|
HC TRACH TUBE HOLDER 1 SZ
|
Facility
IP
|
$15.33
|
|
|
Service Code
|
CPT A7526
|
| Hospital Charge Code |
901698588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Cash Price |
$6.90
|
| Rate for Payer: Central Health Plan Commercial |
$12.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.13
|
| Rate for Payer: Galaxy Health WC |
$13.03
|
| Rate for Payer: Global Benefits Group Commercial |
$9.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.07
|
| Rate for Payer: Multiplan Commercial |
$11.50
|
| Rate for Payer: Networks By Design Commercial |
$9.96
|
| Rate for Payer: Prime Health Services Commercial |
$13.03
|
|
|
HC TRACKER CATH
|
Facility
OP
|
$930.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$186.00 |
| Max. Negotiated Rate |
$837.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$790.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$511.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$511.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$450.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$549.44
|
| Rate for Payer: BCBS Transplant Transplant |
$558.00
|
| Rate for Payer: Blue Shield of California Commercial |
$584.97
|
| Rate for Payer: Blue Shield of California EPN |
$454.77
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Central Health Plan Commercial |
$744.00
|
| Rate for Payer: Cigna of CA HMO |
$595.20
|
| Rate for Payer: Cigna of CA PPO |
$688.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$790.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$372.00
|
| Rate for Payer: Galaxy Health WC |
$790.50
|
| Rate for Payer: Global Benefits Group Commercial |
$558.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$837.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$697.50
|
| Rate for Payer: IEHP medi-cal |
$325.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$620.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.00
|
| Rate for Payer: Multiplan Commercial |
$697.50
|
| Rate for Payer: Networks By Design Commercial |
$604.50
|
| Rate for Payer: Prime Health Services Commercial |
$790.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$558.00
|
| Rate for Payer: Riverside University Health MISP |
$372.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$558.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$558.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$465.00
|
| Rate for Payer: United Healthcare All Other HMO |
$465.00
|
| Rate for Payer: United Healthcare HMO Rider |
$465.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$465.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$790.50
|
| Rate for Payer: Vantage Medical Group Senior |
$790.50
|
|
|
HC TRACKER CATH
|
Facility
IP
|
$930.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081237
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$186.00 |
| Max. Negotiated Rate |
$837.00 |
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Central Health Plan Commercial |
$744.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.00
|
| Rate for Payer: Galaxy Health WC |
$790.50
|
| Rate for Payer: Global Benefits Group Commercial |
$558.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$837.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$620.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.00
|
| Rate for Payer: Multiplan Commercial |
$697.50
|
| Rate for Payer: Networks By Design Commercial |
$604.50
|
| Rate for Payer: Prime Health Services Commercial |
$790.50
|
|
|
HC TRACKER - GUIDEWIRE
|
Facility
OP
|
$606.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.20 |
| Max. Negotiated Rate |
$545.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$396.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$515.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$333.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$333.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$293.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$358.02
|
| Rate for Payer: BCBS Transplant Transplant |
$363.60
|
| Rate for Payer: Blue Shield of California Commercial |
$381.17
|
| Rate for Payer: Blue Shield of California EPN |
$296.33
|
| Rate for Payer: Cash Price |
$272.70
|
| Rate for Payer: Cash Price |
$272.70
|
| Rate for Payer: Central Health Plan Commercial |
$484.80
|
| Rate for Payer: Cigna of CA HMO |
$387.84
|
| Rate for Payer: Cigna of CA PPO |
$448.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$515.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$242.40
|
| Rate for Payer: Galaxy Health WC |
$515.10
|
| Rate for Payer: Global Benefits Group Commercial |
$363.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$545.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$454.50
|
| Rate for Payer: IEHP medi-cal |
$212.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$404.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.20
|
| Rate for Payer: Multiplan Commercial |
$454.50
|
| Rate for Payer: Networks By Design Commercial |
$393.90
|
| Rate for Payer: Prime Health Services Commercial |
$515.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$363.60
|
| Rate for Payer: Riverside University Health MISP |
$242.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$363.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$363.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$303.00
|
| Rate for Payer: United Healthcare All Other HMO |
$303.00
|
| Rate for Payer: United Healthcare HMO Rider |
$303.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$303.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$515.10
|
| Rate for Payer: Vantage Medical Group Senior |
$515.10
|
|
|
HC TRACKER - GUIDEWIRE
|
Facility
IP
|
$606.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081224
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.20 |
| Max. Negotiated Rate |
$545.40 |
| Rate for Payer: Cash Price |
$272.70
|
