|
HC TIBIAL LENGTH SOCK
|
Facility
|
IP
|
$131.00
|
|
|
Service Code
|
CPT L2840
|
| Hospital Charge Code |
905352840
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$117.90 |
| Rate for Payer: Adventist Health Commercial |
$26.20
|
| Rate for Payer: Blue Shield of California Commercial |
$101.26
|
| Rate for Payer: Blue Shield of California EPN |
$66.02
|
| Rate for Payer: Cash Price |
$72.05
|
| Rate for Payer: Central Health Plan Commercial |
$104.80
|
| Rate for Payer: Cigna of CA HMO |
$91.70
|
| Rate for Payer: Cigna of CA PPO |
$91.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.40
|
| Rate for Payer: EPIC Health Plan Senior |
$52.40
|
| Rate for Payer: Galaxy Health WC |
$111.35
|
| Rate for Payer: Global Benefits Group Commercial |
$78.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.20
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
| Rate for Payer: Networks By Design Commercial |
$85.15
|
| Rate for Payer: Prime Health Services Commercial |
$111.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.16
|
| Rate for Payer: United Healthcare All Other HMO |
$47.85
|
| Rate for Payer: United Healthcare HMO Rider |
$46.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.90
|
|
|
HC TIBIAL LENGTH SOCK
|
Facility
|
IP
|
$131.00
|
|
|
Service Code
|
CPT L2840
|
| Hospital Charge Code |
915352840
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$117.90 |
| Rate for Payer: Adventist Health Commercial |
$26.20
|
| Rate for Payer: Blue Shield of California Commercial |
$101.26
|
| Rate for Payer: Blue Shield of California EPN |
$66.02
|
| Rate for Payer: Cash Price |
$72.05
|
| Rate for Payer: Central Health Plan Commercial |
$104.80
|
| Rate for Payer: Cigna of CA HMO |
$91.70
|
| Rate for Payer: Cigna of CA PPO |
$91.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.40
|
| Rate for Payer: EPIC Health Plan Senior |
$52.40
|
| Rate for Payer: Galaxy Health WC |
$111.35
|
| Rate for Payer: Global Benefits Group Commercial |
$78.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.20
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
| Rate for Payer: Networks By Design Commercial |
$85.15
|
| Rate for Payer: Prime Health Services Commercial |
$111.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.16
|
| Rate for Payer: United Healthcare All Other HMO |
$47.85
|
| Rate for Payer: United Healthcare HMO Rider |
$46.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.90
|
|
|
HC TIBIAL LENGTH SOCK
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
CPT L2840
|
| Hospital Charge Code |
915352840
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$117.90 |
| Rate for Payer: Adventist Health Commercial |
$53.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$111.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.94
|
| Rate for Payer: Blue Shield of California Commercial |
$101.26
|
| Rate for Payer: Blue Shield of California EPN |
$66.02
|
| Rate for Payer: Cash Price |
$72.05
|
| Rate for Payer: Cash Price |
$72.05
|
| Rate for Payer: Central Health Plan Commercial |
$104.80
|
| Rate for Payer: Cigna of CA HMO |
$91.70
|
| Rate for Payer: Cigna of CA PPO |
$91.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$111.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$111.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.40
|
| Rate for Payer: EPIC Health Plan Senior |
$52.40
|
| Rate for Payer: Galaxy Health WC |
$111.35
|
| Rate for Payer: Global Benefits Group Commercial |
$78.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.79
|
| Rate for Payer: InnovAge PACE Commercial |
$65.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$91.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91.70
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
| Rate for Payer: Networks By Design Commercial |
$65.50
|
| Rate for Payer: Prime Health Services Commercial |
$111.35
|
| Rate for Payer: Riverside University Health System MISP |
$52.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.16
|
| Rate for Payer: United Healthcare All Other HMO |
$47.85
|
| Rate for Payer: United Healthcare HMO Rider |
$46.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$111.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$111.35
|
| Rate for Payer: Vantage Medical Group Senior |
$111.35
|
|
|
HC TIBIAL LENGTH SOCK
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
CPT L2840
|
| Hospital Charge Code |
905352840
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$31.79 |
| Max. Negotiated Rate |
$117.90 |
| Rate for Payer: Adventist Health Commercial |
$53.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$111.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.94
|
| Rate for Payer: Blue Shield of California Commercial |
$101.26
|
| Rate for Payer: Blue Shield of California EPN |
$66.02
|
| Rate for Payer: Cash Price |
$72.05
|
| Rate for Payer: Cash Price |
$72.05
|
| Rate for Payer: Central Health Plan Commercial |
$104.80
