|
HC TRAY, RADIAL ARTERY CATH 2.5FR
|
Facility
IP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$233.45
|
| 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 TRAY, RADIAL ARTERY CATH 2.5FR
|
Facility
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698160
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$1,019.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,019.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| 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: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: IEHP medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TREAT FOOT DISLOCATION W/ANEST
|
Facility
IP
|
$1,428.00
|
|
|
Service Code
|
CPT 28605
|
| Hospital Charge Code |
902890262
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$1,285.20 |
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,142.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$571.20
|
| Rate for Payer: Galaxy Health WC |
$1,213.80
|
| Rate for Payer: Global Benefits Group Commercial |
$856.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,285.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$952.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$285.60
|
| Rate for Payer: Multiplan Commercial |
$1,071.00
|
| Rate for Payer: Networks By Design Commercial |
$928.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,213.80
|
|
|
HC TREAT FOOT DISLOCATION W/ANEST
|
Facility
OP
|
$1,428.00
|
|
|
Service Code
|
CPT 28605
|
| Hospital Charge Code |
902890262
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$856.80
|
| Rate for Payer: Blue Shield of California Commercial |
$898.21
|
| Rate for Payer: Blue Shield of California EPN |
$698.29
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,142.40
|
| Rate for Payer: Cigna of CA HMO |
$913.92
|
| Rate for Payer: Cigna of CA PPO |
$1,056.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,213.80
|
| Rate for Payer: Global Benefits Group Commercial |
$856.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,285.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,071.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$486.16
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$952.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$285.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,071.00
|
| Rate for Payer: Networks By Design Commercial |
$928.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,213.80
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$856.80
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$856.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$856.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$714.00
|
| Rate for Payer: United Healthcare All Other HMO |
$714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$714.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$714.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC TREAT FOOT DISLOCATION W/ANEST
|
Facility
OP
|
$1,428.00
|
|
|
Service Code
|
CPT 28605
|
| Hospital Charge Code |
902890262
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$856.80
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,142.40
|
| Rate for Payer: Cigna of CA PPO |
$1,056.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,213.80
|
| Rate for Payer: Global Benefits Group Commercial |
$856.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,285.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,071.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$952.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$285.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,071.00
|
| Rate for Payer: Networks By Design Commercial |
$928.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,213.80
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$856.80
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$856.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$714.00
|
| Rate for Payer: United Healthcare All Other HMO |
$714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$714.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$714.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC TREAT FOOT DISLOCATION W/ANEST
|
Facility
IP
|
$1,428.00
|
|
|
Service Code
|
CPT 28605
|
| Hospital Charge Code |
902890262
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$1,285.20 |
| Rate for Payer: Cash Price |
$642.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,142.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$571.20
|
| Rate for Payer: Galaxy Health WC |
$1,213.80
|
| Rate for Payer: Global Benefits Group Commercial |
$856.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,285.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$952.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$285.60
|
| Rate for Payer: Multiplan Commercial |
$1,071.00
|
| Rate for Payer: Networks By Design Commercial |
$928.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,213.80
|
|
|
HC TREAT FX RADIUS & ULNA
|
Facility
OP
|
$27,434.00
|
|
|
Service Code
|
CPT 25575
|
| Hospital Charge Code |
900501765
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$24,690.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$12,220.24
|
| Rate for Payer: BCBS Transplant Transplant |
$16,460.40
|
| Rate for Payer: Caremore Medicare Advantage |
$8,938.53
|
| Rate for Payer: Cash Price |
$12,345.30
|
| Rate for Payer: Cash Price |
$12,345.30
|
| Rate for Payer: Cash Price |
$12,345.30
|
| Rate for Payer: Cash Price |
$12,345.30
|
| Rate for Payer: Central Health Plan Commercial |
$21,947.20
|
| Rate for Payer: Cigna of CA PPO |
$20,301.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$23,318.90
|
| Rate for Payer: Global Benefits Group Commercial |
$16,460.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,690.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20,575.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,659.19
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$8,938.53
|
| Rate for Payer: Innovage PACE Commercial |
$13,407.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,298.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,486.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,977.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$20,575.50
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$17,832.10
|
| Rate for Payer: Preferred Health Network WC |
$12,469.63
|
| Rate for Payer: Prime Health Services Commercial |
$23,318.90
|
