18
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Central Health Plan Commercial |
$236.80
|
| Rate for Payer: Cigna of CA HMO |
$207.20
|
| Rate for Payer: Cigna of CA PPO |
$207.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$251.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$251.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$251.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$118.40
|
| Rate for Payer: Galaxy Health WC |
$251.60
|
| Rate for Payer: Global Benefits Group Commercial |
$177.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$266.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$207.20
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: Networks By Design Commercial |
$148.00
|
| Rate for Payer: Prime Health Services Commercial |
$251.60
|
| Rate for Payer: Riverside University Health System MISP |
$118.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$177.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$177.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.09
|
| Rate for Payer: United Healthcare All Other HMO |
$108.13
|
| Rate for Payer: United Healthcare HMO Rider |
$105.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$251.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$251.60
|
| Rate for Payer: Vantage Medical Group Senior |
$251.60
|
|
|
HC THRCSCPY DGNSTC LUNGS WO BX
|
Facility
|
IP
|
$20,482.00
|
|
|
Service Code
|
CPT 32601
|
| Hospital Charge Code |
900831704
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,096.40 |
| Max. Negotiated Rate |
$18,433.80 |
| Rate for Payer: Adventist Health Commercial |
$4,096.40
|
| Rate for Payer: Cash Price |
$9,216.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,385.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,337.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,192.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,192.80
|
| Rate for Payer: Galaxy Health WC |
$17,409.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,289.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,433.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,006.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,084.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,096.40
|
| Rate for Payer: Multiplan Commercial |
$15,361.50
|
| Rate for Payer: Networks By Design Commercial |
$13,313.30
|
| Rate for Payer: Prime Health Services Commercial |
$17,409.70
|
|
|
HC THRCSCPY DGNSTC LUNGS WO BX
|
Facility
|
OP
|
$20,482.00
|
|
|
Service Code
|
CPT 32601
|
| Hospital Charge Code |
900831704
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$317.62 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$4,096.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,775.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,553.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,775.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,811.52
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$9,216.90
|
| Rate for Payer: Cash Price |
$9,216.90
|
| Rate for Payer: Cash Price |
$9,216.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,385.60
|
| Rate for Payer: Cigna of CA HMO |
$13,108.48
|
| Rate for Payer: Cigna of CA PPO |
$15,156.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,553.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,775.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,337.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,829.67
|
| Rate for Payer: EPIC Health Plan Senior |
$8,553.12
|
| Rate for Payer: Galaxy Health WC |
$17,409.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,289.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,433.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,751.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$317.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,775.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,006.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$350.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,885.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,096.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,419.25
|
| Rate for Payer: Multiplan Commercial |
$15,361.50
|
| Rate for Payer: Multiplan WC |
$11,811.52
|
| Rate for Payer: Networks By Design Commercial |
$13,313.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,775.56
|
| Rate for Payer: Preferred Health Network WC |
$12,052.57
|
| Rate for Payer: Prime Health Services Commercial |
$17,409.70
|
| Rate for Payer: Prime Health Services Medicare |
$8,242.09
|
| Rate for Payer: Prime Health Services WC |
$11,690.99
|
| Rate for Payer: Riverside University Health System MISP |
$8,553.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,289.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,241.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,775.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,553.12
|
| Rate for Payer: Vantage Medical Group Senior |
$7,775.56
|
|
|
HC THRCSCPY DGNSTC W BX OF PLEURA
|
Facility
|
IP
|
$20,482.00
|
|
|
Service Code
|
CPT 32609
|
| Hospital Charge Code |
900831705
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,096.40 |
| Max. Negotiated Rate |
$18,433.80 |
| Rate for Payer: Adventist Health Commercial |
$4,096.40
|
| Rate for Payer: Cash Price |
$9,216.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,385.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,337.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,192.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,192.80
|
| Rate for Payer: Galaxy Health WC |
$17,409.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,289.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,433.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,006.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,084.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,096.40
|
| Rate for Payer: Multiplan Commercial |
$15,361.50
|
| Rate for Payer: Networks By Design Commercial |
$13,313.30
|
| Rate for Payer: Prime Health Services Commercial |
$17,409.70
|
|
