|
HC VAT PIV KIT
|
Facility
|
OP
|
$67.16
|
|
| Hospital Charge Code |
901698272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$60.44 |
| Rate for Payer: Adventist Health Commercial |
$13.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$57.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.07
|
| Rate for Payer: Blue Shield of California Commercial |
$42.58
|
| Rate for Payer: Blue Shield of California EPN |
$26.80
|
| Rate for Payer: Cash Price |
$30.22
|
| Rate for Payer: Central Health Plan Commercial |
$53.73
|
| Rate for Payer: Cigna of CA HMO |
$42.98
|
| Rate for Payer: Cigna of CA PPO |
$49.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$57.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$57.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$47.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.86
|
| Rate for Payer: EPIC Health Plan Senior |
$26.86
|
| Rate for Payer: Galaxy Health WC |
$57.09
|
| Rate for Payer: Global Benefits Group Commercial |
$40.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$47.01
|
| Rate for Payer: Multiplan Commercial |
$50.37
|
| Rate for Payer: Networks By Design Commercial |
$43.65
|
| Rate for Payer: Prime Health Services Commercial |
$57.09
|
| Rate for Payer: Riverside University Health System MISP |
$26.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.58
|
| Rate for Payer: United Healthcare All Other HMO |
$33.58
|
| Rate for Payer: United Healthcare HMO Rider |
$33.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$57.09
|
| Rate for Payer: Vantage Medical Group Senior |
$57.09
|
|
|
HC VEEG 21-12HR INTMT MNTRD
|
Facility
|
IP
|
$2,172.00
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
900605712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$434.40 |
| Max. Negotiated Rate |
$1,954.80 |
| Rate for Payer: Adventist Health Commercial |
$434.40
|
| Rate for Payer: Cash Price |
$977.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,737.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,520.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$868.80
|
| Rate for Payer: EPIC Health Plan Senior |
$868.80
|
| Rate for Payer: Galaxy Health WC |
$1,846.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,303.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,954.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,379.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,281.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.40
|
| Rate for Payer: Multiplan Commercial |
$1,629.00
|
| Rate for Payer: Networks By Design Commercial |
$1,411.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,846.20
|
|
|
HC VEEG 21-12HR INTMT MNTRD
|
Facility
|
OP
|
$2,172.00
|
|
|
Service Code
|
CPT 95712
|
| Hospital Charge Code |
900605712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$434.40 |
| Max. Negotiated Rate |
$3,209.17 |
| Rate for Payer: Adventist Health Commercial |
$434.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$479.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,834.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,263.45
|
| Rate for Payer: Blue Shield of California Commercial |
$1,368.36
|
| Rate for Payer: Blue Shield of California EPN |
$862.28
|
| Rate for Payer: Cash Price |
$977.40
|
| Rate for Payer: Cash Price |
$977.40
|
| Rate for Payer: Cash Price |
$977.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,737.60
|
| Rate for Payer: Cigna of CA HMO |
$1,390.08
|
| Rate for Payer: Cigna of CA PPO |
$1,607.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,520.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: Galaxy Health WC |
$1,846.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,303.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,954.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$641.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,379.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$708.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$1,629.00
|
| Rate for Payer: Networks By Design Commercial |
$1,411.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$479.94
|
| Rate for Payer: Prime Health Services Commercial |
$1,846.20
|
| Rate for Payer: Prime Health Services Medicare |
$508.74
|
| Rate for Payer: Riverside University Health System MISP |
$527.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,303.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,303.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC VEEG 21-12HR UNMNTRD
|
Facility
|
OP
|
$1,249.00
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
900605711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$3,209.17 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$707.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$726.54
|
| Rate for Payer: Blue Shield of California Commercial |
$786.87
|
| Rate for Payer: Blue Shield of California EPN |
$495.85
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: Cigna of CA HMO |
$799.36
|
| Rate for Payer: Cigna of CA PPO |
$924.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$874.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$381.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$793.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$421.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$749.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC VEEG 21-12HR UNMNTRD
|
Facility
|
IP
|
$1,249.00
|
|
|
Service Code
|
CPT 95711
|
| Hospital Charge Code |
900605711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$1,124.10 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$874.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.60
|
| Rate for Payer: EPIC Health Plan Senior |
$499.60
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$793.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$736.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
|
|
HC VEEG 2-12HR CONT MNTRD
|
Facility
|
IP
|
$4,168.00
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
900605713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$833.60 |
| Max. Negotiated Rate |
$3,751.20 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,334.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,917.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,667.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,667.20
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,751.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,646.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,459.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.60
|
| Rate for Payer: Multiplan Commercial |
$3,126.00
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
|
|
HC VEEG 2-12HR CONT MNTRD