| Rate for Payer: Central Health Plan Commercial |
$484.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.40
|
| Rate for Payer: Galaxy Health WC |
$515.10
|
| Rate for Payer: Global Benefits Group Commercial |
$363.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$545.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$404.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.20
|
| Rate for Payer: Multiplan Commercial |
$454.50
|
| Rate for Payer: Networks By Design Commercial |
$393.90
|
| Rate for Payer: Prime Health Services Commercial |
$515.10
|
|
|
HC TRACKER INFUSION KIT
|
Facility
OP
|
$1,148.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081220
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$188.37 |
| Max. Negotiated Rate |
$1,033.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$188.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$975.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$631.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$631.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$555.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$678.24
|
| Rate for Payer: BCBS Transplant Transplant |
$688.80
|
| Rate for Payer: Blue Shield of California Commercial |
$722.09
|
| Rate for Payer: Blue Shield of California EPN |
$561.37
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Central Health Plan Commercial |
$918.40
|
| Rate for Payer: Cigna of CA HMO |
$734.72
|
| Rate for Payer: Cigna of CA PPO |
$849.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$975.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$459.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$459.20
|
| Rate for Payer: Galaxy Health WC |
$975.80
|
| Rate for Payer: Global Benefits Group Commercial |
$688.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,033.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$861.00
|
| Rate for Payer: IEHP medi-cal |
$401.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$765.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.60
|
| Rate for Payer: Multiplan Commercial |
$861.00
|
| Rate for Payer: Networks By Design Commercial |
$746.20
|
| Rate for Payer: Prime Health Services Commercial |
$975.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$688.80
|
| Rate for Payer: Riverside University Health MISP |
$459.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$688.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$688.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$574.00
|
| Rate for Payer: United Healthcare All Other HMO |
$574.00
|
| Rate for Payer: United Healthcare HMO Rider |
$574.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$574.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$975.80
|
| Rate for Payer: Vantage Medical Group Senior |
$975.80
|
|
|
HC TRACKER INFUSION KIT
|
Facility
IP
|
$1,148.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081220
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$229.60 |
| Max. Negotiated Rate |
$1,033.20 |
| Rate for Payer: Cash Price |
$516.60
|
| Rate for Payer: Central Health Plan Commercial |
$918.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$459.20
|
| Rate for Payer: Galaxy Health WC |
$975.80
|
| Rate for Payer: Global Benefits Group Commercial |
$688.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,033.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$765.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.60
|
| Rate for Payer: Multiplan Commercial |
$861.00
|
| Rate for Payer: Networks By Design Commercial |
$746.20
|
| Rate for Payer: Prime Health Services Commercial |
$975.80
|
|
|
HC TRACTION MANUAL 30 MIN OT
|
Facility
IP
|
$228.00
|
|
|
Service Code
|
CPT 97122
|
| Hospital Charge Code |
905104144
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$205.20 |
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Central Health Plan Commercial |
$182.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.20
|
| Rate for Payer: Galaxy Health WC |
$193.80
|
| Rate for Payer: Global Benefits Group Commercial |
$136.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$171.00
|
| Rate for Payer: Networks By Design Commercial |
$148.20
|
| Rate for Payer: Prime Health Services Commercial |
$193.80
|
|
|
HC TRACTION MANUAL 30 MIN OT
|
Facility
OP
|
$228.00
|
|
|
Service Code
|
CPT 97122
|
| Hospital Charge Code |
905104144
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$138.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$193.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$125.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$125.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$136.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Central Health Plan Commercial |
$182.40
|
| Rate for Payer: Cigna of CA HMO |
$145.92
|
| Rate for Payer: Cigna of CA PPO |
$168.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$193.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.20
|
| Rate for Payer: Galaxy Health WC |
$193.80
|
| Rate for Payer: Global Benefits Group Commercial |
$136.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$171.00
|
| Rate for Payer: IEHP medi-cal |
$79.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.48
|
| Rate for Payer: Multiplan Commercial |
$171.00
|
| Rate for Payer: Networks By Design Commercial |
$148.20
|
| Rate for Payer: Prime Health Services Commercial |
$193.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$136.80
|
| Rate for Payer: Riverside University Health MISP |
$91.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$136.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$136.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$193.80
|
| Rate for Payer: Vantage Medical Group Senior |
$193.80
|
|
|
HC TRACTION MANUAL 30 MIN PT
|
Facility
IP
|
$228.00
|
|
|
Service Code
|
CPT 97122
|
| Hospital Charge Code |
905103144