|
| Rate for Payer: Cigna of CA HMO |
$91.70
|
| Rate for Payer: Cigna of CA PPO |
$91.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$111.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$111.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.40
|
| Rate for Payer: EPIC Health Plan Senior |
$52.40
|
| Rate for Payer: Galaxy Health WC |
$111.35
|
| Rate for Payer: Global Benefits Group Commercial |
$78.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.79
|
| Rate for Payer: InnovAge PACE Commercial |
$65.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$91.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91.70
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
| Rate for Payer: Networks By Design Commercial |
$65.50
|
| Rate for Payer: Prime Health Services Commercial |
$111.35
|
| Rate for Payer: Riverside University Health System MISP |
$52.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.16
|
| Rate for Payer: United Healthcare All Other HMO |
$47.85
|
| Rate for Payer: United Healthcare HMO Rider |
$46.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$111.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$111.35
|
| Rate for Payer: Vantage Medical Group Senior |
$111.35
|
|
|
HC TIG HUMAN INTRAMUSCULAR USE
|
Facility
|
OP
|
$212.00
|
|
|
Service Code
|
CPT 90389
|
| Hospital Charge Code |
902890180
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$42.40 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$86.92
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$128.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$116.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$438.11
|
| Rate for Payer: Cash Price |
$116.60
|
| Rate for Payer: Cash Price |
$116.60
|
| Rate for Payer: Cash Price |
$116.60
|
| Rate for Payer: Cash Price |
$116.60
|
| Rate for Payer: Central Health Plan Commercial |
$169.60
|
| Rate for Payer: Cigna of CA HMO |
$135.68
|
| Rate for Payer: Cigna of CA PPO |
$156.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.80
|
| Rate for Payer: EPIC Health Plan Senior |
$84.80
|
| Rate for Payer: Galaxy Health WC |
$180.20
|
| Rate for Payer: Global Benefits Group Commercial |
$127.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$190.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$106.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$148.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$148.40
|
| Rate for Payer: Multiplan Commercial |
$159.00
|
| Rate for Payer: Networks By Design Commercial |
$137.80
|
| Rate for Payer: Prime Health Services Commercial |
$180.20
|
| Rate for Payer: Riverside University Health System MISP |
$84.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.20
|
| Rate for Payer: Vantage Medical Group Senior |
$180.20
|
|
|
HC TIG HUMAN INTRAMUSCULAR USE
|
Facility
|
IP
|
$212.00
|
|
|
Service Code
|
CPT 90389
|
| Hospital Charge Code |
902890180
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$42.40 |
| Max. Negotiated Rate |
$190.80 |
| Rate for Payer: Adventist Health Commercial |
$42.40
|
| Rate for Payer: Cash Price |
$116.60
|
| Rate for Payer: Central Health Plan Commercial |
$169.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.80
|
| Rate for Payer: EPIC Health Plan Senior |
$84.80
|
| Rate for Payer: Galaxy Health WC |
$180.20
|
| Rate for Payer: Global Benefits Group Commercial |
$127.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$190.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.40
|
| Rate for Payer: Multiplan Commercial |
$159.00
|
| Rate for Payer: Networks By Design Commercial |
$137.80
|
| Rate for Payer: Prime Health Services Commercial |
$180.20
|
|
|
HC TILT TABLE TEST
|
Facility
|
IP
|
$4,553.00
|
|
|
Service Code
|
CPT 93660
|
| Hospital Charge Code |
900200144
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$910.60 |
| Max. Negotiated Rate |
$4,097.70 |
| Rate for Payer: Adventist Health Commercial |
$910.60
|
| Rate for Payer: Cash Price |
$2,504.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,642.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,821.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,821.20
|
| Rate for Payer: Galaxy Health WC |
$3,870.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,731.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,097.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,036.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,734.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,818.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$910.60
|
| Rate for Payer: Multiplan Commercial |
$3,414.75
|
| Rate for Payer: Networks By Design Commercial |
$2,959.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,870.05
|
|
|
HC TILT TABLE TEST
|
Facility
|
OP
|
$4,553.00
|
|
|
Service Code
|
CPT 93660
|
| Hospital Charge Code |
900200144
