|
HC SURGERY LEVEL III EA SUBS 30 MIN
|
Facility
IP
|
$3,468.00
|
|
| Hospital Charge Code |
900700034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$693.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$1,560.60
|
| Rate for Payer: Cash Price |
$1,560.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,774.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,387.20
|
| Rate for Payer: Galaxy Health WC |
$2,947.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,080.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,121.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,313.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$693.60
|
| Rate for Payer: Multiplan Commercial |
$2,601.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,947.80
|
|
|
HC SURGERY LEVEL III EA SUBS 30 MIN
|
Facility
OP
|
$3,468.00
|
|
| Hospital Charge Code |
900700034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$693.60 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,106.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,947.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,907.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,907.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,679.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,048.89
|
| Rate for Payer: BCBS Transplant Transplant |
$2,080.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$1,560.60
|
| Rate for Payer: Cash Price |
$1,560.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,774.40
|
| Rate for Payer: Cigna of CA PPO |
$2,566.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,947.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,387.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,387.20
|
| Rate for Payer: Galaxy Health WC |
$2,947.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,080.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,121.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,601.00
|
| Rate for Payer: IEHP medi-cal |
$1,213.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,313.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$693.60
|
| Rate for Payer: Multiplan Commercial |
$2,601.00
|
| Rate for Payer: Networks By Design Commercial |
$2,254.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,947.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,080.80
|
| Rate for Payer: Riverside University Health MISP |
$1,387.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,080.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,734.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,734.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,734.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,734.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,947.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,947.80
|
|
|
HC SURGERY LEVEL IV 1ST ADDL 30 M
|
Facility
OP
|
$4,982.00
|
|
| Hospital Charge Code |
900700043
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$996.40 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,025.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,234.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,740.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,740.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,412.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,943.37
|
| Rate for Payer: BCBS Transplant Transplant |
$2,989.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$2,241.90
|
| Rate for Payer: Cash Price |
$2,241.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,985.60
|
| Rate for Payer: Cigna of CA PPO |
$3,686.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,234.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,992.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,992.80
|
| Rate for Payer: Galaxy Health WC |
$4,234.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,989.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,483.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,736.50
|
| Rate for Payer: IEHP medi-cal |
$1,743.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,322.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$996.40
|
| Rate for Payer: Multiplan Commercial |
$3,736.50
|
| Rate for Payer: Networks By Design Commercial |
$3,238.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,234.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,989.20
|
| Rate for Payer: Riverside University Health MISP |
$1,992.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,989.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,491.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,491.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,491.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,491.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,234.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,234.70
|
|
|
HC SURGERY LEVEL IV 1ST ADDL 30 M
|
Facility
IP
|
$4,982.00
|
|
| Hospital Charge Code |
900700043
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$996.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$2,241.90
|
| Rate for Payer: Cash Price |
$2,241.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,985.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,992.80
|
| Rate for Payer: Galaxy Health WC |
$4,234.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,989.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,483.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,322.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$996.40
|
| Rate for Payer: Multiplan Commercial |
$3,736.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,234.70
|
|
|
HC SURGERY LEVEL IV 1ST HR
|
Facility
OP
|
$32,009.00
|
|
| Hospital Charge Code |
900700040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$28,808.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,439.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27,207.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17,604.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17,604.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,498.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,910.92
|
| Rate for Payer: BCBS Transplant Transplant |
$19,205.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$14,404.05
|
| Rate for Payer: Cash Price |
$14,404.05
|
| Rate for Payer: Central Health Plan Commercial |
$25,607.20
|
| Rate for Payer: Cigna of CA PPO |
$23,686.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27,207.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,803.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,803.60
|
| Rate for Payer: Galaxy Health WC |
$27,207.65
|
| Rate for Payer: Global Benefits Group Commercial |
$19,205.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,808.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,006.75
|
| Rate for Payer: IEHP medi-cal |
$11,203.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,350.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,401.80
|
| Rate for Payer: Multiplan Commercial |
$24,006.75
|
| Rate for Payer: Networks By Design Commercial |