|
Facility
|
OP
|
$4,168.00
|
|
|
Service Code
|
CPT 95713
|
| Hospital Charge Code |
900605713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$479.94 |
| Max. Negotiated Rate |
$3,751.20 |
| Rate for Payer: Adventist Health Commercial |
$833.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$479.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,543.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,424.53
|
| Rate for Payer: Blue Shield of California Commercial |
$2,625.84
|
| Rate for Payer: Blue Shield of California EPN |
$1,654.70
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Cash Price |
$1,875.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,334.40
|
| Rate for Payer: Cigna of CA HMO |
$2,667.52
|
| Rate for Payer: Cigna of CA PPO |
$3,084.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,917.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: Galaxy Health WC |
$3,542.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,500.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,751.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,254.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,646.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,386.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$3,126.00
|
| Rate for Payer: Networks By Design Commercial |
$2,709.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$479.94
|
| Rate for Payer: Prime Health Services Commercial |
$3,542.80
|
| Rate for Payer: Prime Health Services Medicare |
$508.74
|
| Rate for Payer: Riverside University Health System MISP |
$527.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,500.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,500.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
|
IP
|
$4,485.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$897.00 |
| Max. Negotiated Rate |
$4,036.50 |
| Rate for Payer: Adventist Health Commercial |
$897.00
|
| Rate for Payer: Cash Price |
$2,018.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,588.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,139.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,794.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,794.00
|
| Rate for Payer: Galaxy Health WC |
$3,812.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,691.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,036.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,847.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,646.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$897.00
|
| Rate for Payer: Multiplan Commercial |
$3,363.75
|
| Rate for Payer: Networks By Design Commercial |
$2,915.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,812.25
|
|
|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
|
OP
|
$4,485.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$897.00 |
| Max. Negotiated Rate |
$7,371.92 |
| Rate for Payer: Adventist Health Commercial |
$897.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,104.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,088.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,371.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,608.92
|
| Rate for Payer: Blue Shield of California Commercial |
$2,825.55
|
| Rate for Payer: Blue Shield of California EPN |
$1,780.55
|
| Rate for Payer: Cash Price |
$2,018.25
|
| Rate for Payer: Cash Price |
$2,018.25
|
| Rate for Payer: Cash Price |
$2,018.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,588.00
|
| Rate for Payer: Cigna of CA HMO |
$2,870.40
|
| Rate for Payer: Cigna of CA PPO |
$3,318.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,214.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,104.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,139.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,822.39
|
| Rate for Payer: EPIC Health Plan Senior |
$1,214.93
|
| Rate for Payer: Galaxy Health WC |
$3,812.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,691.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,036.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,811.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,012.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,104.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,847.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,222.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,546.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$897.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,480.00
|
| Rate for Payer: Multiplan Commercial |
$3,363.75
|
| Rate for Payer: Networks By Design Commercial |
$2,915.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,104.48
|
| Rate for Payer: Prime Health Services Commercial |
$3,812.25
|
| Rate for Payer: Prime Health Services Medicare |
$1,170.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,214.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,691.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,691.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,104.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Vantage Medical Group Senior |
$1,104.48
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
|
OP
|
$2,290.45
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$458.09 |
| Max. Negotiated Rate |
$7,371.92 |
| Rate for Payer: Adventist Health Commercial |
$458.09
|
| Rate for Payer: Adventist Health Medi-Cal |
$479.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,670.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,371.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,332.35
|
| Rate for Payer: Blue Shield of California Commercial |
$1,442.98
|
| Rate for Payer: Blue Shield of California EPN |
$909.31
|
| Rate for Payer: Cash Price |
$1,030.70
|
| Rate for Payer: Cash Price |
$1,030.70
|
| Rate for Payer: Cash Price |
$1,030.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.36
|
| Rate for Payer: Cigna of CA HMO |
$1,465.89
|
| Rate for Payer: Cigna of CA PPO |
$1,694.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,603.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: Galaxy Health WC |
$1,946.88
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,123.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,454.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,241.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$1,717.84
|
| Rate for Payer: Networks By Design Commercial |
$1,488.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$479.94
|
| Rate for Payer: Prime Health Services Commercial |
$1,946.88
|
| Rate for Payer: Prime Health Services Medicare |
$508.74
|
| Rate for Payer: Riverside University Health System MISP |
