|
HC WASP VENOM IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913640
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$41.58
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC WASP VENOM IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913640
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
IP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
905356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,594.80 |
| Max. Negotiated Rate |
$16,176.60 |
| Rate for Payer: Adventist Health Commercial |
$3,594.80
|
| Rate for Payer: Blue Shield of California Commercial |
$14,415.15
|
| Rate for Payer: Blue Shield of California EPN |
$9,058.90
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Central Health Plan Commercial |
$14,379.20
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,581.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,176.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,413.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,604.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,594.80
|
| Rate for Payer: Multiplan Commercial |
$13,480.50
|
| Rate for Payer: Networks By Design Commercial |
$11,683.10
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
IP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
915356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,594.80 |
| Max. Negotiated Rate |
$16,176.60 |
| Rate for Payer: Adventist Health Commercial |
$3,594.80
|
| Rate for Payer: Blue Shield of California Commercial |
$14,415.15
|
| Rate for Payer: Blue Shield of California EPN |
$9,058.90
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Central Health Plan Commercial |
$14,379.20
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,581.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,176.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,413.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,604.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,594.80
|
| Rate for Payer: Multiplan Commercial |
$13,480.50
|
| Rate for Payer: Networks By Design Commercial |
$11,683.10
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
OP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
905356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5,780.56 |
| Max. Negotiated Rate |
$16,176.60 |
| Rate for Payer: Adventist Health Commercial |
$7,369.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,885.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,480.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,455.48
|
| Rate for Payer: Blue Shield of California Commercial |
$14,415.15
|
| Rate for Payer: Blue Shield of California EPN |
$9,058.90
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Central Health Plan Commercial |
$14,379.20
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,277.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,277.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,581.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,176.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,780.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,413.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,385.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,604.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,369.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,581.80
|
| Rate for Payer: Multiplan Commercial |
$13,480.50
|
| Rate for Payer: Networks By Design Commercial |
$8,987.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: Riverside University Health System MISP |
$7,189.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,784.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Senior |
$15,277.90
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
OP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
915356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5,780.56 |
| Max. Negotiated Rate |
$16,176.60 |
| Rate for Payer: Adventist Health Commercial |
$7,369.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,885.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,480.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,455.48
|
| Rate for Payer: Blue Shield of California Commercial |
$14,415.15
|
| Rate for Payer: Blue Shield of California EPN |
$9,058.90
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Cash Price |
$8,088.30
|
| Rate for Payer: Central Health Plan Commercial |
$14,379.20
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,277.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,277.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,581.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,176.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,780.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,413.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,385.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,604.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,369.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,581.80
|
| Rate for Payer: Multiplan Commercial |
$13,480.50
|
| Rate for Payer: Networks By Design Commercial |
$8,987.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: Riverside University Health System MISP |
$7,189.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,784.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Senior |
$15,277.90
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
IP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
915356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,069.40 |
| Max. Negotiated Rate |
$18,312.30 |
| Rate for Payer: Adventist Health Commercial |
$4,069.40
|
| Rate for Payer: Blue Shield of California Commercial |
$16,318.29
|
| Rate for Payer: Blue Shield of California EPN |
$10,254.89
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Central Health Plan Commercial |
$16,277.60
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,242.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,312.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,920.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,004.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,069.40