$20,805.85
|
| Rate for Payer: Prime Health Services Commercial |
$27,207.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,205.40
|
| Rate for Payer: Riverside University Health MISP |
$12,803.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,205.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,004.50
|
| Rate for Payer: United Healthcare All Other HMO |
$16,004.50
|
| Rate for Payer: United Healthcare HMO Rider |
$16,004.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,004.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,207.65
|
| Rate for Payer: Vantage Medical Group Senior |
$27,207.65
|
|
|
HC SURGERY LEVEL IV 1ST HR
|
Facility
IP
|
$32,009.00
|
|
| Hospital Charge Code |
900700040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,401.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$14,404.05
|
| Rate for Payer: Cash Price |
$14,404.05
|
| Rate for Payer: Central Health Plan Commercial |
$25,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,803.60
|
| Rate for Payer: Galaxy Health WC |
$27,207.65
|
| Rate for Payer: Global Benefits Group Commercial |
$19,205.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,808.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,350.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,401.80
|
| Rate for Payer: Multiplan Commercial |
$24,006.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$27,207.65
|
|
|
HC SURGERY LEVEL IV EA SUB 30 MIN
|
Facility
IP
|
$4,982.00
|
|
| Hospital Charge Code |
900700044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$996.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$2,241.90
|
| Rate for Payer: Cash Price |
$2,241.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,985.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,992.80
|
| Rate for Payer: Galaxy Health WC |
$4,234.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,989.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,483.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,322.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$996.40
|
| Rate for Payer: Multiplan Commercial |
$3,736.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,234.70
|
|
|
HC SURGERY LEVEL IV EA SUB 30 MIN
|
Facility
OP
|
$4,982.00
|
|
| Hospital Charge Code |
900700044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$996.40 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,025.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,234.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,740.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,740.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,412.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,943.37
|
| Rate for Payer: BCBS Transplant Transplant |
$2,989.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$2,241.90
|
| Rate for Payer: Cash Price |
$2,241.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,985.60
|
| Rate for Payer: Cigna of CA PPO |
$3,686.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,234.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,992.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,992.80
|
| Rate for Payer: Galaxy Health WC |
$4,234.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,989.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,483.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,736.50
|
| Rate for Payer: IEHP medi-cal |
$1,743.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,322.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$996.40
|
| Rate for Payer: Multiplan Commercial |
$3,736.50
|
| Rate for Payer: Networks By Design Commercial |
$3,238.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,234.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,989.20
|
| Rate for Payer: Riverside University Health MISP |
$1,992.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,989.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,491.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,491.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,491.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,491.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,234.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,234.70
|
|
|
HC SURGERY LEVEL V 1ST ADDL 30 MI
|
Facility
IP
|
$6,523.00
|
|
| Hospital Charge Code |
900700053
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,304.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$2,935.35
|
| Rate for Payer: Cash Price |
$2,935.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,218.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,609.20
|
| Rate for Payer: Galaxy Health WC |
$5,544.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,913.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,870.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,350.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,304.60
|
| Rate for Payer: Multiplan Commercial |
$4,892.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,544.55
|
|
|
HC SURGERY LEVEL V 1ST ADDL 30 MI
|
Facility
OP
|
$6,523.00
|
|
| Hospital Charge Code |
900700053
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,304.60 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,961.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,544.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,587.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,587.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,158.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,853.79
|
| Rate for Payer: BCBS Transplant Transplant |
$3,913.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$2,935.35
|
| Rate for Payer: Cash Price |
$2,935.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,218.40
|
| Rate for Payer: Cigna of CA PPO |
$4,827.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,544.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,609.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,609.20
|
| Rate for Payer: Galaxy Health WC |
$5,544.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,913.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,870.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,892.25
|
| Rate for Payer: IEHP medi-cal |
$2,283.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,350.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,304.60
|
| Rate for Payer: Multiplan Commercial |
$4,892.25
|
| Rate for Payer: Networks By Design Commercial |
$4,239.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,544.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,913.80
|
| Rate for Payer: Riverside University Health MISP |
$2,609.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,913.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,261.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,261.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,261.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,261.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,544.55
|
| Rate for Payer: Vantage Medical Group Senior |
$5,544.55
|
|
|
HC SURGERY LEVEL V 1ST HR
|
