|
HC VERTEBRAL UNI
|
Facility
|
IP
|
$17,590.00
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
909020149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,518.00 |
| Max. Negotiated Rate |
$15,831.00 |
| Rate for Payer: Adventist Health Commercial |
$3,518.00
|
| Rate for Payer: Cash Price |
$7,915.50
|
| Rate for Payer: Central Health Plan Commercial |
$14,072.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,313.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,036.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,036.00
|
| Rate for Payer: Galaxy Health WC |
$14,951.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10,554.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,831.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,169.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,378.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,518.00
|
| Rate for Payer: Multiplan Commercial |
$13,192.50
|
| Rate for Payer: Networks By Design Commercial |
$11,433.50
|
| Rate for Payer: Prime Health Services Commercial |
$14,951.50
|
|
|
HC VERTEBROPLASTY ADDL INJECT
|
Facility
|
IP
|
$13,725.00
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
909022512
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,745.00 |
| Max. Negotiated Rate |
$12,352.50 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Central Health Plan Commercial |
$10,980.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,607.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,490.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,490.00
|
| Rate for Payer: Galaxy Health WC |
$11,666.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,235.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,352.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,715.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,097.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,745.00
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
| Rate for Payer: Networks By Design Commercial |
$8,921.25
|
| Rate for Payer: Prime Health Services Commercial |
$11,666.25
|
|
|
HC VERTEBROPLASTY ADDL INJECT
|
Facility
|
OP
|
$13,725.00
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
909022512
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.49 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,666.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,548.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,293.75
|
| 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 |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Cash Price |
$6,176.25
|
| Rate for Payer: Central Health Plan Commercial |
$10,980.00
|
| Rate for Payer: Cigna of CA HMO |
$8,784.00
|
| Rate for Payer: Cigna of CA PPO |
$10,156.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,666.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,666.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,666.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,607.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,490.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,490.00
|
| Rate for Payer: Galaxy Health WC |
$11,666.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,235.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,352.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$312.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,715.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$345.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,097.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,745.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,607.50
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
| Rate for Payer: Networks By Design Commercial |
$8,921.25
|
| Rate for Payer: Prime Health Services Commercial |
$11,666.25
|
| Rate for Payer: Riverside University Health System MISP |
$5,490.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,235.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,862.50
|
| 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 |
$11,666.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,666.25
|
| Rate for Payer: Vantage Medical Group Senior |
$11,666.25
|
|
|
HC VESTIBULE OF MOUTH
|
Facility
|
OP
|
$1,751.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
900501785
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.83 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$350.20
|
| 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 |
$1,040.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$693.67
|
| 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 |
$1,030.97
|
| Rate for Payer: Cash Price |
$787.95
|
| Rate for Payer: Cash Price |
$787.95
|
| Rate for Payer: Cash Price |
$787.95
|
| Rate for Payer: Cash Price |
$787.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,400.80
|
| Rate for Payer: Cigna of CA HMO |
$1,120.64
|
| Rate for Payer: Cigna of CA PPO |
$1,295.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$693.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,225.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.56
|
| Rate for Payer: EPIC Health Plan Senior |
$763.04
|
| Rate for Payer: Galaxy Health WC |
$1,488.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,050.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,575.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,137.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$693.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,111.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$89.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$350.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.52
|
| Rate for Payer: Multiplan Commercial |
$1,313.25
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: Networks By Design Commercial |
$1,138.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$693.67
|
| Rate for Payer: Preferred Health Network WC |
$1,052.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,488.35
|
| Rate for Payer: Prime Health Services Medicare |
$735.29
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$763.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,050.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$875.50
|
| Rate for Payer: United Healthcare All Other HMO |
$875.50
|
| Rate for Payer: United Healthcare HMO Rider |
$875.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$875.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$693.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Vantage Medical Group Senior |