$527.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,374.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,374.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
|
IP
|
$2,290.45
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$458.09 |
| Max. Negotiated Rate |
$2,061.41 |
| Rate for Payer: Adventist Health Commercial |
$458.09
|
| Rate for Payer: Cash Price |
$1,030.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,603.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$916.18
|
| Rate for Payer: EPIC Health Plan Senior |
$916.18
|
| Rate for Payer: Galaxy Health WC |
$1,946.88
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,454.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,351.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.09
|
| Rate for Payer: Multiplan Commercial |
$1,717.84
|
| Rate for Payer: Networks By Design Commercial |
$1,488.79
|
| Rate for Payer: Prime Health Services Commercial |
$1,946.88
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
|
IP
|
$2,389.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$477.80 |
| Max. Negotiated Rate |
$2,150.10 |
| Rate for Payer: Adventist Health Commercial |
$477.80
|
| Rate for Payer: Cash Price |
$1,075.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,911.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,672.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$955.60
|
| Rate for Payer: EPIC Health Plan Senior |
$955.60
|
| Rate for Payer: Galaxy Health WC |
$2,030.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,433.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,150.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,517.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,409.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$477.80
|
| Rate for Payer: Multiplan Commercial |
$1,791.75
|
| Rate for Payer: Networks By Design Commercial |
$1,552.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,030.65
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
|
OP
|
$2,389.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$455.92 |
| Max. Negotiated Rate |
$2,150.10 |
| Rate for Payer: Adventist Health Commercial |
$477.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$479.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,134.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$479.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,624.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,389.68
|
| Rate for Payer: Blue Shield of California Commercial |
$1,505.07
|
| Rate for Payer: Blue Shield of California EPN |
$948.43
|
| Rate for Payer: Cash Price |
$1,075.05
|
| Rate for Payer: Cash Price |
$1,075.05
|
| Rate for Payer: Cash Price |
$1,075.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,911.20
|
| Rate for Payer: Cigna of CA HMO |
$1,528.96
|
| Rate for Payer: Cigna of CA PPO |
$1,767.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$719.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$479.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,672.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.90
|
| Rate for Payer: EPIC Health Plan Senior |
$527.93
|
| Rate for Payer: Galaxy Health WC |
$2,030.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,433.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,150.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$787.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$455.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$479.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,517.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$503.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$671.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$477.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$643.12
|
| Rate for Payer: Multiplan Commercial |
$1,791.75
|
| Rate for Payer: Networks By Design Commercial |
$1,552.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$479.94
|
| Rate for Payer: Prime Health Services Commercial |
$2,030.65
|
| Rate for Payer: Prime Health Services Medicare |
$508.74
|
| Rate for Payer: Riverside University Health System MISP |
$527.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,433.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,433.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$479.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$719.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.93
|
| Rate for Payer: Vantage Medical Group Senior |
$479.94
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$192.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$192.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$44.82 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$245.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA HMO |
$209.28
|
| Rate for Payer: Cigna of CA PPO |
$241.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$44.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$192.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$228.90
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
| Rate for Payer: Riverside University Health System MISP |
$130.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.50
|
| 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: Vantage Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.51 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$245.25
|
| 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: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA HMO |
$209.28
|
| Rate for Payer: Cigna of CA PPO |
$241.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$228.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$207.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$192.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$228.90
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
| Rate for Payer: Riverside University Health System MISP |
$130.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.50
|
| Rate for Payer: United Healthcare All Other HMO |
$163.50
|
| Rate for Payer: United Healthcare HMO Rider |
$163.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$163.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
|
IP
|
$797.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.40 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$557.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.80
|
| Rate for Payer: EPIC Health Plan Senior |
$318.80
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$506.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$470.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
|
OP
|