Facility
OP
|
$47,652.00
|
|
| Hospital Charge Code |
900700050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$42,886.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,939.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$40,504.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,208.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$26,208.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,073.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,152.80
|
| Rate for Payer: BCBS Transplant Transplant |
$28,591.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$21,443.40
|
| Rate for Payer: Cash Price |
$21,443.40
|
| Rate for Payer: Central Health Plan Commercial |
$38,121.60
|
| Rate for Payer: Cigna of CA PPO |
$35,262.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40,504.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,060.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$19,060.80
|
| Rate for Payer: Galaxy Health WC |
$40,504.20
|
| Rate for Payer: Global Benefits Group Commercial |
$28,591.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,886.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$35,739.00
|
| Rate for Payer: IEHP medi-cal |
$16,678.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,783.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,530.40
|
| Rate for Payer: Multiplan Commercial |
$35,739.00
|
| Rate for Payer: Networks By Design Commercial |
$30,973.80
|
| Rate for Payer: Prime Health Services Commercial |
$40,504.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$28,591.20
|
| Rate for Payer: Riverside University Health MISP |
$19,060.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,591.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$23,826.00
|
| Rate for Payer: United Healthcare All Other HMO |
$23,826.00
|
| Rate for Payer: United Healthcare HMO Rider |
$23,826.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23,826.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40,504.20
|
| Rate for Payer: Vantage Medical Group Senior |
$40,504.20
|
|
|
HC SURGERY LEVEL V 1ST HR
|
Facility
IP
|
$47,652.00
|
|
| Hospital Charge Code |
900700050
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,530.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$21,443.40
|
| Rate for Payer: Cash Price |
$21,443.40
|
| Rate for Payer: Central Health Plan Commercial |
$38,121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,060.80
|
| Rate for Payer: Galaxy Health WC |
$40,504.20
|
| Rate for Payer: Global Benefits Group Commercial |
$28,591.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,886.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,783.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,530.40
|
| Rate for Payer: Multiplan Commercial |
$35,739.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$40,504.20
|
|
|
HC SURGERY LEVEL V EA SUBS 30 MIN
|
Facility
IP
|
$6,523.00
|
|
| Hospital Charge Code |
900700054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,304.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$2,935.35
|
| Rate for Payer: Cash Price |
$2,935.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,218.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,609.20
|
| Rate for Payer: Galaxy Health WC |
$5,544.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,913.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,870.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,350.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,304.60
|
| Rate for Payer: Multiplan Commercial |
$4,892.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,544.55
|
|
|
HC SURGERY LEVEL V EA SUBS 30 MIN
|
Facility
OP
|
$6,523.00
|
|
| Hospital Charge Code |
900700054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,304.60 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,961.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,544.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,587.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,587.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,158.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,853.79
|
| Rate for Payer: BCBS Transplant Transplant |
$3,913.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$2,935.35
|
| Rate for Payer: Cash Price |
$2,935.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,218.40
|
| Rate for Payer: Cigna of CA PPO |
$4,827.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,544.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,609.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,609.20
|
| Rate for Payer: Galaxy Health WC |
$5,544.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,913.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,870.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,892.25
|
| Rate for Payer: IEHP medi-cal |
$2,283.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,350.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,304.60
|
| Rate for Payer: Multiplan Commercial |
$4,892.25
|
| Rate for Payer: Networks By Design Commercial |
$4,239.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,544.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,913.80
|
| Rate for Payer: Riverside University Health MISP |
$2,609.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,913.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,261.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,261.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,261.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,261.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,544.55
|
| Rate for Payer: Vantage Medical Group Senior |
$5,544.55
|
|
|
HC SURGERY LEVEL VI 1ST ADDL 30MIN
|
Facility
IP
|
$10,048.00
|
|
| Hospital Charge Code |
900700063
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,009.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$4,521.60
|
| Rate for Payer: Cash Price |
$4,521.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,038.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,019.20
|
| Rate for Payer: Galaxy Health WC |
$8,540.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,028.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,043.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,702.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,009.60
|
| Rate for Payer: Multiplan Commercial |
$7,536.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,540.80
|
|
|
HC SURGERY LEVEL VI 1ST ADDL 30MIN
|
Facility
OP
|
$10,048.00
|
|
| Hospital Charge Code |
900700063
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,009.60 |
| Max. Negotiated Rate |
$9,043.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,102.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8,540.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,526.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,526.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,865.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,936.36
|
| Rate for Payer: BCBS Transplant Transplant |
$6,028.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$4,521.60