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$674.18 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$910.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$674.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,765.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,204.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,673.98
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,504.15
|
| Rate for Payer: Cash Price |
$2,504.15
|
| Rate for Payer: Cash Price |
$2,504.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,642.40
|
| Rate for Payer: Cigna of CA HMO |
$2,913.92
|
| Rate for Payer: Cigna of CA PPO |
$3,369.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$3,870.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,731.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,097.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: InnovAge PACE Commercial |
$1,011.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,036.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$910.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$903.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$3,414.75
|
| Rate for Payer: Networks By Design Commercial |
$2,959.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$674.18
|
| Rate for Payer: Prime Health Services Commercial |
$3,870.05
|
| Rate for Payer: Prime Health Services Medicare |
$714.63
|
| Rate for Payer: Riverside University Health System MISP |
$741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,731.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,731.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC TIP ARGYLE YANKAUER SUCTN 12FR
|
Facility
|
OP
|
$4.35
|
|
| Hospital Charge Code |
901698614
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Adventist Health Commercial |
$0.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.55
|
| Rate for Payer: Blue Shield of California Commercial |
$2.66
|
| Rate for Payer: Blue Shield of California EPN |
$1.74
|
| Rate for Payer: Cash Price |
$2.39
|
| Rate for Payer: Central Health Plan Commercial |
$3.48
|
| Rate for Payer: Cigna of CA HMO |
$2.78
|
| Rate for Payer: Cigna of CA PPO |
$3.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.74
|
| Rate for Payer: EPIC Health Plan Senior |
$1.74
|
| Rate for Payer: Galaxy Health WC |
$3.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.92
|
| Rate for Payer: InnovAge PACE Commercial |
$2.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.04
|
| Rate for Payer: Multiplan Commercial |
$3.26
|
| Rate for Payer: Networks By Design Commercial |
$2.83
|
| Rate for Payer: Prime Health Services Commercial |
$3.70
|
| Rate for Payer: Riverside University Health System MISP |
$1.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.17
|
| Rate for Payer: United Healthcare All Other HMO |
$2.17
|
| Rate for Payer: United Healthcare HMO Rider |
$2.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.70
|
| Rate for Payer: Vantage Medical Group Senior |
$3.70
|
|
|
HC TIP ARGYLE YANKAUER SUCTN 12FR
|
Facility
|
IP
|
$4.35
|
|
| Hospital Charge Code |
901698614
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.87 |
| Max. Negotiated Rate |
$3.92 |
| Rate for Payer: Adventist Health Commercial |
$0.87
|
| Rate for Payer: Cash Price |
$2.39
|
| Rate for Payer: Central Health Plan Commercial |
$3.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.74
|
| Rate for Payer: EPIC Health Plan Senior |
$1.74
|
| Rate for Payer: Galaxy Health WC |
$3.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.87
|
| Rate for Payer: Multiplan Commercial |
$3.26
|
| Rate for Payer: Networks By Design Commercial |
$2.83
|
| Rate for Payer: Prime Health Services Commercial |
$3.70
|
|
|
HC TIP DEFLECTING WIRE
|
Facility
|
IP
|
$198.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.60 |
| Max. Negotiated Rate |
$178.20 |
| Rate for Payer: Adventist Health Commercial |
$39.60
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Central Health Plan Commercial |
$158.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.20
|
| Rate for Payer: EPIC Health Plan Senior |
$79.20
|
| Rate for Payer: Galaxy Health WC |
$168.30
|
| Rate for Payer: Global Benefits Group Commercial |
$118.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$178.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$132.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$75.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.60
|
| Rate for Payer: Multiplan Commercial |
$148.50
|
| Rate for Payer: Networks By Design Commercial |
$128.70
|
| Rate for Payer: Prime Health Services Commercial |
$168.30
|
|
|
HC TIP DEFLECTING WIRE
|
Facility
|
OP
|
$198.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909081233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.60 |
| Max. Negotiated Rate |
$178.20 |
| Rate for Payer: Adventist Health Commercial |
$39.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$168.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$108.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$148.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$116.29
