|
HC VAD/CATH DECLOT THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
907201300
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| 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 |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| 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 |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC VAD/CATH DECLOT THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
907201300
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$63.67 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$871.66
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$189.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,275.60
|
| 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 |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC VAD/CATH DECLOT THROMBOLYTIC AGENT
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
907201300
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC VAD/CATH DECLOT THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
907201300
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$63.67 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| 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 |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,063.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,063.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,063.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC VAD DRSNG CHANGE KIT W/PVP
|
Facility
|
OP
|
$220.85
|
|
| Hospital Charge Code |
901698893
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$198.76 |
| Rate for Payer: Adventist Health Commercial |
$44.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$134.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$187.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$121.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$106.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.47
|
| Rate for Payer: Blue Shield of California Commercial |
$140.02
|
| Rate for Payer: Blue Shield of California EPN |
$88.12
|
| Rate for Payer: Cash Price |
$99.38
|
| Rate for Payer: Central Health Plan Commercial |
$176.68
|
| Rate for Payer: Cigna of CA HMO |
$141.34
|
| Rate for Payer: Cigna of CA PPO |
$163.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$187.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$187.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$187.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.34
|
| Rate for Payer: EPIC Health Plan Senior |
$88.34
|
| Rate for Payer: Galaxy Health WC |
$187.72
|
| Rate for Payer: Global Benefits Group Commercial |
$132.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$154.59
|
| Rate for Payer: Multiplan Commercial |
$165.64
|
| Rate for Payer: Networks By Design Commercial |
$143.55
|
| Rate for Payer: Prime Health Services Commercial |
$187.72
|
| Rate for Payer: Riverside University Health System MISP |
$88.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.42
|
| Rate for Payer: United Healthcare All Other HMO |
$110.42
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$110.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$187.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$187.72
|
| Rate for Payer: Vantage Medical Group Senior |
$187.72
|
|
|
HC VAD DRSNG CHANGE KIT W/PVP
|
Facility
|
IP
|
$220.85
|
|
| Hospital Charge Code |
901698893
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.17 |
| Max. Negotiated Rate |
$198.76 |
| Rate for Payer: Adventist Health Commercial |
$44.17
|
| Rate for Payer: Cash Price |
$99.38
|
| Rate for Payer: Central Health Plan Commercial |
$176.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.34
|
| Rate for Payer: EPIC Health Plan Senior |
$88.34
|
| Rate for Payer: Galaxy Health WC |
$187.72
|
| Rate for Payer: Global Benefits Group Commercial |
$132.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.17
|
| Rate for Payer: Multiplan Commercial |
$165.64
|
| Rate for Payer: Networks By Design Commercial |
$143.55
|
| Rate for Payer: Prime Health Services Commercial |
$187.72
|
|
|
HC VAG DEL PLUS ANTE/POST PARTUM
|
Facility
|
IP
|
$9,264.00
|
|
|
Service Code
|
CPT 59400
|
| Hospital Charge Code |
902400310
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,852.80 |
| Max. Negotiated Rate |
$8,337.60 |
| Rate for Payer: Adventist Health Commercial |
$1,852.80
|
| Rate for Payer: Cash Price |
$4,168.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,411.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,484.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,705.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,705.60
|
| Rate for Payer: Galaxy Health WC |
$7,874.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,558.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,337.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,882.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,465.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.80
|
| Rate for Payer: Multiplan Commercial |
$6,948.00
|
| Rate for Payer: Networks By Design Commercial |
$6,021.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,874.40
|
|
|
HC VAG DEL PLUS ANTE/POST PARTUM
|
Facility
|
OP
|
$9,264.00
|
|
|
Service Code
|
CPT 59400
|
| Hospital Charge Code |
902400310
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$581.00 |
| Max. Negotiated Rate |
$12,884.97 |
| Rate for Payer: Adventist Health Commercial |
$1,852.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,884.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,874.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,095.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,948.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,407.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,690.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,873.38
|
| Rate for Payer: Blue Shield of California EPN |
$3,696.34
|
| Rate for Payer: Cash Price |
$4,168.80
|
| Rate for Payer: Cash Price |
$4,168.80
|
| Rate for Payer: Cash Price |
$4,168.80
|
| Rate for Payer: Cash Price |
$4,168.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,411.20
|
| Rate for Payer: Cigna of CA HMO |
$5,928.96
|
| Rate for Payer: Cigna of CA PPO |
$6,855.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,874.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,874.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,874.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,484.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,705.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,705.60
|
| Rate for Payer: Galaxy Health WC |
