|
HC UNLSTD PROCEDURE TRACHEA BRONC
|
Facility
|
IP
|
$3,367.00
|
|
|
Service Code
|
CPT 31899
|
| Hospital Charge Code |
900501511
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$673.40 |
| Max. Negotiated Rate |
$3,030.30 |
| Rate for Payer: Adventist Health Commercial |
$673.40
|
| Rate for Payer: Cash Price |
$1,515.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,693.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,356.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,346.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,346.80
|
| Rate for Payer: Galaxy Health WC |
$2,861.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,020.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,030.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,138.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,986.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$673.40
|
| Rate for Payer: Multiplan Commercial |
$2,525.25
|
| Rate for Payer: Networks By Design Commercial |
$2,188.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,861.95
|
|
|
HC UNLSTD PROCEDURE TRACHEA BRONC
|
Facility
|
OP
|
$3,367.00
|
|
|
Service Code
|
CPT 31899
|
| Hospital Charge Code |
900501511
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$256.73 |
| Max. Negotiated Rate |
$3,030.30 |
| Rate for Payer: Adventist Health Commercial |
$673.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$393.03
|
| Rate for Payer: Cash Price |
$1,515.15
|
| Rate for Payer: Cash Price |
$1,515.15
|
| Rate for Payer: Cash Price |
$1,515.15
|
| Rate for Payer: Cash Price |
$1,515.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,693.60
|
| Rate for Payer: Cigna of CA HMO |
$2,154.88
|
| Rate for Payer: Cigna of CA PPO |
$2,491.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,356.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$2,861.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,020.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,030.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,138.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$673.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$2,525.25
|
| Rate for Payer: Multiplan WC |
$393.03
|
| Rate for Payer: Networks By Design Commercial |
$2,188.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$256.73
|
| Rate for Payer: Preferred Health Network WC |
$401.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,861.95
|
| Rate for Payer: Prime Health Services Medicare |
$272.13
|
| Rate for Payer: Prime Health Services WC |
$389.02
|
| Rate for Payer: Riverside University Health System MISP |
$282.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,020.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,683.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,683.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,683.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,683.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
|
IP
|
$413.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$371.70 |
| Rate for Payer: Adventist Health Commercial |
$82.60
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Central Health Plan Commercial |
$330.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.20
|
| Rate for Payer: EPIC Health Plan Senior |
$165.20
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$371.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$243.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.60
|
| Rate for Payer: Multiplan Commercial |
$309.75
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
|
OP
|
$413.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$82.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Central Health Plan Commercial |
$330.40
|
| Rate for Payer: Cigna of CA HMO |
$264.32
|
| Rate for Payer: Cigna of CA PPO |
$305.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$371.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$309.75
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$247.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.50
|
| Rate for Payer: United Healthcare All Other HMO |
$206.50
|
| Rate for Payer: United Healthcare HMO Rider |
$206.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
|
OP
|
$413.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$169.33
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$250.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$240.24
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Central Health Plan Commercial |
$330.40
|
| Rate for Payer: Cigna of CA HMO |
$264.32
|
| Rate for Payer: Cigna of CA PPO |
$305.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$371.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$309.75
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$247.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$247.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
|
IP
|
$413.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$371.70 |
| Rate for Payer: Adventist Health Commercial |
$82.60
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Central Health Plan Commercial |
$330.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.20
|
| Rate for Payer: EPIC Health Plan Senior |
$165.20
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$371.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$243.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.60
|
| Rate for Payer: Multiplan Commercial |
$309.75
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
|
|
HC UNLSTD TEAR DUCT SYSTEM SURGRY
|
Facility
|
IP
|
$1,037.00
|
|
|
Service Code
|
CPT 68899
|
| Hospital Charge Code |
900501716
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.40 |
| Max. Negotiated Rate |
$933.30 |
| Rate for Payer: Adventist Health Commercial |
$207.40
|
| Rate for Payer: Cash Price |
$466.65
|
| Rate for Payer: Central Health Plan Commercial |
$829.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$725.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.80
|
| Rate for Payer: EPIC Health Plan Senior |
$414.80
|
| Rate for Payer: Galaxy Health WC |
$881.45
|
| Rate for Payer: Global Benefits Group Commercial |
$622.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$933.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$658.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$611.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$207.40
|
| Rate for Payer: Multiplan Commercial |
$777.75
|
| Rate for Payer: Networks By Design Commercial |
$674.05
|
| Rate for Payer: Prime Health Services Commercial |
$881.45
|
|
|
HC UNLSTD TEAR DUCT SYSTEM SURGRY
|
Facility
|
OP
|
$1,037.00
|
|
|
Service Code
|
CPT 68899
|
| Hospital Charge Code |
900501716
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$207.40 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$207.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Cash Price |
$466.65
|
| Rate for Payer: Cash Price |
$466.65
|
| Rate for Payer: Cash Price |
$466.65
|
| Rate for Payer: Cash Price |
$466.65
|
| Rate for Payer: Central Health Plan Commercial |