| Rate for Payer: Prime Health Services Medicare |
$9,474.84
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,460.40
|
| Rate for Payer: Riverside University Health MISP |
$9,832.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,460.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,717.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13,717.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,717.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,717.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC TREAT FX RADIUS & ULNA
|
Facility
IP
|
$27,434.00
|
|
|
Service Code
|
CPT 25575
|
| Hospital Charge Code |
900501765
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$5,486.80 |
| Max. Negotiated Rate |
$24,690.60 |
| Rate for Payer: Cash Price |
$12,345.30
|
| Rate for Payer: Central Health Plan Commercial |
$21,947.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,973.60
|
| Rate for Payer: Galaxy Health WC |
$23,318.90
|
| Rate for Payer: Global Benefits Group Commercial |
$16,460.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,690.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,298.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,486.80
|
| Rate for Payer: Multiplan Commercial |
$20,575.50
|
| Rate for Payer: Networks By Design Commercial |
$17,832.10
|
| Rate for Payer: Prime Health Services Commercial |
$23,318.90
|
|
|
HC TREAT HIP DISLOC W/O ANESTH/MA
|
Facility
OP
|
$1,782.00
|
|
|
Service Code
|
CPT 27256
|
| Hospital Charge Code |
900501604
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,069.20
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$801.90
|
| Rate for Payer: Cash Price |
$801.90
|
| Rate for Payer: Cash Price |
$801.90
|
| Rate for Payer: Cash Price |
$801.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,425.60
|
| Rate for Payer: Cigna of CA PPO |
$1,318.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,514.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,069.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,603.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,336.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,188.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,336.50
|
| Rate for Payer: Networks By Design Commercial |
$1,158.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,514.70
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,069.20
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,069.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$891.00
|
| Rate for Payer: United Healthcare All Other HMO |
$891.00
|
| Rate for Payer: United Healthcare HMO Rider |
$891.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$891.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC TREAT HIP DISLOC W/O ANESTH/MA
|
Facility
IP
|
$1,782.00
|
|
|
Service Code
|
CPT 27256
|
| Hospital Charge Code |
900501604
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$356.40 |
| Max. Negotiated Rate |
$1,603.80 |
| Rate for Payer: Cash Price |
$801.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,425.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$712.80
|
| Rate for Payer: Galaxy Health WC |
$1,514.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,069.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,603.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,188.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$356.40
|
| Rate for Payer: Multiplan Commercial |
$1,336.50
|
| Rate for Payer: Networks By Design Commercial |
$1,158.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,514.70
|
|
|
HC TREAT HIP SOCKET FRACTURE
|
Facility
OP
|
$834.00
|
|
|
Service Code
|
CPT 27222
|
| Hospital Charge Code |
900507222
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$166.80 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$708.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$458.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$458.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$500.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Cash Price |
$375.30
|
| Rate for Payer: Cash Price |
$375.30
|
| Rate for Payer: Central Health Plan Commercial |
$667.20
|
| Rate for Payer: Cigna of CA PPO |
$617.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$708.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$333.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$333.60
|
| Rate for Payer: Galaxy Health WC |
$708.90
|
| Rate for Payer: Global Benefits Group Commercial |
$500.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$750.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$625.50
|
| Rate for Payer: IEHP medi-cal |
$291.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$556.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.80
|
| Rate for Payer: Multiplan Commercial |
$625.50
|
| Rate for Payer: Networks By Design Commercial |
$542.10
|
| Rate for Payer: Prime Health Services Commercial |
$708.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$500.40
|
| Rate for Payer: Riverside University Health MISP |
$333.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$500.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$708.90
|
| Rate for Payer: Vantage Medical Group Senior |
$708.90
|
|
|
HC TREAT HIP SOCKET FRACTURE
|
Facility
IP
|
$834.00
|
|
|
Service Code
|
CPT 27222
|
| Hospital Charge Code |
900507222
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$166.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$375.30
|
| Rate for Payer: Cash Price |
$375.30
|
| Rate for Payer: Central Health Plan Commercial |
$667.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$333.60
|
| Rate for Payer: Galaxy Health WC |
$708.90
|
| Rate for Payer: Global Benefits Group Commercial |
$500.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$750.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$556.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.80
|
| Rate for Payer: Multiplan Commercial |
$625.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$708.90
|
|
|
HC TREAT HIP SOCKET FX
|
Facility
IP
|
$706.00
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
900501683
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$141.20 |
| Max. Negotiated Rate |
$635.40 |
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Central Health Plan Commercial |
$564.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$600.10
|
| Rate for Payer: Global Benefits Group Commercial |
