|
HC TOMO UNILAT
|
Facility
|
OP
|
$467.00
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
900377061
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$93.40 |
| Max. Negotiated Rate |
$724.81 |
| Rate for Payer: Adventist Health Commercial |
$93.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$724.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$396.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$256.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$350.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$349.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$271.65
|
| Rate for Payer: Blue Shield of California Commercial |
$294.21
|
| Rate for Payer: Blue Shield of California EPN |
$185.40
|
| Rate for Payer: Cash Price |
$210.15
|
| Rate for Payer: Cash Price |
$210.15
|
| Rate for Payer: Central Health Plan Commercial |
$373.60
|
| Rate for Payer: Cigna of CA HMO |
$298.88
|
| Rate for Payer: Cigna of CA PPO |
$345.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$396.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$396.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$396.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$326.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.80
|
| Rate for Payer: EPIC Health Plan Senior |
$186.80
|
| Rate for Payer: Galaxy Health WC |
$396.95
|
| Rate for Payer: Global Benefits Group Commercial |
$280.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$420.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$296.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$326.90
|
| Rate for Payer: Multiplan Commercial |
$350.25
|
| Rate for Payer: Networks By Design Commercial |
$303.55
|
| Rate for Payer: Prime Health Services Commercial |
$396.95
|
| Rate for Payer: Riverside University Health System MISP |
$186.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$280.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$280.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$307.94
|
| Rate for Payer: United Healthcare All Other HMO |
$307.94
|
| Rate for Payer: United Healthcare HMO Rider |
$307.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$396.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$396.95
|
| Rate for Payer: Vantage Medical Group Senior |
$396.95
|
|
|
HC TOMO UNILAT
|
Facility
|
IP
|
$467.00
|
|
|
Service Code
|
CPT 77061
|
| Hospital Charge Code |
900377061
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$93.40 |
| Max. Negotiated Rate |
$420.30 |
| Rate for Payer: Adventist Health Commercial |
$93.40
|
| Rate for Payer: Cash Price |
$210.15
|
| Rate for Payer: Central Health Plan Commercial |
$373.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$326.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.80
|
| Rate for Payer: EPIC Health Plan Senior |
$186.80
|
| Rate for Payer: Galaxy Health WC |
$396.95
|
| Rate for Payer: Global Benefits Group Commercial |
$280.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$420.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$296.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.40
|
| Rate for Payer: Multiplan Commercial |
$350.25
|
| Rate for Payer: Networks By Design Commercial |
$303.55
|
| Rate for Payer: Prime Health Services Commercial |
$396.95
|
|
|
HC TORSION CONTROL ANKLE JOINT ADDITION LE
|
Facility
|
OP
|
$243.00
|
|
|
Service Code
|
CPT L2375
|
| Hospital Charge Code |
905352375
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$79.58 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Adventist Health Commercial |
$99.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$182.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.35
|
| Rate for Payer: Blue Shield of California Commercial |
$194.89
|
| Rate for Payer: Blue Shield of California EPN |
$122.47
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Central Health Plan Commercial |
$194.40
|
| Rate for Payer: Cigna of CA HMO |
$170.10
|
| Rate for Payer: Cigna of CA PPO |
$170.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$206.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$206.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Senior |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$120.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$154.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$133.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$143.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$170.10
|
| Rate for Payer: Multiplan Commercial |
$182.25
|
| Rate for Payer: Networks By Design Commercial |
$121.50
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: Riverside University Health System MISP |
$97.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.20
|
| Rate for Payer: United Healthcare All Other HMO |
$88.77
|
| Rate for Payer: United Healthcare HMO Rider |
$86.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$79.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.55
|
| Rate for Payer: Vantage Medical Group Senior |
$206.55
|
|
|
HC TORSION CONTROL ANKLE JOINT ADDITION LE
|
Facility
|
IP
|
$243.00
|
|
|
Service Code
|
CPT L2375
|
| Hospital Charge Code |
915352375
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Adventist Health Commercial |
$48.60
|
| Rate for Payer: Blue Shield of California Commercial |
$194.89
|
| Rate for Payer: Blue Shield of California EPN |
$122.47
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Central Health Plan Commercial |
$194.40
|
| Rate for Payer: Cigna of CA HMO |
$170.10
|
| Rate for Payer: Cigna of CA PPO |
$170.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Senior |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$154.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$143.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.60
|
| Rate for Payer: Multiplan Commercial |
$182.25
|
| Rate for Payer: Networks By Design Commercial |
$157.95
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.20
|
| Rate for Payer: United Healthcare All Other HMO |
$88.77
|
| Rate for Payer: United Healthcare HMO Rider |
$86.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$79.58
|
|
|
HC TORSION CONTROL ANKLE JOINT ADDITION LE
|
Facility
|
OP
|
$243.00
|
|
|
Service Code
|
CPT L2375
|
| Hospital Charge Code |
915352375
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$79.58 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Adventist Health Commercial |
