|
HC USER ADJUSTABLE HEEL HEIGHT
|
Facility
|
IP
|
$2,857.00
|
|
|
Service Code
|
CPT L5990
|
| Hospital Charge Code |
915355990
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$571.40 |
| Max. Negotiated Rate |
$2,571.30 |
| Rate for Payer: United Healthcare HMO Rider |
$1,021.09
|
| Rate for Payer: Adventist Health Commercial |
$571.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,291.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,439.93
|
| Rate for Payer: Cash Price |
$1,285.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,285.60
|
| Rate for Payer: Cigna of CA HMO |
$1,999.90
|
| Rate for Payer: Cigna of CA PPO |
$1,999.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,999.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,142.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,142.80
|
| Rate for Payer: Galaxy Health WC |
$2,428.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,714.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,571.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,814.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,685.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$571.40
|
| Rate for Payer: Multiplan Commercial |
$2,142.75
|
| Rate for Payer: Networks By Design Commercial |
$1,857.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,428.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,072.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,043.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$935.67
|
|
|
HC USER ADJUSTABLE HEEL HEIGHT
|
Facility
|
OP
|
$2,857.00
|
|
|
Service Code
|
CPT L5990
|
| Hospital Charge Code |
915355990
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$935.67 |
| Max. Negotiated Rate |
$2,571.30 |
| Rate for Payer: Adventist Health Commercial |
$1,171.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,428.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,571.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,142.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,661.92
|
| Rate for Payer: Blue Shield of California Commercial |
$2,291.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,439.93
|
| Rate for Payer: Cash Price |
$1,285.65
|
| Rate for Payer: Cash Price |
$1,285.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,285.60
|
| Rate for Payer: Cigna of CA HMO |
$1,999.90
|
| Rate for Payer: Cigna of CA PPO |
$1,999.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,428.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,428.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,428.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,999.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,142.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,142.80
|
| Rate for Payer: Galaxy Health WC |
$2,428.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,714.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,571.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,965.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,814.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,171.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,685.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,171.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,999.90
|
| Rate for Payer: Multiplan Commercial |
$2,142.75
|
| Rate for Payer: Networks By Design Commercial |
$1,428.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,428.45
|
| Rate for Payer: Riverside University Health System MISP |
$1,142.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,714.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,714.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,072.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,043.66
|
| Rate for Payer: United Healthcare HMO Rider |
$1,021.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$935.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,428.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,428.45
|
| Rate for Payer: Vantage Medical Group Senior |
$2,428.45
|
|
|
HC USER ADJUSTABLE HEEL HEIGHT
|
Facility
|
OP
|
$2,857.00
|
|
|
Service Code
|
CPT L5990
|
| Hospital Charge Code |
905355990
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$935.67 |
| Max. Negotiated Rate |
$2,571.30 |
| Rate for Payer: Adventist Health Commercial |
$1,171.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,428.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,571.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,142.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,661.92
|
| Rate for Payer: Blue Shield of California Commercial |
$2,291.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,439.93
|
| Rate for Payer: Cash Price |
$1,285.65
|
| Rate for Payer: Cash Price |
$1,285.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,285.60
|
| Rate for Payer: Cigna of CA HMO |
$1,999.90
|
| Rate for Payer: Cigna of CA PPO |
$1,999.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,428.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,428.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,428.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,999.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,142.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,142.80
|
| Rate for Payer: Galaxy Health WC |
$2,428.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,714.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,571.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,965.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,814.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,171.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,685.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,171.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,999.90
|
| Rate for Payer: Multiplan Commercial |
$2,142.75
|
| Rate for Payer: Networks By Design Commercial |
$1,428.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,428.45
|
| Rate for Payer: Riverside University Health System MISP |
$1,142.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,714.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,714.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,072.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,043.66
|
| Rate for Payer: United Healthcare HMO Rider |
$1,021.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$935.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,428.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,428.45
|
| Rate for Payer: Vantage Medical Group Senior |
$2,428.45
|
|
|
HC US GUID AMNIOCENTESIS
|
Facility
|
IP
|
$1,611.00
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
902400752
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$322.20 |
| Max. Negotiated Rate |
$1,449.90 |
| Rate for Payer: Adventist Health Commercial |
$322.20
|
| Rate for Payer: Cash Price |
$724.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,288.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,127.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$644.40
|
| Rate for Payer: EPIC Health Plan Senior |
$644.40
|
| Rate for Payer: Galaxy Health WC |
$1,369.35
|
| Rate for Payer: Global Benefits Group Commercial |
$966.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,449.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,022.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$950.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.20
|
| Rate for Payer: Multiplan Commercial |
$1,208.25
|
| Rate for Payer: Networks By Design Commercial |
$1,047.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,369.35
|
|
|
HC US GUID AMNIOCENTESIS
|
Facility
|
OP
|
$1,611.00
|
|
|
Service Code
|
CPT 76946
|
| Hospital Charge Code |
902400752
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$49.28 |
| Max. Negotiated Rate |
$1,449.90 |
| Rate for Payer: Adventist Health Commercial |
$322.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,369.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$886.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,208.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$937.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,014.93
|
| Rate for Payer: Blue Shield of California EPN |
$639.57
|
| Rate for Payer: Cash Price |
$724.95
|
| Rate for Payer: Cash Price |