$7,874.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,558.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,337.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,596.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,882.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,973.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,465.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,852.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,484.80
|
| Rate for Payer: Multiplan Commercial |
$6,948.00
|
| Rate for Payer: Networks By Design Commercial |
$6,021.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,874.40
|
| Rate for Payer: Riverside University Health System MISP |
$3,705.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,558.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,558.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,874.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,874.40
|
| Rate for Payer: Vantage Medical Group Senior |
$7,874.40
|
|
|
HC VAGINAL DELIVERY ONLY
|
Facility
|
IP
|
$7,016.00
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
900501171
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,403.20 |
| Max. Negotiated Rate |
$6,314.40 |
| Rate for Payer: Adventist Health Commercial |
$1,403.20
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,612.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,911.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,806.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,806.40
|
| Rate for Payer: Galaxy Health WC |
$5,963.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,209.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,314.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,455.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,139.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,403.20
|
| Rate for Payer: Multiplan Commercial |
$5,262.00
|
| Rate for Payer: Networks By Design Commercial |
$4,560.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,963.60
|
|
|
HC VAGINAL DELIVERY ONLY
|
Facility
|
OP
|
$7,016.00
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
900501171
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,690.00 |
| Rate for Payer: Adventist Health Commercial |
$1,403.20
|
| 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 |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,407.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,690.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,436.87
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,612.80
|
| Rate for Payer: Cigna of CA HMO |
$4,490.24
|
| Rate for Payer: Cigna of CA PPO |
$5,191.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,911.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$5,963.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,209.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,314.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,455.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,034.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,475.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,403.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$5,262.00
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: Networks By Design Commercial |
$4,560.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Preferred Health Network WC |
$6,568.23
|
| Rate for Payer: Prime Health Services Commercial |
$5,963.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,209.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,508.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,508.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,508.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,508.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC VAGINAL REPAIR
|
Facility
|
OP
|
$9,569.00
|
|
|
Service Code
|
CPT 59300
|
| Hospital Charge Code |
902400755
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$358.07 |
| Max. Negotiated Rate |
$8,612.10 |
| Rate for Payer: Adventist Health Commercial |
$1,913.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,163.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$895.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,066.75
|
| Rate for Payer: Blue Shield of California EPN |
$3,818.03
|
| Rate for Payer: Cash Price |
$4,306.05
|
| Rate for Payer: Cash Price |
$4,306.05
|
| Rate for Payer: Cash Price |
$4,306.05
|
| Rate for Payer: Cash Price |
$4,306.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,655.20
|
| Rate for Payer: Cigna of CA HMO |
$6,124.16
|
| Rate for Payer: Cigna of CA PPO |
$7,081.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,698.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$8,133.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,741.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,612.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$358.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,076.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$395.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,828.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,913.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$7,176.75
|
| Rate for Payer: Networks By Design Commercial |
$6,219.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Prime Health Services Commercial |
$8,133.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,741.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,741.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC VAGINAL REPAIR
|
Facility
|
IP
|
$9,569.00
|
|
|
Service Code
|
CPT 59300
|
| Hospital Charge Code |
902400755
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,913.80 |
| Max. Negotiated Rate |
$8,612.10 |
| Rate for Payer: Adventist Health Commercial |
$1,913.80
|
| Rate for Payer: Cash Price |
$4,306.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,655.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,698.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,827.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,827.60
|
| Rate for Payer: Galaxy Health WC |
$8,133.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,741.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,612.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,076.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,645.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,913.80
|
| Rate for Payer: Multiplan Commercial |
$7,176.75
|
| Rate for Payer: Networks By Design Commercial |
$6,219.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,133.65
|
|
|
HC VALPROIC ACID (DEPAKENE)
|
Facility
|
OP
|
$116.00
|
|
|
Service Code
|
CPT 80164
|
| Hospital Charge Code |
900910927
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$137.00 |
| Rate for Payer: Adventist Health Commercial |
$23.20
|