$99.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$182.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.35
|
| Rate for Payer: Blue Shield of California Commercial |
$194.89
|
| Rate for Payer: Blue Shield of California EPN |
$122.47
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Central Health Plan Commercial |
$194.40
|
| Rate for Payer: Cigna of CA HMO |
$170.10
|
| Rate for Payer: Cigna of CA PPO |
$170.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$206.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$206.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Senior |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$120.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$154.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$133.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$143.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$170.10
|
| Rate for Payer: Multiplan Commercial |
$182.25
|
| Rate for Payer: Networks By Design Commercial |
$121.50
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: Riverside University Health System MISP |
$97.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.20
|
| Rate for Payer: United Healthcare All Other HMO |
$88.77
|
| Rate for Payer: United Healthcare HMO Rider |
$86.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$79.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.55
|
| Rate for Payer: Vantage Medical Group Senior |
$206.55
|
|
|
HC TORSION CONTROL ANKLE JOINT ADDITION LE
|
Facility
|
IP
|
$243.00
|
|
|
Service Code
|
CPT L2375
|
| Hospital Charge Code |
905352375
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$218.70 |
| Rate for Payer: Adventist Health Commercial |
$48.60
|
| Rate for Payer: Blue Shield of California Commercial |
$194.89
|
| Rate for Payer: Blue Shield of California EPN |
$122.47
|
| Rate for Payer: Cash Price |
$109.35
|
| Rate for Payer: Central Health Plan Commercial |
$194.40
|
| Rate for Payer: Cigna of CA HMO |
$170.10
|
| Rate for Payer: Cigna of CA PPO |
$170.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.20
|
| Rate for Payer: EPIC Health Plan Senior |
$97.20
|
| Rate for Payer: Galaxy Health WC |
$206.55
|
| Rate for Payer: Global Benefits Group Commercial |
$145.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$154.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$143.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.60
|
| Rate for Payer: Multiplan Commercial |
$182.25
|
| Rate for Payer: Networks By Design Commercial |
$157.95
|
| Rate for Payer: Prime Health Services Commercial |
$206.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.20
|
| Rate for Payer: United Healthcare All Other HMO |
$88.77
|
| Rate for Payer: United Healthcare HMO Rider |
$86.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$79.58
|
|
|
HC TORSION CONTROL KNEE JOINT ADDITION LE
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT L2380
|
| Hospital Charge Code |
905352380
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Blue Shield of California Commercial |
$160.40
|
| Rate for Payer: Blue Shield of California EPN |
$100.80
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: Cigna of CA HMO |
$140.00
|
| Rate for Payer: Cigna of CA PPO |
$140.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.06
|
| Rate for Payer: United Healthcare All Other HMO |
$73.06
|
| Rate for Payer: United Healthcare HMO Rider |
$71.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.50
|
|
|
HC TORSION CONTROL KNEE JOINT ADDITION LE
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT L2380
|
| Hospital Charge Code |
915352380
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Blue Shield of California Commercial |
$160.40
|
| Rate for Payer: Blue Shield of California EPN |
$100.80
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: Cigna of CA HMO |
$140.00
|
| Rate for Payer: Cigna of CA PPO |
$140.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$130.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.06
|
| Rate for Payer: United Healthcare All Other HMO |
$73.06
|
| Rate for Payer: United Healthcare HMO Rider |
$71.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.50
|
|
|
HC TORSION CONTROL KNEE JOINT ADDITION LE
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT L2380
|
| Hospital Charge Code |
915352380
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$65.50 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Adventist Health Commercial |
$82.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$110.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$116.34
|
| Rate for Payer: Blue Shield of California Commercial |
$160.40
|
| Rate for Payer: Blue Shield of California EPN |
$100.80
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: Cigna of CA HMO |
$140.00
|
| Rate for Payer: Cigna of CA PPO |
$140.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$170.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$170.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$142.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$157.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$140.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$100.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: Riverside University Health System MISP |
$80.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.06
|
| Rate for Payer: United Healthcare All Other HMO |
$73.06
|
| Rate for Payer: United Healthcare HMO Rider |
$71.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$170.00
|
| Rate for Payer: Vantage Medical Group Senior |
$170.00
|
|
|
HC TORSION CONTROL KNEE JOINT ADDITION LE
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT L2380
|
| Hospital Charge Code |
905352380
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$65.50 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Adventist Health Commercial |
$82.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$110.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$116.34
|
| Rate for Payer: Blue Shield of California Commercial |
$160.40
|
| Rate for Payer: Blue Shield of California EPN |
$100.80
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Central Health Plan Commercial |
$160.00
|
| Rate for Payer: Cigna of CA HMO |
$140.00
|
| Rate for Payer: Cigna of CA PPO |
$140.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$170.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$170.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.00
|