|
| Rate for Payer: Multiplan Commercial |
$15,260.25
|
| Rate for Payer: Networks By Design Commercial |
$13,225.55
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
OP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
915356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6,588.60 |
| Max. Negotiated Rate |
$18,312.30 |
| Rate for Payer: Adventist Health Commercial |
$8,342.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,190.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,260.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,835.85
|
| Rate for Payer: Blue Shield of California Commercial |
$16,318.29
|
| Rate for Payer: Blue Shield of California EPN |
$10,254.89
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Central Health Plan Commercial |
$16,277.60
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,294.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,294.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,242.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,312.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,588.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,920.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,278.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,004.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,342.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,242.90
|
| Rate for Payer: Multiplan Commercial |
$15,260.25
|
| Rate for Payer: Networks By Design Commercial |
$10,173.50
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: Riverside University Health System MISP |
$8,138.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,208.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,208.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Senior |
$17,294.95
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
OP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
905356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6,588.60 |
| Max. Negotiated Rate |
$18,312.30 |
| Rate for Payer: Adventist Health Commercial |
$8,342.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,190.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,260.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,835.85
|
| Rate for Payer: Blue Shield of California Commercial |
$16,318.29
|
| Rate for Payer: Blue Shield of California EPN |
$10,254.89
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Central Health Plan Commercial |
$16,277.60
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,294.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,294.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,242.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,312.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,588.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,920.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,278.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,004.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,342.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,242.90
|
| Rate for Payer: Multiplan Commercial |
$15,260.25
|
| Rate for Payer: Networks By Design Commercial |
$10,173.50
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: Riverside University Health System MISP |
$8,138.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,208.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,208.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Senior |
$17,294.95
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
IP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
905356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,069.40 |
| Max. Negotiated Rate |
$18,312.30 |
| Rate for Payer: Adventist Health Commercial |
$4,069.40
|
| Rate for Payer: Blue Shield of California Commercial |
$16,318.29
|
| Rate for Payer: Blue Shield of California EPN |
$10,254.89
|
| Rate for Payer: Cash Price |
$9,156.15
|
| Rate for Payer: Central Health Plan Commercial |
$16,277.60
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,242.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,312.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,920.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,004.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,069.40
|
| Rate for Payer: Multiplan Commercial |
$15,260.25
|
| Rate for Payer: Networks By Design Commercial |
$13,225.55
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
|
|
HC WEAK ACIDIC DRUG CONF & ID
|
Facility
|
IP
|
$624.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910512
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$124.80 |
| Max. Negotiated Rate |
$561.60 |
| Rate for Payer: Adventist Health Commercial |
$124.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Central Health Plan Commercial |
$499.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$436.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$249.60
|
| Rate for Payer: EPIC Health Plan Senior |
$249.60
|
| Rate for Payer: Galaxy Health WC |
$530.40
|
| Rate for Payer: Global Benefits Group Commercial |
$374.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$561.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$396.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$368.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.80
|
| Rate for Payer: Multiplan Commercial |
$468.00
|
| Rate for Payer: Networks By Design Commercial |
$405.60
|
| Rate for Payer: Prime Health Services Commercial |
$530.40
|
|
|
HC WEAK ACIDIC DRUG CONF & ID
|
Facility
|
OP
|
$518.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910512
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.34 |
| Max. Negotiated Rate |
$623.23 |
| Rate for Payer: Adventist Health Commercial |
$103.60
|
| Rate for Payer: Adventist Health Commercial |
$124.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$62.14
|