|
| Rate for Payer: Blue Shield of California Commercial |
$120.98
|
| Rate for Payer: Blue Shield of California EPN |
$79.00
|
| Rate for Payer: Cash Price |
$108.90
|
| Rate for Payer: Central Health Plan Commercial |
$158.40
|
| Rate for Payer: Cigna of CA HMO |
$126.72
|
| Rate for Payer: Cigna of CA PPO |
$146.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$168.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$168.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$168.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.20
|
| Rate for Payer: EPIC Health Plan Senior |
$79.20
|
| Rate for Payer: Galaxy Health WC |
$168.30
|
| Rate for Payer: Global Benefits Group Commercial |
$118.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$178.20
|
| Rate for Payer: InnovAge PACE Commercial |
$99.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$132.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$75.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$122.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$138.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$138.60
|
| Rate for Payer: Multiplan Commercial |
$148.50
|
| Rate for Payer: Networks By Design Commercial |
$128.70
|
| Rate for Payer: Prime Health Services Commercial |
$168.30
|
| Rate for Payer: Riverside University Health System MISP |
$79.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$118.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$118.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.00
|
| Rate for Payer: United Healthcare All Other HMO |
$99.00
|
| Rate for Payer: United Healthcare HMO Rider |
$99.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$99.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$168.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$168.30
|
| Rate for Payer: Vantage Medical Group Senior |
$168.30
|
|
|
HC TIPS CATHETER SET
|
Facility
|
IP
|
$1,062.00
|
|
| Hospital Charge Code |
909081222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$955.80 |
| Rate for Payer: Adventist Health Commercial |
$212.40
|
| Rate for Payer: Cash Price |
$584.10
|
| Rate for Payer: Central Health Plan Commercial |
$849.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Senior |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$955.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$657.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.40
|
| Rate for Payer: Multiplan Commercial |
$796.50
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
|
|
HC TIPS CATHETER SET
|
Facility
|
OP
|
$1,062.00
|
|
| Hospital Charge Code |
909081222
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$955.80 |
| Rate for Payer: Adventist Health Commercial |
$212.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$644.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$584.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$796.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$514.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$623.71
|
| Rate for Payer: Blue Shield of California Commercial |
$648.88
|
| Rate for Payer: Blue Shield of California EPN |
$423.74
|
| Rate for Payer: Cash Price |
$584.10
|
| Rate for Payer: Central Health Plan Commercial |
$849.60
|
| Rate for Payer: Cigna of CA HMO |
$679.68
|
| Rate for Payer: Cigna of CA PPO |
$785.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$902.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$902.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$902.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Senior |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$955.80
|
| Rate for Payer: InnovAge PACE Commercial |
$531.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$657.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$743.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$743.40
|
| Rate for Payer: Multiplan Commercial |
$796.50
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
| Rate for Payer: Riverside University Health System MISP |
$424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$637.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$637.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$531.00
|
| Rate for Payer: United Healthcare All Other HMO |
$531.00
|
| Rate for Payer: United Healthcare HMO Rider |
$531.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$531.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$902.70
|
| Rate for Payer: Vantage Medical Group Senior |
$902.70
|
|
|
HC T.I.P.S. (PORTOCAVAL SHUNT)
|
Facility
|
OP
|
$12,014.00
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
909081331
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$187.62 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$2,402.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26,109.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,211.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,607.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,010.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$6,607.70