| Rate for Payer: EPIC Health Plan Senior |
$80.00
|
| Rate for Payer: Galaxy Health WC |
$170.00
|
| Rate for Payer: Global Benefits Group Commercial |
$120.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$142.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$157.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$140.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Networks By Design Commercial |
$100.00
|
| Rate for Payer: Prime Health Services Commercial |
$170.00
|
| Rate for Payer: Riverside University Health System MISP |
$80.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.06
|
| Rate for Payer: United Healthcare All Other HMO |
$73.06
|
| Rate for Payer: United Healthcare HMO Rider |
$71.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$170.00
|
| Rate for Payer: Vantage Medical Group Senior |
$170.00
|
|
|
HC TORSION MECHANISM KNEE/ANKLE
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT L2861
|
| Hospital Charge Code |
905352861
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$164.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$300.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$232.68
|
| Rate for Payer: Blue Shield of California Commercial |
$320.80
|
| Rate for Payer: Blue Shield of California EPN |
$201.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$340.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$340.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$280.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Riverside University Health System MISP |
$160.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
|
HC TORSION MECHANISM KNEE/ANKLE
|
Facility
|
IP
|
$400.00
|
|
|
Service Code
|
CPT L2861
|
| Hospital Charge Code |
905352861
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Blue Shield of California Commercial |
$320.80
|
| Rate for Payer: Blue Shield of California EPN |
$201.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
|
|
HC TORSION MECHANISM WRIST ELBOW
|
Facility
|
IP
|
$400.00
|
|
|
Service Code
|
CPT L3891
|
| Hospital Charge Code |
905353891
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$80.00
|
| Rate for Payer: Blue Shield of California Commercial |
$320.80
|
| Rate for Payer: Blue Shield of California EPN |
$201.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
|
|
HC TORSION MECHANISM WRIST ELBOW
|
Facility
|
OP
|
$400.00
|
|
|
Service Code
|
CPT L3891
|
| Hospital Charge Code |
905353891
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$131.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$164.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$220.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$300.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$232.68
|
| Rate for Payer: Blue Shield of California Commercial |
$320.80
|
| Rate for Payer: Blue Shield of California EPN |
$201.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$280.00
|
| Rate for Payer: Cigna of CA PPO |
$280.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$340.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$340.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$340.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: EPIC Health Plan Senior |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$254.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$236.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$280.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$200.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Riverside University Health System MISP |
$160.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.12
|
| Rate for Payer: United Healthcare All Other HMO |
$146.12
|
| Rate for Payer: United Healthcare HMO Rider |
$142.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$340.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$340.00
|
| Rate for Payer: Vantage Medical Group Senior |
$340.00
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
|
OP
|
$3,778.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$223.26 |
| Max. Negotiated Rate |
$3,400.20 |
| Rate for Payer: Adventist Health Commercial |
$755.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$698.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,759.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$768.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$698.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$985.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,197.66
|
| Rate for Payer: Blue Shield of California Commercial |
$2,380.14
|
| Rate for Payer: Blue Shield of California EPN |
$1,499.87
|
| Rate for Payer: Cash Price |
$1,700.10
|
| Rate for Payer: Cash Price |
$1,700.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,022.40
|
| Rate for Payer: Cigna of CA HMO |
$2,417.92
|
| Rate for Payer: Cigna of CA PPO |
$2,795.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$768.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$698.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,644.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.28
|
| Rate for Payer: EPIC Health Plan Senior |
$768.18
|
| Rate for Payer: Galaxy Health WC |
$3,211.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,266.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,400.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,145.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$223.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$698.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,399.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$246.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$977.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$935.79
|
| Rate for Payer: Multiplan Commercial |
$2,833.50
|
| Rate for Payer: Networks By Design Commercial |
$2,455.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$698.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,211.30
|
| Rate for Payer: Prime Health Services Medicare |
$740.25
|
| Rate for Payer: Riverside University Health System MISP |
$768.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,266.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,266.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$717.15
|
| Rate for Payer: United Healthcare All Other HMO |
$717.15
|
| Rate for Payer: United Healthcare HMO Rider |
$717.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$717.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$698.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$768.18