$829.60
|
| Rate for Payer: Cigna of CA HMO |
$663.68
|
| Rate for Payer: Cigna of CA PPO |
$767.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$612.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$725.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$449.06
|
| Rate for Payer: Galaxy Health WC |
$881.45
|
| Rate for Payer: Global Benefits Group Commercial |
$622.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$933.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$669.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$408.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$658.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$207.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.04
|
| Rate for Payer: Multiplan Commercial |
$777.75
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$674.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$408.24
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$881.45
|
| Rate for Payer: Prime Health Services Medicare |
$432.73
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$449.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$622.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$518.50
|
| Rate for Payer: United Healthcare All Other HMO |
$518.50
|
| Rate for Payer: United Healthcare HMO Rider |
$518.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$518.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$408.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Vantage Medical Group Senior |
$408.24
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
|
OP
|
$682.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.40 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$136.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$209.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$319.45
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Central Health Plan Commercial |
$545.60
|
| Rate for Payer: Cigna of CA HMO |
$436.48
|
| Rate for Payer: Cigna of CA PPO |
$504.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$313.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$209.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$477.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.85
|
| Rate for Payer: EPIC Health Plan Senior |
$229.90
|
| Rate for Payer: Galaxy Health WC |
$579.70
|
| Rate for Payer: Global Benefits Group Commercial |
$409.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$613.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$342.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$433.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$511.50
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$443.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$209.00
|
| Rate for Payer: Preferred Health Network WC |
$325.97
|
| Rate for Payer: Prime Health Services Commercial |
$579.70
|
| Rate for Payer: Prime Health Services Medicare |
$221.54
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Riverside University Health System MISP |
$229.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$409.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$341.00
|
| Rate for Payer: United Healthcare HMO Rider |
$341.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$341.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Vantage Medical Group Senior |
$209.00
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
|
IP
|
$682.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.40 |
| Max. Negotiated Rate |
$613.80 |
| Rate for Payer: Adventist Health Commercial |
$136.40
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Central Health Plan Commercial |
$545.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$477.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$272.80
|
| Rate for Payer: EPIC Health Plan Senior |
$272.80
|
| Rate for Payer: Galaxy Health WC |
$579.70
|
| Rate for Payer: Global Benefits Group Commercial |
$409.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$613.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$433.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$402.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.40
|
| Rate for Payer: Multiplan Commercial |
$511.50
|
| Rate for Payer: Networks By Design Commercial |
$443.30
|
| Rate for Payer: Prime Health Services Commercial |
$579.70
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
|
IP
|
$682.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.40 |
| Max. Negotiated Rate |
$613.80 |
| Rate for Payer: Adventist Health Commercial |
$136.40
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Central Health Plan Commercial |
$545.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$477.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$272.80
|
| Rate for Payer: EPIC Health Plan Senior |
$272.80
|
| Rate for Payer: Galaxy Health WC |
$579.70
|
| Rate for Payer: Global Benefits Group Commercial |
$409.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$613.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$433.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$402.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.40
|
| Rate for Payer: Multiplan Commercial |
$511.50
|
| Rate for Payer: Networks By Design Commercial |
$443.30
|
| Rate for Payer: Prime Health Services Commercial |
$579.70
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
|
OP
|
$682.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.40 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$136.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$209.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$209.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$330.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$396.72
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$319.45
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Cash Price |
$306.90
|
| Rate for Payer: Central Health Plan Commercial |
$545.60
|
| Rate for Payer: Cigna of CA HMO |
$436.48
|
| Rate for Payer: Cigna of CA PPO |
$504.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$313.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$209.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$477.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.85
|
| Rate for Payer: EPIC Health Plan Senior |
$229.90
|
| Rate for Payer: Galaxy Health WC |
$579.70
|
| Rate for Payer: Global Benefits Group Commercial |
$409.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$613.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$342.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$209.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$433.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$292.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$280.06
|
| Rate for Payer: Multiplan Commercial |
$511.50
|
| Rate for Payer: Multiplan WC |
$319.45
|
| Rate for Payer: Networks By Design Commercial |
$443.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$209.00
|
| Rate for Payer: Preferred Health Network WC |
$325.97
|