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.54
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.00
|
| Rate for Payer: Blue Shield of California Commercial |
$137.34
|
| Rate for Payer: Blue Shield of California Commercial |
$73.08
|
| Rate for Payer: Blue Shield of California EPN |
$86.55
|
| Rate for Payer: Blue Shield of California EPN |
$46.05
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Central Health Plan Commercial |
$92.80
|
| Rate for Payer: Central Health Plan Commercial |
$174.40
|
| Rate for Payer: Cigna of CA HMO |
$139.52
|
| Rate for Payer: Cigna of CA HMO |
$74.24
|
| Rate for Payer: Cigna of CA PPO |
$161.32
|
| Rate for Payer: Cigna of CA PPO |
$85.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$81.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.34
|
| Rate for Payer: EPIC Health Plan Senior |
$14.89
|
| Rate for Payer: EPIC Health Plan Senior |
$14.89
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Galaxy Health WC |
$98.60
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Global Benefits Group Commercial |
$69.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$73.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.14
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Networks By Design Commercial |
$75.40
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.54
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.54
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
| Rate for Payer: Prime Health Services Commercial |
$98.60
|
| Rate for Payer: Prime Health Services Medicare |
$14.35
|
| Rate for Payer: Prime Health Services Medicare |
$14.35
|
| Rate for Payer: Riverside University Health System MISP |
$14.89
|
| Rate for Payer: Riverside University Health System MISP |
$14.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.97
|
| Rate for Payer: United Healthcare All Other HMO |
$10.97
|
| Rate for Payer: United Healthcare All Other HMO |
$10.97
|
| Rate for Payer: United Healthcare HMO Rider |
$10.97
|
| Rate for Payer: United Healthcare HMO Rider |
$10.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.89
|
| Rate for Payer: Vantage Medical Group Senior |
$13.54
|
| Rate for Payer: Vantage Medical Group Senior |
$13.54
|
|
|
HC VALPROIC ACID (DEPAKENE)
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 80164
|
| Hospital Charge Code |
900910927
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.60 |
| Max. Negotiated Rate |
$196.20 |
| Rate for Payer: Adventist Health Commercial |
$43.60
|
| Rate for Payer: Cash Price |
$98.10
|
| Rate for Payer: Central Health Plan Commercial |
$174.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$152.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.20
|
| Rate for Payer: EPIC Health Plan Senior |
$87.20
|
| Rate for Payer: Galaxy Health WC |
$185.30
|
| Rate for Payer: Global Benefits Group Commercial |
$130.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.60
|
| Rate for Payer: Multiplan Commercial |
$163.50
|
| Rate for Payer: Networks By Design Commercial |
$141.70
|
| Rate for Payer: Prime Health Services Commercial |
$185.30
|
|
|
HC VALVE ANTI-REFLUXALE KIT
|
Facility
|
IP
|
$25.17
|
|
| Hospital Charge Code |
901605441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Adventist Health Commercial |
$5.03
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Central Health Plan Commercial |
$20.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.07
|
| Rate for Payer: EPIC Health Plan Senior |
$10.07
|
| Rate for Payer: Galaxy Health WC |
$21.39
|
| Rate for Payer: Global Benefits Group Commercial |
$15.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.03
|
| Rate for Payer: Multiplan Commercial |
$18.88
|
| Rate for Payer: Networks By Design Commercial |
$16.36
|
| Rate for Payer: Prime Health Services Commercial |
$21.39
|
|
|
HC VALVE ANTI-REFLUXALE KIT
|
Facility
|
OP
|
$25.17
|
|
| Hospital Charge Code |
901605441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Adventist Health Commercial |
$5.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.64
|
| Rate for Payer: Blue Shield of California Commercial |
$15.96
|
| Rate for Payer: Blue Shield of California EPN |
$10.04
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Central Health Plan Commercial |
$20.14
|
| Rate for Payer: Cigna of CA HMO |
$16.11
|
| Rate for Payer: Cigna of CA PPO |
$18.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.07
|
| Rate for Payer: EPIC Health Plan Senior |
$10.07
|
| Rate for Payer: Galaxy Health WC |
$21.39
|
| Rate for Payer: Global Benefits Group Commercial |
$15.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.62
|
| Rate for Payer: Multiplan Commercial |
$18.88
|
| Rate for Payer: Networks By Design Commercial |
$16.36
|
| Rate for Payer: Prime Health Services Commercial |
$21.39
|
| Rate for Payer: Riverside University Health System MISP |
$10.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.59
|
| Rate for Payer: United Healthcare All Other HMO |
$12.59
|
| Rate for Payer: United Healthcare HMO Rider |
$12.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.39
|
| Rate for Payer: Vantage Medical Group Senior |
$21.39
|
|
|
HC VALVE HEIMLICH
|
Facility
|
IP
|
$274.89
|
|
| Hospital Charge Code |
901600145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.98 |
| Max. Negotiated Rate |
$247.40 |
| Rate for Payer: Adventist Health Commercial |
$54.98
|
| Rate for Payer: Cash Price |
$123.70
|
| Rate for Payer: Central Health Plan Commercial |
$219.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$192.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.96
|
| Rate for Payer: EPIC Health Plan Senior |
$109.96
|
| Rate for Payer: Galaxy Health WC |
$233.66
|
| Rate for Payer: Global Benefits Group Commercial |
$164.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$247.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$174.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$162.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.98
|
| Rate for Payer: Multiplan Commercial |
$206.17
|
| Rate for Payer: Networks By Design Commercial |
$178.68
|
| Rate for Payer: Prime Health Services Commercial |
$233.66
|
|
|
HC VALVE HEIMLICH
|
Facility
|
OP
|
$274.89
|
|
| Hospital Charge Code |
901600145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.98 |
| Max. Negotiated Rate |
$247.40 |
| Rate for Payer: Adventist Health Commercial |
$54.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$233.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$206.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$133.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.90
|
| Rate for Payer: Blue Shield of California Commercial |
$174.28
|