|
| Rate for Payer: Cash Price |
$6,607.70
|
| Rate for Payer: Cash Price |
$6,607.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,611.20
|
| Rate for Payer: Cigna of CA HMO |
$7,688.96
|
| Rate for Payer: Cigna of CA PPO |
$8,890.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,211.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,211.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,211.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,805.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,805.60
|
| Rate for Payer: Galaxy Health WC |
$10,211.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,208.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,812.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.62
|
| Rate for Payer: InnovAge PACE Commercial |
$6,007.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,013.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,436.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,402.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,409.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,409.80
|
| Rate for Payer: Multiplan Commercial |
$9,010.50
|
| Rate for Payer: Networks By Design Commercial |
$7,809.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,211.90
|
| Rate for Payer: Riverside University Health System MISP |
$4,805.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,208.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,211.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,211.90
|
| Rate for Payer: Vantage Medical Group Senior |
$10,211.90
|
|
|
HC T.I.P.S. (PORTOCAVAL SHUNT)
|
Facility
|
IP
|
$12,014.00
|
|
|
Service Code
|
CPT 37182
|
| Hospital Charge Code |
909081331
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,402.80 |
| Max. Negotiated Rate |
$10,812.60 |
| Rate for Payer: Adventist Health Commercial |
$2,402.80
|
| Rate for Payer: Cash Price |
$6,607.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,611.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,805.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,805.60
|
| Rate for Payer: Galaxy Health WC |
$10,211.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,208.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,812.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,013.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,577.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,436.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,402.80
|
| Rate for Payer: Multiplan Commercial |
$9,010.50
|
| Rate for Payer: Networks By Design Commercial |
$7,809.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,211.90
|
|
|
HC TIPS TX SHEATH
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909081695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.20 |
| Max. Negotiated Rate |
$261.90 |
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Cash Price |
$160.05
|
| Rate for Payer: Central Health Plan Commercial |
$232.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.40
|
| Rate for Payer: EPIC Health Plan Senior |
$116.40
|
| Rate for Payer: Galaxy Health WC |
$247.35
|
| Rate for Payer: Global Benefits Group Commercial |
$174.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$180.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.20
|
| Rate for Payer: Multiplan Commercial |
$218.25
|
| Rate for Payer: Networks By Design Commercial |
$189.15
|
| Rate for Payer: Prime Health Services Commercial |
$247.35
|
|
|
HC TIPS TX SHEATH
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
909081695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.20 |
| Max. Negotiated Rate |
$261.90 |
| Rate for Payer: Adventist Health Commercial |
$58.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$176.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$247.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$160.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$218.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.90
|
| Rate for Payer: Blue Shield of California Commercial |
$177.80
|
| Rate for Payer: Blue Shield of California EPN |
$116.11
|
| Rate for Payer: Cash Price |
$160.05
|
| Rate for Payer: Central Health Plan Commercial |
$232.80
|
| Rate for Payer: Cigna of CA HMO |
$186.24
|
| Rate for Payer: Cigna of CA PPO |
$215.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$247.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$247.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$247.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.40
|
| Rate for Payer: EPIC Health Plan Senior |
$116.40
|
| Rate for Payer: Galaxy Health WC |
$247.35
|
| Rate for Payer: Global Benefits Group Commercial |
$174.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.90
|
| Rate for Payer: InnovAge PACE Commercial |