| Rate for Payer: Prime Health Services Commercial |
$579.70
|
| Rate for Payer: Prime Health Services Medicare |
$221.54
|
| Rate for Payer: Prime Health Services WC |
$316.19
|
| Rate for Payer: Riverside University Health System MISP |
$229.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$409.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$313.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.90
|
| Rate for Payer: Vantage Medical Group Senior |
$209.00
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$722.70 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Central Health Plan Commercial |
$642.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$562.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$321.20
|
| Rate for Payer: EPIC Health Plan Senior |
$321.20
|
| Rate for Payer: Galaxy Health WC |
$682.55
|
| Rate for Payer: Global Benefits Group Commercial |
$481.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$722.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$509.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$473.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.60
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
| Rate for Payer: Networks By Design Commercial |
$521.95
|
| Rate for Payer: Prime Health Services Commercial |
$682.55
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
|
OP
|
$803.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$329.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$487.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$467.11
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Central Health Plan Commercial |
$642.40
|
| Rate for Payer: Cigna of CA HMO |
$513.92
|
| Rate for Payer: Cigna of CA PPO |
$594.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$562.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$682.55
|
| Rate for Payer: Global Benefits Group Commercial |
$481.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$722.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$509.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$521.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$682.55
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$481.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$481.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
|
IP
|
$803.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$722.70 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Central Health Plan Commercial |
$642.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$562.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$321.20
|
| Rate for Payer: EPIC Health Plan Senior |
$321.20
|
| Rate for Payer: Galaxy Health WC |
$682.55
|
| Rate for Payer: Global Benefits Group Commercial |
$481.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$722.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$509.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$473.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.60
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
| Rate for Payer: Networks By Design Commercial |
$521.95
|
| Rate for Payer: Prime Health Services Commercial |
$682.55
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
|
OP
|
$803.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.60 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$160.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Cash Price |
$361.35
|
| Rate for Payer: Central Health Plan Commercial |
$642.40
|
| Rate for Payer: Cigna of CA HMO |
$513.92
|
| Rate for Payer: Cigna of CA PPO |
$594.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$562.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$682.55
|
| Rate for Payer: Global Benefits Group Commercial |
$481.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$722.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$509.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$602.25
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$521.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$682.55
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$481.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$401.50
|
| Rate for Payer: United Healthcare All Other HMO |
$401.50
|
| Rate for Payer: United Healthcare HMO Rider |
$401.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$401.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC UNOS REGISTRATION HEART
|
Facility
|
OP
|
$1,264.00
|
|
| Hospital Charge Code |
902200120
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Adventist Health Commercial |
$252.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$767.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$695.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$948.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$735.27
|
| Rate for Payer: Blue Shield of California Commercial |
$801.38
|
| Rate for Payer: Blue Shield of California EPN |
$504.34
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Cigna of CA HMO |
$808.96
|
| Rate for Payer: Cigna of CA PPO |
$935.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,074.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,074.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$884.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Senior |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$802.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$458.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$884.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
| Rate for Payer: Riverside University Health System MISP |
$505.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$758.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.40
|
|
|
HC UNOS REGISTRATION HEART
|
Facility
|
IP
|
$1,264.00
|
|
| Hospital Charge Code |
902200120
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Adventist Health Commercial |
$252.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$884.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Senior |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$802.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
|
|
HC UNOS REGISTRATION KIDNEY
|
Facility
|
OP
|
$1,264.00
|
|
| Hospital Charge Code |
904700020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Adventist Health Commercial |
$252.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$767.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$695.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$948.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$735.27
|
| Rate for Payer: Blue Shield of California Commercial |
$801.38
|
| Rate for Payer: Blue Shield of California EPN |
$504.34
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Cigna of CA HMO |
$808.96
|
| Rate for Payer: Cigna of CA PPO |
$935.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,074.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,074.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$884.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Senior |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$802.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$458.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$884.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