| Rate for Payer: Blue Shield of California EPN |
$109.68
|
| Rate for Payer: Cash Price |
$123.70
|
| Rate for Payer: Central Health Plan Commercial |
$219.91
|
| Rate for Payer: Cigna of CA HMO |
$175.93
|
| Rate for Payer: Cigna of CA PPO |
$203.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$233.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$233.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$233.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$192.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.96
|
| Rate for Payer: EPIC Health Plan Senior |
$109.96
|
| Rate for Payer: Galaxy Health WC |
$233.66
|
| Rate for Payer: Global Benefits Group Commercial |
$164.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$247.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$174.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$162.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$192.42
|
| Rate for Payer: Multiplan Commercial |
$206.17
|
| Rate for Payer: Networks By Design Commercial |
$178.68
|
| Rate for Payer: Prime Health Services Commercial |
$233.66
|
| Rate for Payer: Riverside University Health System MISP |
$109.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$164.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$164.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$137.44
|
| Rate for Payer: United Healthcare All Other HMO |
$137.44
|
| Rate for Payer: United Healthcare HMO Rider |
$137.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$137.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$233.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$233.66
|
| Rate for Payer: Vantage Medical Group Senior |
$233.66
|
|
|
HC VALVE PASSY MUIR (PURPLE)
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
901603797
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$189.95 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$237.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC VALVE PASSY MUIR (PURPLE)
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
901603797
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC VALVE PASSY MUIR (PURPLE)
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
901605980
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC VALVE PASSY MUIR (PURPLE)
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
901605980
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$189.95 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$237.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$465.16
|
| Rate for Payer: Blue Shield of California EPN |
$292.32
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC VALVULOPLASTY, AORTIC
|
Facility
|
IP
|
$15,457.00
|
|
|
Service Code
|
CPT 92986
|
| Hospital Charge Code |
906811113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,091.40 |
| Max. Negotiated Rate |
$13,911.30 |
| Rate for Payer: Adventist Health Commercial |
$3,091.40
|
| Rate for Payer: Cash Price |
$6,955.65
|
| Rate for Payer: Central Health Plan Commercial |
$12,365.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,819.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,182.80
|
| Rate for Payer: Galaxy Health WC |
$13,138.45
|
| Rate for Payer: Global Benefits Group Commercial |
$9,274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,911.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,815.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,119.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,091.40
|
| Rate for Payer: Multiplan Commercial |
$11,592.75
|
| Rate for Payer: Networks By Design Commercial |
$10,047.05
|
| Rate for Payer: Prime Health Services Commercial |
$13,138.45
|
|
|
HC VALVULOPLASTY, AORTIC
|
Facility
|
OP
|
$15,457.00
|
|
|
Service Code
|
CPT 92986
|
| Hospital Charge Code |
906811113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,661.31 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,091.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,320.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$6,955.65
|
| Rate for Payer: Cash Price |
$6,955.65
|
| Rate for Payer: Cash Price |
$6,955.65
|
| Rate for Payer: Central Health Plan Commercial |
$12,365.60
|
| Rate for Payer: Cigna of CA HMO |
$10,047.05
|
| Rate for Payer: Cigna of CA PPO |
$11,438.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,819.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$13,138.45
|
| Rate for Payer: Global Benefits Group Commercial |
$9,274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,911.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,661.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,815.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,835.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,091.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$11,592.75
|
| Rate for Payer: Networks By Design Commercial |
$10,047.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,138.45
|
| Rate for Payer: Prime Health Services Medicare |
$7,759.52
|
| Rate for Payer: Riverside University Health System MISP |
$8,052.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,728.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC VALVULOPLASTY, MITRAL
|
Facility
|
OP
|
$10,305.00
|
|
|
Service Code
|
CPT 92987
|
| Hospital Charge Code |
906811138
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$359.08 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,061.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,231.02
|
| Rate for Payer: Blue Shield of California EPN |
$8,315.83
|
| Rate for Payer: Cash Price |
$4,637.25
|
| Rate for Payer: Cash Price |
$4,637.25
|
| Rate for Payer: Cash Price |
$4,637.25
|
| Rate for Payer: Central Health Plan Commercial |
$8,244.00
|
| Rate for Payer: Cigna of CA HMO |
$6,698.25
|
| Rate for Payer: Cigna of CA PPO |
$7,625.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,213.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$8,759.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,183.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,274.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$359.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,543.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$396.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,061.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$7,728.75
|
| Rate for Payer: Networks By Design Commercial |
$6,698.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Prime Health Services Commercial |
$8,759.25
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,183.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,183.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,152.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