$145.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$194.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$180.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$203.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$203.70
|
| Rate for Payer: Multiplan Commercial |
$218.25
|
| Rate for Payer: Networks By Design Commercial |
$189.15
|
| Rate for Payer: Prime Health Services Commercial |
$247.35
|
| Rate for Payer: Riverside University Health System MISP |
$116.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.50
|
| Rate for Payer: United Healthcare All Other HMO |
$145.50
|
| Rate for Payer: United Healthcare HMO Rider |
$145.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$247.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$247.35
|
| Rate for Payer: Vantage Medical Group Senior |
$247.35
|
|
|
HC TIP SUCTION YANKAUER BULB TIP
|
Facility
|
IP
|
$2.62
|
|
| Hospital Charge Code |
901698170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.36 |
| Rate for Payer: Adventist Health Commercial |
$0.52
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Central Health Plan Commercial |
$2.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.05
|
| Rate for Payer: EPIC Health Plan Senior |
$1.05
|
| Rate for Payer: Galaxy Health WC |
$2.23
|
| Rate for Payer: Global Benefits Group Commercial |
$1.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.52
|
| Rate for Payer: Multiplan Commercial |
$1.97
|
| Rate for Payer: Networks By Design Commercial |
$1.70
|
| Rate for Payer: Prime Health Services Commercial |
$2.23
|
|
|
HC TIP SUCTION YANKAUER BULB TIP
|
Facility
|
OP
|
$2.62
|
|
| Hospital Charge Code |
901698170
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.36 |
| Rate for Payer: Adventist Health Commercial |
$0.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.54
|
| Rate for Payer: Blue Shield of California Commercial |
$1.60
|
| Rate for Payer: Blue Shield of California EPN |
$1.05
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Central Health Plan Commercial |
$2.10
|
| Rate for Payer: Cigna of CA HMO |
$1.68
|
| Rate for Payer: Cigna of CA PPO |
$1.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.05
|
| Rate for Payer: EPIC Health Plan Senior |
$1.05
|
| Rate for Payer: Galaxy Health WC |
$2.23
|
| Rate for Payer: Global Benefits Group Commercial |
$1.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.36
|
| Rate for Payer: InnovAge PACE Commercial |
$1.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.83
|
| Rate for Payer: Multiplan Commercial |
$1.97
|
| Rate for Payer: Networks By Design Commercial |
$1.70
|
| Rate for Payer: Prime Health Services Commercial |
$2.23
|
| Rate for Payer: Riverside University Health System MISP |
$1.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.31
|
| Rate for Payer: United Healthcare All Other HMO |
$1.31
|
| Rate for Payer: United Healthcare HMO Rider |
$1.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.23
|
| Rate for Payer: Vantage Medical Group Senior |
$2.23
|
|
|
HC TIP SUCTION YANKAUER REG CAP
|
Facility
|
OP
|
$4.02
|
|
| Hospital Charge Code |
901605747
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$3.62 |
| Rate for Payer: Adventist Health Commercial |
$0.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.36
|
| Rate for Payer: Blue Shield of California Commercial |
$2.46
|
| Rate for Payer: Blue Shield of California EPN |
$1.60
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Central Health Plan Commercial |
$3.22
|
| Rate for Payer: Cigna of CA HMO |
$2.57
|
| Rate for Payer: Cigna of CA PPO |
$2.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1.61
|
| Rate for Payer: Galaxy Health WC |
$3.42
|
| Rate for Payer: Global Benefits Group Commercial |
$2.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.62
|
| Rate for Payer: InnovAge PACE Commercial |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.81
|
| Rate for Payer: Multiplan Commercial |
$3.02
|
| Rate for Payer: Networks By Design Commercial |
$2.61
|
| Rate for Payer: Prime Health Services Commercial |
$3.42
|
| Rate for Payer: Riverside University Health System MISP |
$1.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.01
|
| Rate for Payer: United Healthcare All Other HMO |
$2.01
|
| Rate for Payer: United Healthcare HMO Rider |
$2.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.42
|
| Rate for Payer: Vantage Medical Group Senior |
$3.42
|
|
|
HC TIP SUCTION YANKAUER REG CAP
|
Facility
|
IP
|
$4.02
|
|
| Hospital Charge Code |
901605747
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$3.62 |
| Rate for Payer: Adventist Health Commercial |
$0.80
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Central Health Plan Commercial |
$3.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1.61
|
| Rate for Payer: Galaxy Health WC |
$3.42
|
| Rate for Payer: Global Benefits Group Commercial |
$2.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$3.02
|