$724.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,288.80
|
| Rate for Payer: Cigna of CA HMO |
$1,031.04
|
| Rate for Payer: Cigna of CA PPO |
$1,192.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,369.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,369.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,369.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,127.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$644.40
|
| Rate for Payer: EPIC Health Plan Senior |
$644.40
|
| Rate for Payer: Galaxy Health WC |
$1,369.35
|
| Rate for Payer: Global Benefits Group Commercial |
$966.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,449.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$49.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,022.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$950.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,127.70
|
| Rate for Payer: Multiplan Commercial |
$1,208.25
|
| Rate for Payer: Networks By Design Commercial |
$1,047.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,369.35
|
| Rate for Payer: Riverside University Health System MISP |
$644.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$966.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$966.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$805.50
|
| Rate for Payer: United Healthcare All Other HMO |
$805.50
|
| Rate for Payer: United Healthcare HMO Rider |
$805.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$805.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,369.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,369.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,369.35
|
|
|
HC US GUIDE FETAL TRANSFUSION
|
Facility
|
OP
|
$1,137.00
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
906601995
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$194.29 |
| Max. Negotiated Rate |
$1,023.30 |
| Rate for Payer: Adventist Health Commercial |
$227.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$366.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$966.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$625.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$852.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$661.39
|
| Rate for Payer: Blue Shield of California Commercial |
$716.31
|
| Rate for Payer: Blue Shield of California EPN |
$451.39
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Central Health Plan Commercial |
$909.60
|
| Rate for Payer: Cigna of CA HMO |
$727.68
|
| Rate for Payer: Cigna of CA PPO |
$841.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$966.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$966.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$795.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$454.80
|
| Rate for Payer: EPIC Health Plan Senior |
$454.80
|
| Rate for Payer: Galaxy Health WC |
$966.45
|
| Rate for Payer: Global Benefits Group Commercial |
$682.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,023.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$194.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$722.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$214.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$670.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$795.90
|
| Rate for Payer: Multiplan Commercial |
$852.75
|
| Rate for Payer: Networks By Design Commercial |
$739.05
|
| Rate for Payer: Prime Health Services Commercial |
$966.45
|
| Rate for Payer: Riverside University Health System MISP |
$454.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$682.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$682.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.50
|
| Rate for Payer: United Healthcare All Other HMO |
$568.50
|
| Rate for Payer: United Healthcare HMO Rider |
$568.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$568.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$966.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.45
|
| Rate for Payer: Vantage Medical Group Senior |
$966.45
|
|
|
HC US GUIDE FETAL TRANSFUSION
|
Facility
|
IP
|
$1,137.00
|
|
|
Service Code
|
CPT 76941
|
| Hospital Charge Code |
906601995
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$227.40 |
| Max. Negotiated Rate |
$1,023.30 |
| Rate for Payer: Adventist Health Commercial |
$227.40
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Central Health Plan Commercial |
$909.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$795.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$454.80
|
| Rate for Payer: EPIC Health Plan Senior |
$454.80
|
| Rate for Payer: Galaxy Health WC |
$966.45
|
| Rate for Payer: Global Benefits Group Commercial |
$682.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,023.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$722.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$670.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.40
|
| Rate for Payer: Multiplan Commercial |
$852.75
|
| Rate for Payer: Networks By Design Commercial |
$739.05
|
| Rate for Payer: Prime Health Services Commercial |
$966.45
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
OP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
901200046
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$87.07 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,045.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,435.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,957.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,518.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,644.30
|
| Rate for Payer: Blue Shield of California EPN |
$1,036.17
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: Cigna of CA HMO |
$1,670.40
|
| Rate for Payer: Cigna of CA PPO |
$1,931.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,218.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,218.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,827.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,657.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,539.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,827.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,044.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,566.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,566.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,305.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,218.50
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
OP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
906601444
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$87.07 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,045.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,435.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,957.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,518.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,644.30
|
| Rate for Payer: Blue Shield of California EPN |
$1,036.17
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: Cigna of CA HMO |
$1,670.40
|
| Rate for Payer: Cigna of CA PPO |
$1,931.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,218.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,218.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,827.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,657.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,539.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,827.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,044.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,566.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,566.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,305.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,218.50
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
IP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
906601444
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$522.00 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,827.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,657.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,539.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
IP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
901200046