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$205.20 |
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Central Health Plan Commercial |
$182.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.20
|
| Rate for Payer: Galaxy Health WC |
$193.80
|
| Rate for Payer: Global Benefits Group Commercial |
$136.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$171.00
|
| Rate for Payer: Networks By Design Commercial |
$148.20
|
| Rate for Payer: Prime Health Services Commercial |
$193.80
|
|
|
HC TRACTION MANUAL 30 MIN PT
|
Facility
OP
|
$228.00
|
|
|
Service Code
|
CPT 97122
|
| Hospital Charge Code |
905103144
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$79.80 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$138.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$193.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$125.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$125.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$136.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Central Health Plan Commercial |
$182.40
|
| Rate for Payer: Cigna of CA HMO |
$145.92
|
| Rate for Payer: Cigna of CA PPO |
$168.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$193.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.20
|
| Rate for Payer: Galaxy Health WC |
$193.80
|
| Rate for Payer: Global Benefits Group Commercial |
$136.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$171.00
|
| Rate for Payer: IEHP medi-cal |
$79.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.48
|
| Rate for Payer: Multiplan Commercial |
$171.00
|
| Rate for Payer: Networks By Design Commercial |
$148.20
|
| Rate for Payer: Prime Health Services Commercial |
$193.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$136.80
|
| Rate for Payer: Riverside University Health MISP |
$91.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$136.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$136.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$193.80
|
| Rate for Payer: Vantage Medical Group Senior |
$193.80
|
|
|
HC TRACTION MECHANICAL
|
Facility
OP
|
$210.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
905103103
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$62.89 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$115.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$157.50
|
| Rate for Payer: IEHP medi-cal |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.10
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: Riverside University Health MISP |
$84.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC TRACTION MECHANICAL
|
Facility
IP
|
$210.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
900417012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC TRACTION MECHANICAL
|
Facility
IP
|
$210.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
905103103
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC TRACTION MECHANICAL
|
Facility
OP
|
$210.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
900417012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$62.89 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$115.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$157.50
|
| Rate for Payer: IEHP medi-cal |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.10
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: Riverside University Health MISP |
$84.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC TRACTION MECHANICAL MCAL
|
Facility
OP
|
$210.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
900400025
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$62.89 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$115.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$157.50
|
| Rate for Payer: IEHP medi-cal |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.10
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: Riverside University Health MISP |
$84.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC TRACTION MECHANICAL MCAL
|
Facility
IP
|
$210.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
900400025
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC TRACTION MECHANICAL MCARE COMM
|
Facility
IP
|
$210.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
900407037
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC TRACTION MECHANICAL MCARE COMM
|
Facility
OP
|
$210.00
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
900407037
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$62.89 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$62.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$115.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$126.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$157.50
|
| Rate for Payer: IEHP medi-cal |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.10
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: Riverside University Health MISP |
$84.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC TRANSABD AMNIOINFUSION ADDL FETUS
|
Facility
IP
|
$775.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
902400112
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$155.00 |
| Max. Negotiated Rate |
$697.50 |
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Central Health Plan Commercial |
$620.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$310.00
|
| Rate for Payer: Galaxy Health WC |
$658.75
|
| Rate for Payer: Global Benefits Group Commercial |
$465.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$697.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.00
|
| Rate for Payer: Multiplan Commercial |
$581.25
|
| Rate for Payer: Networks By Design Commercial |
$503.75
|
| Rate for Payer: Prime Health Services Commercial |
$658.75
|
|
|
HC TRANSABD AMNIOINFUSION ADDL FETUS
|
Facility
OP
|
$775.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
902400112
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$155.00 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$487.48