|
| Rate for Payer: Cash Price |
$4,521.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,038.40
|
| Rate for Payer: Cigna of CA PPO |
$7,435.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,540.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,019.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,019.20
|
| Rate for Payer: Galaxy Health WC |
$8,540.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,028.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,043.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,536.00
|
| Rate for Payer: IEHP medi-cal |
$3,516.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,702.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,009.60
|
| Rate for Payer: Multiplan Commercial |
$7,536.00
|
| Rate for Payer: Networks By Design Commercial |
$6,531.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,540.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,028.80
|
| Rate for Payer: Riverside University Health MISP |
$4,019.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,028.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,024.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,024.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,024.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,540.80
|
| Rate for Payer: Vantage Medical Group Senior |
$8,540.80
|
|
|
HC SURGERY LEVEL VI 1ST HR
|
Facility
IP
|
$87,049.00
|
|
| Hospital Charge Code |
900700060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$17,409.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$39,172.05
|
| Rate for Payer: Cash Price |
$39,172.05
|
| Rate for Payer: Central Health Plan Commercial |
$69,639.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,819.60
|
| Rate for Payer: Galaxy Health WC |
$73,991.65
|
| Rate for Payer: Global Benefits Group Commercial |
$52,229.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$78,344.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58,061.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17,409.80
|
| Rate for Payer: Multiplan Commercial |
$65,286.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$73,991.65
|
|
|
HC SURGERY LEVEL VI 1ST HR
|
Facility
OP
|
$87,049.00
|
|
| Hospital Charge Code |
900700060
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$78,344.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,864.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$73,991.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$47,876.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$47,876.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42,149.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51,428.55
|
| Rate for Payer: BCBS Transplant Transplant |
$52,229.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$39,172.05
|
| Rate for Payer: Cash Price |
$39,172.05
|
| Rate for Payer: Central Health Plan Commercial |
$69,639.20
|
| Rate for Payer: Cigna of CA PPO |
$64,416.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$73,991.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,819.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$34,819.60
|
| Rate for Payer: Galaxy Health WC |
$73,991.65
|
| Rate for Payer: Global Benefits Group Commercial |
$52,229.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$78,344.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$65,286.75
|
| Rate for Payer: IEHP medi-cal |
$30,467.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58,061.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17,409.80
|
| Rate for Payer: Multiplan Commercial |
$65,286.75
|
| Rate for Payer: Networks By Design Commercial |
$56,581.85
|
| Rate for Payer: Prime Health Services Commercial |
$73,991.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$52,229.40
|
| Rate for Payer: Riverside University Health MISP |
$34,819.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52,229.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,524.50
|
| Rate for Payer: United Healthcare All Other HMO |
$43,524.50
|
| Rate for Payer: United Healthcare HMO Rider |
$43,524.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43,524.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73,991.65
|
| Rate for Payer: Vantage Medical Group Senior |
$73,991.65
|
|
|
HC SURGERY LEVEL VI EA SUBS 30 MIN
|
Facility
OP
|
$10,048.00
|
|
| Hospital Charge Code |
900700064
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,009.60 |
| Max. Negotiated Rate |
$9,043.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,102.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8,540.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,526.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,526.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,865.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,936.36
|
| Rate for Payer: BCBS Transplant Transplant |
$6,028.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$4,521.60
|
| Rate for Payer: Cash Price |
$4,521.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,038.40
|
| Rate for Payer: Cigna of CA PPO |
$7,435.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,540.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,019.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,019.20
|
| Rate for Payer: Galaxy Health WC |
$8,540.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,028.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,043.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,536.00
|
| Rate for Payer: IEHP medi-cal |
$3,516.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,702.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,009.60
|
| Rate for Payer: Multiplan Commercial |
$7,536.00
|
| Rate for Payer: Networks By Design Commercial |
$6,531.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,540.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,028.80
|
| Rate for Payer: Riverside University Health MISP |
$4,019.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,028.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,024.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,024.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,024.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,540.80
|
| Rate for Payer: Vantage Medical Group Senior |
$8,540.80
|
|
|
HC SURGERY LEVEL VI EA SUBS 30 MIN
|
Facility
IP
|
$10,048.00
|
|
| Hospital Charge Code |
900700064
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,009.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$4,521.60
|
| Rate for Payer: Cash Price |
$4,521.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,038.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,019.20
|
| Rate for Payer: Galaxy Health WC |
$8,540.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,028.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,043.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,702.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,009.60
|
| Rate for Payer: Multiplan Commercial |
$7,536.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,540.80