| Rate for Payer: Networks By Design Commercial |
$2.61
|
| Rate for Payer: Prime Health Services Commercial |
$3.42
|
|
|
HC TISS CUL NEO BONE MARROW BLD
|
Facility
|
OP
|
$648.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900918003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$116.44 |
| Max. Negotiated Rate |
$780.06 |
| Rate for Payer: Adventist Health Commercial |
$129.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$143.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$393.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$143.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$780.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$158.31
|
| Rate for Payer: Blue Shield of California Commercial |
$393.34
|
| Rate for Payer: Blue Shield of California EPN |
$257.26
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Central Health Plan Commercial |
$518.40
|
| Rate for Payer: Cigna of CA HMO |
$414.72
|
| Rate for Payer: Cigna of CA PPO |
$479.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$215.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$158.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$143.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.06
|
| Rate for Payer: EPIC Health Plan Senior |
$143.75
|
| Rate for Payer: Galaxy Health WC |
$550.80
|
| Rate for Payer: Global Benefits Group Commercial |
$388.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$583.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$235.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$171.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$143.75
|
| Rate for Payer: InnovAge PACE Commercial |
$215.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$432.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$189.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$143.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$192.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$192.62
|
| Rate for Payer: Multiplan Commercial |
$486.00
|
| Rate for Payer: Networks By Design Commercial |
$421.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$143.75
|
| Rate for Payer: Prime Health Services Commercial |
$550.80
|
| Rate for Payer: Prime Health Services Medicare |
$152.38
|
| Rate for Payer: Riverside University Health System MISP |
$158.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$388.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$388.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$116.44
|
| Rate for Payer: United Healthcare All Other HMO |
$116.44
|
| Rate for Payer: United Healthcare HMO Rider |
$116.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.44
|
| Rate for Payer: Upland Medical Group Pediatric |
$143.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$215.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$158.12
|
| Rate for Payer: Vantage Medical Group Senior |
$143.75
|
|
|
HC TISS CUL NEO BONE MARROW BLD
|
Facility
|
IP
|
$648.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
900918003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$129.60 |
| Max. Negotiated Rate |
$583.20 |
| Rate for Payer: Adventist Health Commercial |
$129.60
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Central Health Plan Commercial |
$518.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$259.20
|
| Rate for Payer: EPIC Health Plan Senior |
$259.20
|
| Rate for Payer: Galaxy Health WC |
$550.80
|
| Rate for Payer: Global Benefits Group Commercial |
$388.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$583.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$432.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$246.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$401.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.60
|
| Rate for Payer: Multiplan Commercial |
$486.00
|
| Rate for Payer: Networks By Design Commercial |
$421.20
|
| Rate for Payer: Prime Health Services Commercial |
$550.80
|
|
|
HC TISS CUL NEO SOLID TUMOR
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 88239
|
| Hospital Charge Code |
900918002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$59.00 |
| Max. Negotiated Rate |
$265.50 |
| Rate for Payer: Adventist Health Commercial |
$59.00
|
| Rate for Payer: Cash Price |
$162.25
|
| Rate for Payer: Central Health Plan Commercial |
$236.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.00
|
| Rate for Payer: EPIC Health Plan Senior |
$118.00
|
| Rate for Payer: Galaxy Health WC |
$250.75
|
| Rate for Payer: Global Benefits Group Commercial |
$177.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$265.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$196.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$182.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.00
|
| Rate for Payer: Multiplan Commercial |
$221.25
|
| Rate for Payer: Networks By Design Commercial |
$191.75
|
| Rate for Payer: Prime Health Services Commercial |
$250.75
|
|