$693.67
|
|
|
HC VESTIBULE OF MOUTH
|
Facility
|
IP
|
$1,751.00
|
|
|
Service Code
|
CPT 40808
|
| Hospital Charge Code |
900501785
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$350.20 |
| Max. Negotiated Rate |
$1,575.90 |
| Rate for Payer: Adventist Health Commercial |
$350.20
|
| Rate for Payer: Cash Price |
$787.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,400.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,225.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.40
|
| Rate for Payer: EPIC Health Plan Senior |
$700.40
|
| Rate for Payer: Galaxy Health WC |
$1,488.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,050.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,575.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,111.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,033.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$350.20
|
| Rate for Payer: Multiplan Commercial |
$1,313.25
|
| Rate for Payer: Networks By Design Commercial |
$1,138.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,488.35
|
|
|
HC VES V 1 (COMMON WASP), IGE
|
Facility
|
OP
|
$16.38
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913747
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$12.39
|
| Rate for Payer: Blue Shield of California Commercial |
$10.32
|
| Rate for Payer: Blue Shield of California EPN |
$7.81
|
| Rate for Payer: Blue Shield of California EPN |
$6.50
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Central Health Plan Commercial |
$13.10
|
| Rate for Payer: Central Health Plan Commercial |
$15.73
|
| Rate for Payer: Cigna of CA HMO |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$10.48
|
| Rate for Payer: Cigna of CA PPO |
$14.55
|
| Rate for Payer: Cigna of CA PPO |
$12.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Galaxy Health WC |
$13.92
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: Multiplan Commercial |
$12.29
|
| Rate for Payer: Networks By Design Commercial |
$10.65
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
| Rate for Payer: Prime Health Services Commercial |
$13.92
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC VES V 1 (COMMON WASP), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913747
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$17.69 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Central Health Plan Commercial |
$15.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Senior |
$7.86
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
|
|
HC VES V 5 (COMMON WASP), IGE
|
Facility
|
OP
|
$16.38
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913748
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$12.39
|
| Rate for Payer: Blue Shield of California Commercial |
$10.32
|
| Rate for Payer: Blue Shield of California EPN |
$7.81
|
| Rate for Payer: Blue Shield of California EPN |
$6.50
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Central Health Plan Commercial |
$13.10
|
| Rate for Payer: Central Health Plan Commercial |
$15.73
|
| Rate for Payer: Cigna of CA HMO |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$10.48
|
| Rate for Payer: Cigna of CA PPO |
$14.55
|
| Rate for Payer: Cigna of CA PPO |
$12.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Galaxy Health WC |
$13.92
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: Multiplan Commercial |
$12.29
|
| Rate for Payer: Networks By Design Commercial |
$10.65
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
| Rate for Payer: Prime Health Services Commercial |
$13.92
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC VES V 5 (COMMON WASP), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913748
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$17.69 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Central Health Plan Commercial |
$15.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Senior |
$7.86
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
|
|
HC VISCOELASTIC TEST
|
Facility
|
OP
|
$96.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$162.19 |
| Rate for Payer: Adventist Health Commercial |
$19.20
|
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$100.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$116.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$116.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.19
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California Commercial |
$60.48
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Blue Shield of California EPN |
$38.11
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Central Health Plan Commercial |
$76.80
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA HMO |
$61.44
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Cigna of CA PPO |
$71.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$38.40
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$67.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$93.80
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
| Rate for Payer: Riverside University Health System MISP |
$38.40
|
| Rate for Payer: Riverside University Health System MISP |
$53.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.98
|
| Rate for Payer: United Healthcare All Other HMO |
$15.98
|
| Rate for Payer: United Healthcare All Other HMO |
$15.98
|
| Rate for Payer: United Healthcare HMO Rider |
$15.98
|
| Rate for Payer: United Healthcare HMO Rider |
$15.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.90
|
| Rate for Payer: Vantage Medical Group Senior |
$113.90
|
| Rate for Payer: Vantage Medical Group Senior |
$81.60
|
|
|
HC VISCOELASTIC TEST
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912037
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC VITAL CAPACITY TOTAL
|
Facility
|
IP
|
$667.00
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
900800430
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$133.40 |
| Max. Negotiated Rate |
$600.30 |
| Rate for Payer: Adventist Health Commercial |
$133.40
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Central Health Plan Commercial |
$533.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$466.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.80
|
| Rate for Payer: EPIC Health Plan Senior |
$266.80
|
| Rate for Payer: Galaxy Health WC |
$566.95
|
| Rate for Payer: Global Benefits Group Commercial |