$797.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.40 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$340.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$431.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$599.80
|
| Rate for Payer: Blue Shield of California Commercial |
$502.11
|
| Rate for Payer: Blue Shield of California EPN |
$316.41
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: Cigna of CA HMO |
$510.08
|
| Rate for Payer: Cigna of CA PPO |
$589.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$557.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$506.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$289.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$478.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$478.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC VENA CAVA FILTER
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,138.76
|
| Rate for Payer: Blue Shield of California Commercial |
$3,127.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,415.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC VENA CAVA FILTER
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,127.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
IP
|
$813.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$731.70 |
| Rate for Payer: Adventist Health Commercial |
$162.60
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Central Health Plan Commercial |
$650.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$569.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$325.20
|
| Rate for Payer: EPIC Health Plan Senior |
$325.20
|
| Rate for Payer: Galaxy Health WC |
$691.05
|
| Rate for Payer: Global Benefits Group Commercial |
$487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$516.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$479.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.60
|
| Rate for Payer: Multiplan Commercial |
$609.75
|
| Rate for Payer: Networks By Design Commercial |
$528.45
|
| Rate for Payer: Prime Health Services Commercial |
$691.05
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
OP
|
$813.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$113.89 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$333.33
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$228.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$574.56
|
| 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 |
$807.84
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Central Health Plan Commercial |
$650.40
|
| Rate for Payer: Cigna of CA HMO |
$520.32
|
| Rate for Payer: Cigna of CA PPO |
$601.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$861.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$574.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$569.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.02
|
| Rate for Payer: EPIC Health Plan Senior |
$632.02
|
| Rate for Payer: Galaxy Health WC |
$691.05
|
| Rate for Payer: Global Benefits Group Commercial |
$487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$942.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$574.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$516.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$113.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$617.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$769.91
|
| Rate for Payer: Multiplan Commercial |
$609.75
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$528.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$574.56
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$691.05
|
| Rate for Payer: Prime Health Services Medicare |
$609.03
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$632.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$487.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$574.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Vantage Medical Group Senior |
$574.56
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
OP
|
$813.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.89 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$162.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$574.56
|
| 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 |
$807.84
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Central Health Plan Commercial |
$650.40
|
| Rate for Payer: Cigna of CA HMO |
$520.32
|
| Rate for Payer: Cigna of CA PPO |
$601.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$861.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$574.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$569.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.02
|
| Rate for Payer: EPIC Health Plan Senior |
$632.02
|
| Rate for Payer: Galaxy Health WC |
$691.05
|
| Rate for Payer: Global Benefits Group Commercial |
$487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$942.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$574.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$516.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$113.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$617.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$769.91
|
| Rate for Payer: Multiplan Commercial |
$609.75
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$528.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$574.56
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$691.05
|
| Rate for Payer: Prime Health Services Medicare |
$609.03
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$632.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$406.50
|
| Rate for Payer: United Healthcare All Other HMO |
$406.50
|
| Rate for Payer: United Healthcare HMO Rider |
$406.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$406.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$574.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Vantage Medical Group Senior |
$574.56
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
IP
|
$813.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$731.70 |
| Rate for Payer: Adventist Health Commercial |
$162.60
|
| Rate for Payer: Cash Price |
$365.85
|
| Rate for Payer: Central Health Plan Commercial |
$650.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$569.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$325.20
|
| Rate for Payer: EPIC Health Plan Senior |
$325.20
|
| Rate for Payer: Galaxy Health WC |
$691.05
|
| Rate for Payer: Global Benefits Group Commercial |
$487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$516.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$479.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.60
|
| Rate for Payer: Multiplan Commercial |
$609.75
|
| Rate for Payer: Networks By Design Commercial |
$528.45
|
| Rate for Payer: Prime Health Services Commercial |
$691.05
|
|