| Rate for Payer: Riverside University Health System MISP |
$505.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$758.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.40
|
|
|
HC UNOS REGISTRATION KIDNEY
|
Facility
|
IP
|
$1,264.00
|
|
| Hospital Charge Code |
904700020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Adventist Health Commercial |
$252.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$884.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Senior |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$802.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
|
|
HC UNOS REGISTRATION LIVER
|
Facility
|
OP
|
$1,264.00
|
|
| Hospital Charge Code |
904700520
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Adventist Health Commercial |
$252.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$767.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$695.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$948.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$735.27
|
| Rate for Payer: Blue Shield of California Commercial |
$801.38
|
| Rate for Payer: Blue Shield of California EPN |
$504.34
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Cigna of CA HMO |
$808.96
|
| Rate for Payer: Cigna of CA PPO |
$935.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,074.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,074.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$884.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Senior |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$802.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$458.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$884.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
| Rate for Payer: Riverside University Health System MISP |
$505.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$758.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.40
|
|
|
HC UNOS REGISTRATION LIVER
|
Facility
|
IP
|
$1,264.00
|
|
| Hospital Charge Code |
904700520
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Adventist Health Commercial |
$252.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$884.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Senior |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$802.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
|
|
HC UNOS REGISTRATION PANCREAS
|
Facility
|
OP
|
$1,264.00
|
|
| Hospital Charge Code |
904701020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Adventist Health Commercial |
$252.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$767.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$695.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$948.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$735.27
|
| Rate for Payer: Blue Shield of California Commercial |
$801.38
|
| Rate for Payer: Blue Shield of California EPN |
$504.34
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Cigna of CA HMO |
$808.96
|
| Rate for Payer: Cigna of CA PPO |
$935.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,074.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,074.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$884.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Senior |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$802.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$458.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$884.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
| Rate for Payer: Riverside University Health System MISP |
$505.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$758.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.40
|
|
|
HC UNOS REGISTRATION PANCREAS
|
Facility
|
IP
|
$1,264.00
|
|
| Hospital Charge Code |
904701020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Adventist Health Commercial |
$252.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$884.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Senior |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$802.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
|
|
HC UNSCHED DIALYSIS ESRD PT OP
|
Facility
|
OP
|
$2,567.00
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
944000111
|
|
Hospital Revenue Code
|
829
|
| Min. Negotiated Rate |
$97.35 |
| Max. Negotiated Rate |
$2,310.30 |
| Rate for Payer: Adventist Health Commercial |
$513.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$882.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$430.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,324.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$970.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$882.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,242.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,493.22
|
| Rate for Payer: Cash Price |
$1,155.15
|
| Rate for Payer: Cash Price |
$1,155.15
|
| Rate for Payer: Cash Price |
$1,155.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,053.60
|
| Rate for Payer: Cigna of CA HMO |
$1,642.88
|
| Rate for Payer: Cigna of CA PPO |
$1,899.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,324.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$970.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$882.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,796.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,456.49
|
| Rate for Payer: EPIC Health Plan Senior |
$970.99
|
| Rate for Payer: Galaxy Health WC |
$2,181.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,540.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,310.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,447.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$97.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$882.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,630.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,235.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$513.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,182.84
|
| Rate for Payer: Multiplan Commercial |
$1,925.25
|
| Rate for Payer: Networks By Design Commercial |
$1,668.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$882.72
|
| Rate for Payer: Prime Health Services Commercial |
$2,181.95
|
| Rate for Payer: Prime Health Services Medicare |
$935.68
|
| Rate for Payer: Riverside University Health System MISP |
$970.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,540.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,540.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,570.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,610.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,170.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,072.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$882.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,324.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$970.99
|
| Rate for Payer: Vantage Medical Group Senior |
$882.72
|
|