$400.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$600.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$423.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$393.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.40
|
| Rate for Payer: Multiplan Commercial |
$500.25
|
| Rate for Payer: Networks By Design Commercial |
$433.55
|
| Rate for Payer: Prime Health Services Commercial |
$566.95
|
|
|
HC VITAL CAPACITY TOTAL
|
Facility
|
OP
|
$667.00
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
900800430
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$10.58 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$273.47
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$387.99
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$316.75
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Central Health Plan Commercial |
$533.60
|
| Rate for Payer: Cigna of CA HMO |
$426.88
|
| Rate for Payer: Cigna of CA PPO |
$493.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$466.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$566.95
|
| Rate for Payer: Global Benefits Group Commercial |
$400.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$600.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$423.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$500.25
|
| Rate for Payer: Multiplan WC |
$316.75
|
| Rate for Payer: Networks By Design Commercial |
$433.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Preferred Health Network WC |
$323.21
|
| Rate for Payer: Prime Health Services Commercial |
$566.95
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Prime Health Services WC |
$313.51
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$400.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$400.20
|
| 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 |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC VITAL CAPACITY TOTAL
|
Facility
|
IP
|
$667.00
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
900800430
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$133.40 |
| Max. Negotiated Rate |
$600.30 |
| Rate for Payer: Adventist Health Commercial |
$133.40
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Central Health Plan Commercial |
$533.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$466.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.80
|
| Rate for Payer: EPIC Health Plan Senior |
$266.80
|
| Rate for Payer: Galaxy Health WC |
$566.95
|
| Rate for Payer: Global Benefits Group Commercial |
$400.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$600.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$423.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$393.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.40
|
| Rate for Payer: Multiplan Commercial |
$500.25
|
| Rate for Payer: Networks By Design Commercial |
$433.55
|
| Rate for Payer: Prime Health Services Commercial |
$566.95
|
|
|
HC VITAL CAPACITY TOTAL
|
Facility
|
OP
|
$667.00
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
900800430
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$133.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$387.99
|
| Rate for Payer: Blue Shield of California Commercial |
$420.21
|
| Rate for Payer: Blue Shield of California EPN |
$264.80
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Cash Price |
$300.15
|
| Rate for Payer: Central Health Plan Commercial |
$533.60
|
| Rate for Payer: Cigna of CA HMO |
$426.88
|
| Rate for Payer: Cigna of CA PPO |
$493.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$466.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$566.95
|
| Rate for Payer: Global Benefits Group Commercial |
$400.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$600.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$423.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$500.25
|
| Rate for Payer: Networks By Design Commercial |
$433.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$566.95
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$400.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$400.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC VITAMIN B12
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
900910830
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$243.00 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$189.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$171.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$159.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
|
|
HC VITAMIN B12
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
900910830
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.21 |
| Max. Negotiated Rate |
$152.45 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$109.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$109.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.45
|
| Rate for Payer: Blue Shield of California Commercial |
$170.10
|
| Rate for Payer: Blue Shield of California Commercial |
$69.30
|
| Rate for Payer: Blue Shield of California EPN |
$107.19
|
| Rate for Payer: Blue Shield of California EPN |
$43.67
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Central Health Plan Commercial |
$88.00
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: Cigna of CA HMO |
$172.80
|
| Rate for Payer: Cigna of CA HMO |
$70.40
|
| Rate for Payer: Cigna of CA PPO |
$199.80
|
| Rate for Payer: Cigna of CA PPO |
$81.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$189.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.88
|
| Rate for Payer: EPIC Health Plan Senior |
$16.59
|
| Rate for Payer: EPIC Health Plan Senior |
$16.59
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Galaxy Health WC |
$93.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Global Benefits Group Commercial |
$66.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.73
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$69.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$171.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.21
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: Networks By Design Commercial |
$71.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.08
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
| Rate for Payer: Prime Health Services Commercial |
$93.50
|
| Rate for Payer: Prime Health Services Medicare |
$15.98
|
| Rate for Payer: Prime Health Services Medicare |
$15.98
|
| Rate for Payer: Riverside University Health System MISP |
$16.59
|
| Rate for Payer: Riverside University Health System MISP |