|
| Rate for Payer: Vantage Medical Group Senior |
$698.35
|
|
|
HC TOTAL BODY THYROID SCAN
|
Facility
|
IP
|
$3,778.00
|
|
|
Service Code
|
CPT 78018
|
| Hospital Charge Code |
909301317
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$755.60 |
| Max. Negotiated Rate |
$3,400.20 |
| Rate for Payer: Adventist Health Commercial |
$755.60
|
| Rate for Payer: Cash Price |
$1,700.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,022.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,644.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,511.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,511.20
|
| Rate for Payer: Galaxy Health WC |
$3,211.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,266.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,400.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,399.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,229.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$755.60
|
| Rate for Payer: Multiplan Commercial |
$2,833.50
|
| Rate for Payer: Networks By Design Commercial |
$2,455.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,211.30
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
|
OP
|
$1,013.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.60 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$359.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$607.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.73
|
| Rate for Payer: Anthem Blue Cross of CA 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 |
$642.24
|
| Rate for Payer: Blue Shield of California EPN |
$404.19
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Central Health Plan Commercial |
$810.40
|
| Rate for Payer: Cigna of CA HMO |
$648.32
|
| Rate for Payer: Cigna of CA PPO |
$749.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$395.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$709.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.55
|
| Rate for Payer: EPIC Health Plan Senior |
$395.70
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$589.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$235.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$359.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$259.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$503.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$359.73
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
| Rate for Payer: Prime Health Services Medicare |
$381.31
|
| Rate for Payer: Riverside University Health System MISP |
$395.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.50
|
| Rate for Payer: United Healthcare All Other HMO |
$506.50
|
| Rate for Payer: United Healthcare HMO Rider |
$506.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$359.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Vantage Medical Group Senior |
$359.73
|
|
|
HC TOTAL CONTACT CAST LEG
|
Facility
|
IP
|
$1,013.00
|
|
|
Service Code
|
CPT 29445
|
| Hospital Charge Code |
900101505
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$202.60 |
| Max. Negotiated Rate |
$911.70 |
| Rate for Payer: Adventist Health Commercial |
$202.60
|
| Rate for Payer: Cash Price |
$455.85
|
| Rate for Payer: Central Health Plan Commercial |
$810.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$709.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$405.20
|
| Rate for Payer: EPIC Health Plan Senior |
$405.20
|
| Rate for Payer: Galaxy Health WC |
$861.05
|
| Rate for Payer: Global Benefits Group Commercial |
$607.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.60
|
| Rate for Payer: Multiplan Commercial |
$759.75
|
| Rate for Payer: Networks By Design Commercial |
$658.45
|
| Rate for Payer: Prime Health Services Commercial |
$861.05
|
|
|
HC TOTAL HEMOGLOBIN
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$23.90 |
| Rate for Payer: Adventist Health Commercial |
$2.00
|
| Rate for Payer: Adventist Health Commercial |
$3.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.37
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.90
|
| Rate for Payer: Blue Shield of California Commercial |
$11.97
|
| Rate for Payer: Blue Shield of California Commercial |
$6.30
|
| Rate for Payer: Blue Shield of California EPN |
$7.54
|
| Rate for Payer: Blue Shield of California EPN |
$3.97
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Cash Price |
$4.50
|
| Rate for Payer: Central Health Plan Commercial |
$8.00
|
| Rate for Payer: Central Health Plan Commercial |
$15.20
|
| Rate for Payer: Cigna of CA HMO |
$12.16
|
| Rate for Payer: Cigna of CA HMO |
$6.40
|
| Rate for Payer: Cigna of CA PPO |
$14.06
|
| Rate for Payer: Cigna of CA PPO |
$7.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.91
|
| Rate for Payer: EPIC Health Plan Senior |
$2.61
|
| Rate for Payer: EPIC Health Plan Senior |
$2.61
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Galaxy Health WC |
$8.50
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.89
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.18
|
| Rate for Payer: Multiplan Commercial |
$14.25
|
| Rate for Payer: Multiplan Commercial |
$7.50
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.37
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.37
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
| Rate for Payer: Prime Health Services Commercial |
$8.50
|
| Rate for Payer: Prime Health Services Medicare |
$2.51
|
| Rate for Payer: Prime Health Services Medicare |
$2.51
|
| Rate for Payer: Riverside University Health System MISP |
$2.61
|
| Rate for Payer: Riverside University Health System MISP |
$2.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.92
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.37
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.61
|
| Rate for Payer: Vantage Medical Group Senior |
$2.37
|
| Rate for Payer: Vantage Medical Group Senior |
$2.37
|
|
|
HC TOTAL HEMOGLOBIN
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
900912031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$17.10 |
| Rate for Payer: Adventist Health Commercial |
$3.80
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Central Health Plan Commercial |
$15.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7.60
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.80
|
| Rate for Payer: Multiplan Commercial |
$14.25
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
|
|
HC TOTAL LUNG LAVAGE UNILATERAL