| Rate for Payer: Adventist Health Medi-Cal |
$62.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$416.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$416.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$448.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$448.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$623.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$623.23
|
| Rate for Payer: Blue Shield of California Commercial |
$393.12
|
| Rate for Payer: Blue Shield of California Commercial |
$326.34
|
| Rate for Payer: Blue Shield of California EPN |
$247.73
|
| Rate for Payer: Blue Shield of California EPN |
$205.65
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Cash Price |
$233.10
|
| Rate for Payer: Central Health Plan Commercial |
$414.40
|
| Rate for Payer: Central Health Plan Commercial |
$499.20
|
| Rate for Payer: Cigna of CA HMO |
$399.36
|
| Rate for Payer: Cigna of CA HMO |
$331.52
|
| Rate for Payer: Cigna of CA PPO |
$461.76
|
| Rate for Payer: Cigna of CA PPO |
$383.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$362.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$436.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$102.53
|
| Rate for Payer: EPIC Health Plan Senior |
$68.35
|
| Rate for Payer: EPIC Health Plan Senior |
$68.35
|
| Rate for Payer: Galaxy Health WC |
$530.40
|
| Rate for Payer: Galaxy Health WC |
$440.30
|
| Rate for Payer: Global Benefits Group Commercial |
$374.40
|
| Rate for Payer: Global Benefits Group Commercial |
$310.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$561.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$466.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$101.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$328.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$396.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$87.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$87.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$468.00
|
| Rate for Payer: Multiplan Commercial |
$388.50
|
| Rate for Payer: Networks By Design Commercial |
$336.70
|
| Rate for Payer: Networks By Design Commercial |
$405.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$62.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$62.14
|
| Rate for Payer: Prime Health Services Commercial |
$530.40
|
| Rate for Payer: Prime Health Services Commercial |
$440.30
|
| Rate for Payer: Prime Health Services Medicare |
$65.87
|
| Rate for Payer: Prime Health Services Medicare |
$65.87
|
| Rate for Payer: Riverside University Health System MISP |
$68.35
|
| Rate for Payer: Riverside University Health System MISP |
$68.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$310.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$374.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$374.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$310.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$62.14
|
| Rate for Payer: Upland Medical Group Pediatric |
$62.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC WEDGE EX OF SKIN OF NAIL FOLD
|
Facility
|
IP
|
$1,103.00
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
900501019
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$220.60 |
| Max. Negotiated Rate |
$992.70 |
| Rate for Payer: Adventist Health Commercial |
$220.60
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$772.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$441.20
|
| Rate for Payer: EPIC Health Plan Senior |
$441.20
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$700.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$650.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.60
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Networks By Design Commercial |
$716.95
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
|
|
HC WEDGE EX OF SKIN OF NAIL FOLD
|
Facility
|
OP
|
$1,103.00
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
900501019
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$100.45 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$452.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$392.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| 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 |
$808.84
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Cigna of CA HMO |
$705.92
|
| Rate for Payer: Cigna of CA PPO |
$816.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$772.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$700.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$100.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$716.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$661.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC WEDGE EX OF SKIN OF NAIL FOLD
|
Facility
|
OP
|
$1,103.00
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
900501019
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$100.45 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$220.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| 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 |
$808.84
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Cigna of CA HMO |
$705.92
|
| Rate for Payer: Cigna of CA PPO |
$816.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$772.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$700.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$100.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$716.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$551.50
|
| Rate for Payer: United Healthcare All Other HMO |
$551.50
|
| Rate for Payer: United Healthcare HMO Rider |
$551.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$551.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC WEDGE EX OF SKIN OF NAIL FOLD
|
Facility
|
IP
|
$1,103.00
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
900501019
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$220.60 |
| Max. Negotiated Rate |
$992.70 |
| Rate for Payer: Adventist Health Commercial |
$220.60
|
| Rate for Payer: Cash Price |
$496.35