$16.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.21
|
| Rate for Payer: United Healthcare All Other HMO |
$12.21
|
| Rate for Payer: United Healthcare All Other HMO |
$12.21
|
| Rate for Payer: United Healthcare HMO Rider |
$12.21
|
| Rate for Payer: United Healthcare HMO Rider |
$12.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.21
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Vantage Medical Group Senior |
$15.08
|
| Rate for Payer: Vantage Medical Group Senior |
$15.08
|
|
|
HC VITAMIN D TOTAL
|
Facility
|
OP
|
$165.00
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
900912240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.98 |
| Max. Negotiated Rate |
$299.39 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$29.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$29.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$217.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$217.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$215.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$215.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$299.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$299.39
|
| Rate for Payer: Blue Shield of California Commercial |
$134.19
|
| Rate for Payer: Blue Shield of California Commercial |
$103.95
|
| Rate for Payer: Blue Shield of California EPN |
$84.56
|
| Rate for Payer: Blue Shield of California EPN |
$65.50
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Central Health Plan Commercial |
$132.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA HMO |
$105.60
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Cigna of CA PPO |
$122.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$115.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.84
|
| Rate for Payer: EPIC Health Plan Senior |
$32.56
|
| Rate for Payer: EPIC Health Plan Senior |
$32.56
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Galaxy Health WC |
$140.25
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Global Benefits Group Commercial |
$99.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$148.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48.54
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$48.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$35.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$35.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$104.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$39.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$39.66
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: Networks By Design Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$29.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$29.60
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Prime Health Services Commercial |
$140.25
|
| Rate for Payer: Prime Health Services Medicare |
$31.38
|
| Rate for Payer: Prime Health Services Medicare |
$31.38
|
| Rate for Payer: Riverside University Health System MISP |
$32.56
|
| Rate for Payer: Riverside University Health System MISP |
$32.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.98
|
| Rate for Payer: United Healthcare All Other HMO |
$23.98
|
| Rate for Payer: United Healthcare All Other HMO |
$23.98
|
| Rate for Payer: United Healthcare HMO Rider |
$23.98
|
| Rate for Payer: United Healthcare HMO Rider |
$23.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.98
|
| Rate for Payer: Upland Medical Group Pediatric |
$29.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$29.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: Vantage Medical Group Senior |
$29.60
|
| Rate for Payer: Vantage Medical Group Senior |
$29.60
|
|
|
HC VITAMIN D TOTAL
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
900912240
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.60
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC VNUS ABLATION CATHETER
|
Facility
|
IP
|
$1,740.00
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
909080043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,566.00 |
| Rate for Payer: Adventist Health Commercial |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,395.48
|
| Rate for Payer: Blue Shield of California EPN |
$876.96
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.00
|
| Rate for Payer: Cigna of CA HMO |
$1,218.00
|
| Rate for Payer: Cigna of CA PPO |
$1,218.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,218.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.00
|
| Rate for Payer: EPIC Health Plan Senior |
$696.00
|
| Rate for Payer: Galaxy Health WC |
$1,479.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,104.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,026.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.00
|
| Rate for Payer: Multiplan Commercial |
$1,305.00
|
| Rate for Payer: Networks By Design Commercial |
$870.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$653.02
|
| Rate for Payer: United Healthcare All Other HMO |
$635.62
|
| Rate for Payer: United Healthcare HMO Rider |
$621.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$569.85
|
|
|
HC VNUS ABLATION CATHETER
|
Facility
|
OP
|
$1,740.00
|
|
|
Service Code
|
CPT C1888
|
| Hospital Charge Code |
909080043
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$348.00 |
| Max. Negotiated Rate |
$1,566.00 |
| Rate for Payer: Adventist Health Commercial |
$348.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$957.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,305.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$794.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$954.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,395.48
|
| Rate for Payer: Blue Shield of California EPN |
$876.96
|
| Rate for Payer: Cash Price |
$783.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.00
|
| Rate for Payer: Cigna of CA HMO |
$1,218.00
|
| Rate for Payer: Cigna of CA PPO |
$1,218.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,479.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,479.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,218.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.00
|
| Rate for Payer: EPIC Health Plan Senior |
$696.00
|
| Rate for Payer: Galaxy Health WC |
$1,479.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,104.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$631.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,026.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,218.00
|