|
|
|
HC SURGICAL BRA 2X LARGE
|
Facility
IP
|
$539.63
|
|
| Hospital Charge Code |
901698645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.93 |
| Max. Negotiated Rate |
$485.67 |
| Rate for Payer: Cash Price |
$242.83
|
| Rate for Payer: Central Health Plan Commercial |
$431.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.85
|
| Rate for Payer: Galaxy Health WC |
$458.69
|
| Rate for Payer: Global Benefits Group Commercial |
$323.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$485.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$359.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.93
|
| Rate for Payer: Multiplan Commercial |
$404.72
|
| Rate for Payer: Networks By Design Commercial |
$350.76
|
| Rate for Payer: Prime Health Services Commercial |
$458.69
|
|
|
HC SURGICAL BRA 2X LARGE
|
Facility
OP
|
$539.63
|
|
| Hospital Charge Code |
901698645
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.93 |
| Max. Negotiated Rate |
$485.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$327.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$458.69
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$296.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$296.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$261.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$318.81
|
| Rate for Payer: BCBS Transplant Transplant |
$323.78
|
| Rate for Payer: Blue Shield of California Commercial |
$339.43
|
| Rate for Payer: Blue Shield of California EPN |
$263.88
|
| Rate for Payer: Cash Price |
$242.83
|
| Rate for Payer: Central Health Plan Commercial |
$431.70
|
| Rate for Payer: Cigna of CA HMO |
$345.36
|
| Rate for Payer: Cigna of CA PPO |
$399.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$458.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$215.85
|
| Rate for Payer: Galaxy Health WC |
$458.69
|
| Rate for Payer: Global Benefits Group Commercial |
$323.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$485.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$404.72
|
| Rate for Payer: IEHP medi-cal |
$188.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$359.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.93
|
| Rate for Payer: Multiplan Commercial |
$404.72
|
| Rate for Payer: Networks By Design Commercial |
$350.76
|
| Rate for Payer: Prime Health Services Commercial |
$458.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$323.78
|
| Rate for Payer: Riverside University Health MISP |
$215.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$323.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$323.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$269.82
|
| Rate for Payer: United Healthcare All Other HMO |
$269.82
|
| Rate for Payer: United Healthcare HMO Rider |
$269.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$269.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$458.69
|
| Rate for Payer: Vantage Medical Group Senior |
$458.69
|
|
|
HC SURGICAL COLONOSCOPY
|
Facility
OP
|
$2,698.00
|
|
|
Service Code
|
CPT 45399
|
| Hospital Charge Code |
906745399
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$539.60 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,306.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,593.98
|
| Rate for Payer: BCBS Transplant Transplant |
$1,618.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,214.10
|
| Rate for Payer: Cash Price |
$1,214.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,158.40
|
| Rate for Payer: Cigna of CA PPO |
$1,996.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,293.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,618.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,428.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,023.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,799.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$539.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,023.50
|
| Rate for Payer: Networks By Design Commercial |
$1,753.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,293.30
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,618.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SURGICAL COLONOSCOPY
|
Facility
IP
|
$2,698.00
|
|
|
Service Code
|
CPT 45399
|
| Hospital Charge Code |
906745399
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$539.60 |
| Max. Negotiated Rate |
$2,428.20 |
| Rate for Payer: Cash Price |
$1,214.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,158.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,079.20
|
| Rate for Payer: Galaxy Health WC |
$2,293.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,618.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,428.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,799.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$539.60
|
| Rate for Payer: Multiplan Commercial |
$2,023.50
|
| Rate for Payer: Networks By Design Commercial |
$1,753.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,293.30
|
|
|
HC SURGICAL PROCEDURE
|
Facility
OP
|
$13,155.00
|
|
| Hospital Charge Code |
900501689
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,631.00 |
| Max. Negotiated Rate |
$11,839.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,989.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11,181.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,235.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,235.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,369.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,771.97
|
| Rate for Payer: BCBS Transplant Transplant |
$7,893.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$5,919.75
|
| Rate for Payer: Cash Price |
$5,919.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,524.00
|
| Rate for Payer: Cigna of CA PPO |
$9,734.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,181.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,262.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,262.00
|
| Rate for Payer: Galaxy Health WC |
$11,181.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,893.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,839.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,866.25
|
| Rate for Payer: IEHP medi-cal |
$4,604.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,774.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,631.00
|
| Rate for Payer: Multiplan Commercial |
$9,866.25
|
| Rate for Payer: Networks By Design Commercial |
$8,550.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,181.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,893.00
|
| Rate for Payer: Riverside University Health MISP |
$5,262.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,893.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,577.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,577.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,577.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,577.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,181.75
|
| Rate for Payer: Vantage Medical Group Senior |
$11,181.75
|
|