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$772.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$441.20
|
| Rate for Payer: EPIC Health Plan Senior |
$441.20
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$700.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$650.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.60
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Networks By Design Commercial |
$716.95
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
|
|
HC WEDGE, FOAM, 15 DEGREE. PAIR
|
Facility
|
IP
|
$250.81
|
|
| Hospital Charge Code |
901698446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.16 |
| Max. Negotiated Rate |
$225.73 |
| Rate for Payer: Adventist Health Commercial |
$50.16
|
| Rate for Payer: Cash Price |
$112.86
|
| Rate for Payer: Central Health Plan Commercial |
$200.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.32
|
| Rate for Payer: EPIC Health Plan Senior |
$100.32
|
| Rate for Payer: Galaxy Health WC |
$213.19
|
| Rate for Payer: Global Benefits Group Commercial |
$150.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$159.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.16
|
| Rate for Payer: Multiplan Commercial |
$188.11
|
| Rate for Payer: Networks By Design Commercial |
$163.03
|
| Rate for Payer: Prime Health Services Commercial |
$213.19
|
|
|
HC WEDGE, FOAM, 15 DEGREE. PAIR
|
Facility
|
OP
|
$250.81
|
|
| Hospital Charge Code |
901698446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.16 |
| Max. Negotiated Rate |
$225.73 |
| Rate for Payer: Adventist Health Commercial |
$50.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$213.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$137.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$188.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$121.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.90
|
| Rate for Payer: Blue Shield of California Commercial |
$159.01
|
| Rate for Payer: Blue Shield of California EPN |
$100.07
|
| Rate for Payer: Cash Price |
$112.86
|
| Rate for Payer: Central Health Plan Commercial |
$200.65
|
| Rate for Payer: Cigna of CA HMO |
$160.52
|
| Rate for Payer: Cigna of CA PPO |
$185.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$213.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$213.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$213.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.32
|
| Rate for Payer: EPIC Health Plan Senior |
$100.32
|
| Rate for Payer: Galaxy Health WC |
$213.19
|
| Rate for Payer: Global Benefits Group Commercial |
$150.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$159.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$91.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.57
|
| Rate for Payer: Multiplan Commercial |
$188.11
|
| Rate for Payer: Networks By Design Commercial |
$163.03
|
| Rate for Payer: Prime Health Services Commercial |
$213.19
|
| Rate for Payer: Riverside University Health System MISP |
$100.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$150.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$150.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$125.41
|
| Rate for Payer: United Healthcare All Other HMO |
$125.41
|
| Rate for Payer: United Healthcare HMO Rider |
$125.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$125.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$213.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$213.19
|
| Rate for Payer: Vantage Medical Group Senior |
$213.19
|
|
|
HC WEDGE,FOAM 30 DEGREE, PAIR
|
Facility
|
OP
|
$227.99
|
|
|
Service Code
|
CPT E0190
|
| Hospital Charge Code |
901607585
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$687.20 |
| Rate for Payer: Adventist Health Commercial |
$45.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$687.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$193.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$125.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$170.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.62
|
| Rate for Payer: Blue Shield of California Commercial |
$144.55
|
| Rate for Payer: Blue Shield of California EPN |
$90.97
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Central Health Plan Commercial |
$182.39
|
| Rate for Payer: Cigna of CA HMO |
$145.91
|
| Rate for Payer: Cigna of CA PPO |
$168.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$193.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$193.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$193.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$159.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.20
|
| Rate for Payer: EPIC Health Plan Senior |
$91.20
|
| Rate for Payer: Galaxy Health WC |
$193.79
|
| Rate for Payer: Global Benefits Group Commercial |
$136.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$144.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$82.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$134.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$159.59
|
| Rate for Payer: Multiplan Commercial |
$170.99
|
| Rate for Payer: Networks By Design Commercial |
$148.19
|
| Rate for Payer: Prime Health Services Commercial |
$193.79
|
| Rate for Payer: Riverside University Health System MISP |
$91.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$136.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$136.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.00
|
| Rate for Payer: United Healthcare All Other HMO |
$114.00
|
| Rate for Payer: United Healthcare HMO Rider |
$114.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$193.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$193.79
|
| Rate for Payer: Vantage Medical Group Senior |
$193.79
|
|
|
HC WEDGE,FOAM 30 DEGREE, PAIR
|
Facility
|
IP
|
$227.99
|
|
|
Service Code
|
CPT E0190
|
| Hospital Charge Code |
901607585
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$205.19 |
| Rate for Payer: Adventist Health Commercial |
$45.60