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$522.00 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,827.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,657.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,539.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
OP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
900501576
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$87.07 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,045.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,435.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,957.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,518.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,644.30
|
| Rate for Payer: Blue Shield of California EPN |
$1,036.17
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: Cigna of CA HMO |
$1,670.40
|
| Rate for Payer: Cigna of CA PPO |
$1,931.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,218.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,218.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,827.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,657.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,539.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,827.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,044.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,566.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,566.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,305.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,218.50
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
IP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
900501576
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$522.00 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Cash Price |
$1,174.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,827.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,657.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,539.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
IP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
901200114
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$481.80 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,686.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,529.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,421.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
OP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
909001488
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$124.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,324.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,806.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,401.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,517.67
|
| Rate for Payer: Blue Shield of California EPN |
$956.37
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Cigna of CA HMO |
$1,541.76
|
| Rate for Payer: Cigna of CA PPO |
$1,782.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,047.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,047.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,686.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,529.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,421.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,686.30
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
| Rate for Payer: Riverside University Health System MISP |
$963.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,445.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,445.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,204.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,204.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,204.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,204.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
OP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
901200114
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$124.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,324.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,806.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,401.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,517.67
|
| Rate for Payer: Blue Shield of California EPN |
$956.37
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Cigna of CA HMO |
$1,541.76
|
| Rate for Payer: Cigna of CA PPO |
$1,782.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,047.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,047.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,686.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,529.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,421.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,686.30
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
| Rate for Payer: Riverside University Health System MISP |
$963.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,445.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,445.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,204.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,204.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,204.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,204.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
IP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
910100008
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$481.80 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,686.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,529.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,421.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
OP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
910100008
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$124.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,324.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,806.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,401.32
|
| Rate for Payer: Blue Shield of California Commercial |
$1,517.67
|
| Rate for Payer: Blue Shield of California EPN |
$956.37
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Cigna of CA HMO |
$1,541.76
|
| Rate for Payer: Cigna of CA PPO |
$1,782.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,047.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,047.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,686.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,529.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,421.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,686.30
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
| Rate for Payer: Riverside University Health System MISP |
$963.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,445.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,445.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,204.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,204.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,204.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,204.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
IP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
909001488
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$481.80 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Cash Price |
$1,084.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,686.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,529.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,421.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
|
|
HC US GUIDE VISCERAL TISS ABLATN
|
Facility
|
OP
|
$14,482.00
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
909001920
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$240.28 |
| Max. Negotiated Rate |
$13,033.80 |
| Rate for Payer: Adventist Health Commercial |
$2,896.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$404.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,309.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,965.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,861.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$352.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,424.18
|
| Rate for Payer: Blue Shield of California Commercial |
$9,123.66
|
| Rate for Payer: Blue Shield of California EPN |
$5,749.35
|
| Rate for Payer: Cash Price |
$6,516.90
|
| Rate for Payer: Cash Price |
$6,516.90
|
| Rate for Payer: Central Health Plan Commercial |
$11,585.60
|
| Rate for Payer: Cigna of CA HMO |
$9,268.48
|
| Rate for Payer: Cigna of CA PPO |