|
| Rate for Payer: Blue Shield of California EPN |
$378.98
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Central Health Plan Commercial |
$620.00
|
| Rate for Payer: Cigna of CA HMO |
$496.00
|
| Rate for Payer: Cigna of CA PPO |
$573.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$658.75
|
| Rate for Payer: Global Benefits Group Commercial |
$465.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$697.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$581.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: IEHP medi-cal |
$661.35
|
| Rate for Payer: IEHP Medicare Advantage |
$400.82
|
| Rate for Payer: Innovage PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$581.25
|
| Rate for Payer: Networks By Design Commercial |
$503.75
|
| Rate for Payer: Prime Health Services Commercial |
$658.75
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$465.00
|
| Rate for Payer: Riverside University Health MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$465.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$465.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC TRANSABDOMINAL AMNIOINFUSION
|
Facility
IP
|
$775.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
910400088
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$155.00 |
| Max. Negotiated Rate |
$697.50 |
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Central Health Plan Commercial |
$620.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$310.00
|
| Rate for Payer: Galaxy Health WC |
$658.75
|
| Rate for Payer: Global Benefits Group Commercial |
$465.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$697.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.00
|
| Rate for Payer: Multiplan Commercial |
$581.25
|
| Rate for Payer: Networks By Design Commercial |
$503.75
|
| Rate for Payer: Prime Health Services Commercial |
$658.75
|
|
|
HC TRANSABDOMINAL AMNIOINFUSION
|
Facility
OP
|
$775.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
910400088
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$155.00 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$487.48
|
| Rate for Payer: Blue Shield of California EPN |
$378.98
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Central Health Plan Commercial |
$620.00
|
| Rate for Payer: Cigna of CA HMO |
$496.00
|
| Rate for Payer: Cigna of CA PPO |
$573.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$658.75
|
| Rate for Payer: Global Benefits Group Commercial |
$465.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$697.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$581.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: IEHP medi-cal |
$661.35
|
| Rate for Payer: IEHP Medicare Advantage |
$400.82
|
| Rate for Payer: Innovage PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$581.25
|
| Rate for Payer: Networks By Design Commercial |
$503.75
|
| Rate for Payer: Prime Health Services Commercial |
$658.75
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$465.00
|
| Rate for Payer: Riverside University Health MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$465.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$465.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
IP
|
$6,587.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,317.40 |
| Max. Negotiated Rate |
$5,928.30 |
| Rate for Payer: Cash Price |
$2,964.15
|
| Rate for Payer: Central Health Plan Commercial |
$5,269.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,634.80
|
| Rate for Payer: Galaxy Health WC |
$5,598.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,952.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,928.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,393.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,317.40
|
| Rate for Payer: Multiplan Commercial |
$4,940.25
|
| Rate for Payer: Networks By Design Commercial |
$4,281.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,598.95
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
OP
|
$6,587.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,317.40 |
| Max. Negotiated Rate |
$7,720.23 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,678.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,952.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,143.22
|
| Rate for Payer: Blue Shield of California EPN |
$3,221.04
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Cash Price |
$2,964.15
|
| Rate for Payer: Cash Price |
$2,964.15
|
| Rate for Payer: Central Health Plan Commercial |
$5,269.60
|
| Rate for Payer: Cigna of CA HMO |
$4,215.68
|
| Rate for Payer: Cigna of CA PPO |
$4,874.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Galaxy Health WC |
$5,598.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,952.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,928.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,940.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: IEHP medi-cal |
$7,720.23
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Innovage PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,393.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,317.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Multiplan Commercial |
$4,940.25
|
| Rate for Payer: Networks By Design Commercial |
$4,281.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,598.95
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,952.20
|
| Rate for Payer: Riverside University Health MISP |
$5,146.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,952.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,952.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,293.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,293.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,293.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,293.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