| Rate for Payer: Multiplan Commercial |
$1,305.00
|
| Rate for Payer: Networks By Design Commercial |
$870.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.00
|
| Rate for Payer: Riverside University Health System MISP |
$696.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,044.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,044.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$653.02
|
| Rate for Payer: United Healthcare All Other HMO |
$635.62
|
| Rate for Payer: United Healthcare HMO Rider |
$621.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$569.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,479.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,479.00
|
|
|
HC VOCATIONAL EVAL 10 DAY
|
Facility
|
IP
|
$283.00
|
|
| Hospital Charge Code |
903200103
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$56.60 |
| Max. Negotiated Rate |
$254.70 |
| Rate for Payer: Adventist Health Commercial |
$56.60
|
| Rate for Payer: Cash Price |
$127.35
|
| Rate for Payer: Central Health Plan Commercial |
$226.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$198.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.20
|
| Rate for Payer: EPIC Health Plan Senior |
$113.20
|
| Rate for Payer: Galaxy Health WC |
$240.55
|
| Rate for Payer: Global Benefits Group Commercial |
$169.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$254.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$179.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$166.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.60
|
| Rate for Payer: Multiplan Commercial |
$212.25
|
| Rate for Payer: Networks By Design Commercial |
$183.95
|
| Rate for Payer: Prime Health Services Commercial |
$240.55
|
|
|
HC VOCATIONAL EVAL 10 DAY
|
Facility
|
OP
|
$283.00
|
|
| Hospital Charge Code |
903200103
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$102.73 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$116.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$171.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$240.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$155.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$212.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$127.35
|
| Rate for Payer: Cash Price |
$127.35
|
| Rate for Payer: Central Health Plan Commercial |
$226.40
|
| Rate for Payer: Cigna of CA HMO |
$181.12
|
| Rate for Payer: Cigna of CA PPO |
$209.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$240.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$240.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$240.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$198.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$113.20
|
| Rate for Payer: EPIC Health Plan Senior |
$113.20
|
| Rate for Payer: Galaxy Health WC |
$240.55
|
| Rate for Payer: Global Benefits Group Commercial |
$169.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$254.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$179.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$166.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$198.10
|
| Rate for Payer: Multiplan Commercial |
$212.25
|
| Rate for Payer: Networks By Design Commercial |
$183.95
|
| Rate for Payer: Prime Health Services Commercial |
$240.55
|
| Rate for Payer: Riverside University Health System MISP |
$113.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$169.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$169.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$240.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$240.55
|
| Rate for Payer: Vantage Medical Group Senior |
$240.55
|
|
|
HC VOCATIONAL EVAL 1 DAY
|
Facility
|
IP
|
$461.00
|
|
| Hospital Charge Code |
903200100
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$92.20 |
| Max. Negotiated Rate |
$414.90 |
| Rate for Payer: Adventist Health Commercial |
$92.20
|
| Rate for Payer: Cash Price |
$207.45
|
| Rate for Payer: Central Health Plan Commercial |
$368.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$322.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.40
|
| Rate for Payer: EPIC Health Plan Senior |
$184.40
|
| Rate for Payer: Galaxy Health WC |
$391.85
|
| Rate for Payer: Global Benefits Group Commercial |
$276.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$292.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$271.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.20
|
| Rate for Payer: Multiplan Commercial |
$345.75
|
| Rate for Payer: Networks By Design Commercial |
$299.65
|
| Rate for Payer: Prime Health Services Commercial |
$391.85
|
|
|
HC VOCATIONAL EVAL 1 DAY
|
Facility
|
OP
|
$461.00
|
|
| Hospital Charge Code |
903200100
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$167.34 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$189.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$279.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$391.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$253.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$345.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$207.45
|
| Rate for Payer: Cash Price |
$207.45
|
| Rate for Payer: Central Health Plan Commercial |
$368.80
|
| Rate for Payer: Cigna of CA HMO |
$295.04
|
| Rate for Payer: Cigna of CA PPO |
$341.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$391.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$391.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$322.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.40
|
| Rate for Payer: EPIC Health Plan Senior |
$184.40
|
| Rate for Payer: Galaxy Health WC |
$391.85
|
| Rate for Payer: Global Benefits Group Commercial |
$276.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$292.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$167.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$271.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$322.70
|
| Rate for Payer: Multiplan Commercial |
$345.75
|
| Rate for Payer: Networks By Design Commercial |
$299.65
|
| Rate for Payer: Prime Health Services Commercial |
$391.85
|
| Rate for Payer: Riverside University Health System MISP |
$184.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$276.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$276.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$391.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$391.85
|
| Rate for Payer: Vantage Medical Group Senior |
$391.85
|
|