$10,716.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,309.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,309.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12,309.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,137.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,792.80
|
| Rate for Payer: Galaxy Health WC |
$12,309.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,689.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,033.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$240.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,196.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$265.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,544.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,896.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,137.40
|
| Rate for Payer: Multiplan Commercial |
$10,861.50
|
| Rate for Payer: Networks By Design Commercial |
$9,413.30
|
| Rate for Payer: Prime Health Services Commercial |
$12,309.70
|
| Rate for Payer: Riverside University Health System MISP |
$5,792.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,689.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,689.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,241.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,241.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,241.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,241.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,309.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,309.70
|
| Rate for Payer: Vantage Medical Group Senior |
$12,309.70
|
|
|
HC US GUIDE VISCERAL TISS ABLATN
|
Facility
|
IP
|
$14,482.00
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
909001920
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$2,896.40 |
| Max. Negotiated Rate |
$13,033.80 |
| Rate for Payer: Adventist Health Commercial |
$2,896.40
|
| Rate for Payer: Cash Price |
$6,516.90
|
| Rate for Payer: Central Health Plan Commercial |
$11,585.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,137.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,792.80
|
| Rate for Payer: Galaxy Health WC |
$12,309.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,689.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,033.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,196.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,544.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,896.40
|
| Rate for Payer: Multiplan Commercial |
$10,861.50
|
| Rate for Payer: Networks By Design Commercial |
$9,413.30
|
| Rate for Payer: Prime Health Services Commercial |
$12,309.70
|
|
|
HC US INFANT HIP W/O MANIPULATION
|
Facility
|
IP
|
$2,258.00
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
906601414
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$451.60 |
| Max. Negotiated Rate |
$2,032.20 |
| Rate for Payer: Adventist Health Commercial |
$451.60
|
| Rate for Payer: Cash Price |
$1,016.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,806.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,580.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$903.20
|
| Rate for Payer: EPIC Health Plan Senior |
$903.20
|
| Rate for Payer: Galaxy Health WC |
$1,919.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,354.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,032.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,433.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,332.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$451.60
|
| Rate for Payer: Multiplan Commercial |
$1,693.50
|
| Rate for Payer: Networks By Design Commercial |
$1,467.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,919.30
|
|
|
HC US INFANT HIP W/O MANIPULATION
|
Facility
|
OP
|
$2,258.00
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
906601414
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$111.93 |
| Max. Negotiated Rate |
$2,032.20 |
| Rate for Payer: Adventist Health Commercial |
$451.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$394.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$295.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,313.48
|
| Rate for Payer: Blue Shield of California Commercial |
$1,422.54
|
| Rate for Payer: Blue Shield of California EPN |
$896.43
|
| Rate for Payer: Cash Price |
$1,016.10
|
| Rate for Payer: Cash Price |
$1,016.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,806.40
|
| Rate for Payer: Cigna of CA HMO |
$1,445.12
|
| Rate for Payer: Cigna of CA PPO |
$1,670.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,580.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$1,919.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,354.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,032.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$116.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,433.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$128.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$451.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$1,693.50
|
| Rate for Payer: Networks By Design Commercial |
$1,467.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.93
|
| Rate for Payer: Prime Health Services Commercial |
$1,919.30
|
| Rate for Payer: Prime Health Services Medicare |
$118.65
|
| Rate for Payer: Riverside University Health System MISP |
$123.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,354.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,354.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC US SOFT TISS EXT COMP
|
Facility
|
OP
|
$2,247.00
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
906601419
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$91.66 |
| Max. Negotiated Rate |
$2,022.30 |
| Rate for Payer: Adventist Health Commercial |
$449.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$548.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$500.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,307.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,415.61
|
| Rate for Payer: Blue Shield of California EPN |
$892.06
|
| Rate for Payer: Cash Price |
$1,011.15
|
| Rate for Payer: Cash Price |
$1,011.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,797.60
|
| Rate for Payer: Cigna of CA HMO |
$1,438.08
|
| Rate for Payer: Cigna of CA PPO |
$1,662.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,572.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$1,909.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,348.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,022.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$91.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,426.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$101.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$449.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$1,685.25
|
| Rate for Payer: Networks By Design Commercial |
$1,460.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,909.95
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,348.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,348.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$246.56
|
| Rate for Payer: United Healthcare All Other HMO |
$246.56
|
| Rate for Payer: United Healthcare HMO Rider |
$246.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC US SOFT TISS EXT COMP
|
Facility
|
IP
|
$2,247.00
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
906601419
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$449.40 |
| Max. Negotiated Rate |
$2,022.30 |
| Rate for Payer: Adventist Health Commercial |
$449.40
|
| Rate for Payer: Cash Price |
$1,011.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,797.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,572.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$898.80
|
| Rate for Payer: EPIC Health Plan Senior |
$898.80
|
| Rate for Payer: Galaxy Health WC |
$1,909.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,348.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,022.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,426.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,325.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$449.40
|
| Rate for Payer: Multiplan Commercial |
$1,685.25
|
| Rate for Payer: Networks By Design Commercial |
$1,460.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,909.95
|
|