|
Facility
|
OP
|
$2,263.00
|
|
|
Service Code
|
CPT 32997
|
| Hospital Charge Code |
900803550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.60 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$452.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,923.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,923.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,244.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,697.25
|
| 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 |
$1,434.74
|
| Rate for Payer: Blue Shield of California EPN |
$902.94
|
| Rate for Payer: Cash Price |
$1,018.35
|
| Rate for Payer: Cash Price |
$1,018.35
|
| Rate for Payer: Cash Price |
$1,018.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,810.40
|
| Rate for Payer: Cigna of CA HMO |
$1,448.32
|
| Rate for Payer: Cigna of CA PPO |
$1,674.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,923.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,923.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,923.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,584.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$905.20
|
| Rate for Payer: EPIC Health Plan Senior |
$905.20
|
| Rate for Payer: Galaxy Health WC |
$1,923.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,357.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,036.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,437.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$821.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,335.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,584.10
|
| Rate for Payer: Multiplan Commercial |
$1,697.25
|
| Rate for Payer: Networks By Design Commercial |
$1,470.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,923.55
|
| Rate for Payer: Riverside University Health System MISP |
$905.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,357.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,357.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,131.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,131.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,131.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,131.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,923.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,923.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,923.55
|
|
|
HC TOTAL LUNG LAVAGE UNILATERAL
|
Facility
|
IP
|
$2,263.00
|
|
|
Service Code
|
CPT 32997
|
| Hospital Charge Code |
900803550
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$452.60 |
| Max. Negotiated Rate |
$2,036.70 |
| Rate for Payer: Adventist Health Commercial |
$452.60
|
| Rate for Payer: Cash Price |
$1,018.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,810.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,584.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$905.20
|
| Rate for Payer: EPIC Health Plan Senior |
$905.20
|
| Rate for Payer: Galaxy Health WC |
$1,923.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,357.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,036.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,437.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,335.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$452.60
|
| Rate for Payer: Multiplan Commercial |
$1,697.25
|
| Rate for Payer: Networks By Design Commercial |
$1,470.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,923.55
|
|
|
HC TOXOABG
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
900913713
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
|
|
HC TOXOABG
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
900913713
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$151.64 |
| Rate for Payer: Adventist Health Commercial |
$3.00
|
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.99
|
| Rate for Payer: Adventist Health Medi-Cal |
$14.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$109.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$109.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.64
|
| Rate for Payer: Blue Shield of California Commercial |
$11.34
|
| Rate for Payer: Blue Shield of California Commercial |
$9.45
|
| Rate for Payer: Blue Shield of California EPN |
$7.15
|
| Rate for Payer: Blue Shield of California EPN |
$5.96
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Cash Price |
$6.75
|
| Rate for Payer: Central Health Plan Commercial |
$12.00
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Cigna of CA HMO |
$11.52
|
| Rate for Payer: Cigna of CA HMO |
$9.60
|
| Rate for Payer: Cigna of CA PPO |
$13.32
|
| Rate for Payer: Cigna of CA PPO |
$11.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.73
|
| Rate for Payer: EPIC Health Plan Senior |
$16.49
|
| Rate for Payer: EPIC Health Plan Senior |
$16.49
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Galaxy Health WC |
$12.75
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.58
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.09
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Multiplan Commercial |
$11.25
|
| Rate for Payer: Networks By Design Commercial |
$9.75
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.99
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14.99
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Commercial |
$12.75
|
| Rate for Payer: Prime Health Services Medicare |
$15.89
|
| Rate for Payer: Prime Health Services Medicare |
$15.89
|
| Rate for Payer: Riverside University Health System MISP |
$16.49
|
| Rate for Payer: Riverside University Health System MISP |
$16.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.14
|
| Rate for Payer: United Healthcare All Other HMO |
$12.14
|
| Rate for Payer: United Healthcare All Other HMO |
$12.14
|
| Rate for Payer: United Healthcare HMO Rider |
$12.14
|
| Rate for Payer: United Healthcare HMO Rider |
$12.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.14
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$14.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.49
|
| Rate for Payer: Vantage Medical Group Senior |
$14.99
|
| Rate for Payer: Vantage Medical Group Senior |
$14.99
|
|
|
HC TOXOABM
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
900913714
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Adventist Health Commercial |
$3.60
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Networks By Design Commercial |
$11.70
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
|