|
| Rate for Payer: Cash Price |
$102.60
|
| Rate for Payer: Central Health Plan Commercial |
$182.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$159.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.20
|
| Rate for Payer: EPIC Health Plan Senior |
$91.20
|
| Rate for Payer: Galaxy Health WC |
$193.79
|
| Rate for Payer: Global Benefits Group Commercial |
$136.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$205.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$144.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$134.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.60
|
| Rate for Payer: Multiplan Commercial |
$170.99
|
| Rate for Payer: Networks By Design Commercial |
$148.19
|
| Rate for Payer: Prime Health Services Commercial |
$193.79
|
|
|
HC WEDGE,FOAM 30 DEGREE, PAIR XL
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT E0190
|
| Hospital Charge Code |
901607586
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC WEDGE,FOAM 30 DEGREE, PAIR XL
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT E0190
|
| Hospital Charge Code |
901607586
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$687.20 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$687.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.59
|
| Rate for Payer: Blue Shield of California Commercial |
$221.90
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC WEDGE STBLIZR HEELMEDIX
|
Facility
|
OP
|
$41.49
|
|
| Hospital Charge Code |
901606283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.30 |
| Max. Negotiated Rate |
$37.34 |
| Rate for Payer: Adventist Health Commercial |
$8.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.13
|
| Rate for Payer: Blue Shield of California Commercial |
$26.30
|
| Rate for Payer: Blue Shield of California EPN |
$16.55
|
| Rate for Payer: Cash Price |
$18.67
|
| Rate for Payer: Central Health Plan Commercial |
$33.19
|
| Rate for Payer: Cigna of CA HMO |
$26.55
|
| Rate for Payer: Cigna of CA PPO |
$30.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$35.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.60
|
| Rate for Payer: EPIC Health Plan Senior |
$16.60
|
| Rate for Payer: Galaxy Health WC |
$35.27
|
| Rate for Payer: Global Benefits Group Commercial |
$24.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.04
|
| Rate for Payer: Multiplan Commercial |
$31.12
|
| Rate for Payer: Networks By Design Commercial |
$26.97
|
| Rate for Payer: Prime Health Services Commercial |
$35.27
|
| Rate for Payer: Riverside University Health System MISP |
$16.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.75
|
| Rate for Payer: United Healthcare All Other HMO |
$20.75
|
| Rate for Payer: United Healthcare HMO Rider |
$20.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.27
|
| Rate for Payer: Vantage Medical Group Senior |
$35.27
|
|
|
HC WEDGE STBLIZR HEELMEDIX
|
Facility
|
IP
|
$41.49
|
|
| Hospital Charge Code |
901606283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.30 |
| Max. Negotiated Rate |
$37.34 |
| Rate for Payer: Adventist Health Commercial |
$8.30
|
| Rate for Payer: Cash Price |
$18.67
|
| Rate for Payer: Central Health Plan Commercial |
$33.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.60
|
| Rate for Payer: EPIC Health Plan Senior |
$16.60
|
| Rate for Payer: Galaxy Health WC |
$35.27
|
| Rate for Payer: Global Benefits Group Commercial |
$24.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.30
|
| Rate for Payer: Multiplan Commercial |
$31.12
|
| Rate for Payer: Networks By Design Commercial |
$26.97
|
| Rate for Payer: Prime Health Services Commercial |
$35.27
|
|
|
HC WEDGING OF CLUBFOOT CAST
|
Facility
|
OP
|
$1,316.00
|
|
|
Service Code
|
CPT 29750
|
| Hospital Charge Code |
900501517
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$118.12 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$263.20
|
| 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 |
$539.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$359.73
|
| 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 |
$537.66
|
| Rate for Payer: Cash Price |
$592.20
|
| Rate for Payer: Cash Price |
$592.20
|
| Rate for Payer: Cash Price |
$592.20
|
| Rate for Payer: Cash Price |
$592.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,052.80
|
| Rate for Payer: Cigna of CA HMO |
$842.24
|
| Rate for Payer: Cigna of CA PPO |
$973.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$395.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$921.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$593.55
|
| Rate for Payer: EPIC Health Plan Senior |
$395.70
|
| Rate for Payer: Galaxy Health WC |
$1,118.60
|
| Rate for Payer: Global Benefits Group Commercial |
$789.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,184.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$589.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$359.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$835.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$118.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$386.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$263.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$482.04
|
| Rate for Payer: Multiplan Commercial |
$987.00
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$855.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$359.73
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$1,118.60
|
| Rate for Payer: Prime Health Services Medicare |
$381.31
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$395.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$789.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$658.00
|
| Rate for Payer: United Healthcare All Other HMO |
$658.00
|
| Rate for Payer: United Healthcare HMO Rider |
$658.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$658.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$359.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$395.70
|
| Rate for Payer: Vantage Medical Group Senior |
$359.73
|
|