$423.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$635.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$470.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.20
|
| Rate for Payer: Multiplan Commercial |
$529.50
|
| Rate for Payer: Networks By Design Commercial |
$458.90
|
| Rate for Payer: Prime Health Services Commercial |
$600.10
|
|
|
HC TREAT HIP SOCKET FX
|
Facility
OP
|
$706.00
|
|
|
Service Code
|
CPT 27220
|
| Hospital Charge Code |
900501683
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$141.20 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$423.60
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Cash Price |
$317.70
|
| Rate for Payer: Central Health Plan Commercial |
$564.80
|
| Rate for Payer: Cigna of CA PPO |
$522.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$600.10
|
| Rate for Payer: Global Benefits Group Commercial |
$423.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$635.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$529.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$470.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$141.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$529.50
|
| Rate for Payer: Networks By Design Commercial |
$458.90
|
| Rate for Payer: Prime Health Services Commercial |
$600.10
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$423.60
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$423.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$353.00
|
| Rate for Payer: United Healthcare All Other HMO |
$353.00
|
| Rate for Payer: United Healthcare HMO Rider |
$353.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$353.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC TREAT INCOMPLETE ABORTION SURG
|
Facility
IP
|
$8,195.00
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
900501515
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,639.00 |
| Max. Negotiated Rate |
$7,375.50 |
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,278.00
|
| Rate for Payer: Galaxy Health WC |
$6,965.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,375.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,466.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.00
|
| Rate for Payer: Multiplan Commercial |
$6,146.25
|
| Rate for Payer: Networks By Design Commercial |
$5,326.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,965.75
|
|
|
HC TREAT INCOMPLETE ABORTION SURG
|
Facility
OP
|
$8,195.00
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
900501515
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,639.00 |
| Max. Negotiated Rate |
$11,071.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,906.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,917.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,154.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,007.36
|
| Rate for Payer: Caremore Medicare Advantage |
$3,906.18
|
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Cigna of CA HMO |
$5,244.80
|
| Rate for Payer: Cigna of CA PPO |
$6,064.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Galaxy Health WC |
$6,965.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,375.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,146.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: IEHP medi-cal |
$6,445.20
|
| Rate for Payer: IEHP Medicare Advantage |
$3,906.18
|
| Rate for Payer: Innovage PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,466.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Multiplan Commercial |
$6,146.25
|
| Rate for Payer: Networks By Design Commercial |
$5,326.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,965.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,917.00
|
| Rate for Payer: Riverside University Health MISP |
$4,296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,917.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,917.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,097.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,097.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,097.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,097.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC TREAT INCOMPLETE ABORTION SURG
|
Facility
OP
|
$8,195.00
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
900501515
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,071.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,917.00
|
| Rate for Payer: Caremore Medicare Advantage |
$3,906.18
|
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Cigna of CA PPO |
$6,064.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Galaxy Health WC |
$6,965.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,375.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,146.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$3,906.18
|
| Rate for Payer: Innovage PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,466.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Multiplan Commercial |
$6,146.25
|
| Rate for Payer: Networks By Design Commercial |
$5,326.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,965.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,917.00
|
| Rate for Payer: Riverside University Health MISP |
$4,296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,917.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,097.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,097.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,097.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,097.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC TREAT INCOMPLETE ABORTION SURG
|
Facility
IP
|
$8,195.00
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
900501515
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,639.00 |
| Max. Negotiated Rate |
$7,375.50 |
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,278.00
|
| Rate for Payer: Galaxy Health WC |
$6,965.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,375.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,466.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.00
|
| Rate for Payer: Multiplan Commercial |
$6,146.25
|
| Rate for Payer: Networks By Design Commercial |
$5,326.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,965.75
|
|
|
HC TREAT INCOMPLETE ABORTION SURG
|
Facility
IP
|
$8,195.00
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
900501515
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,639.00 |
| Max. Negotiated Rate |
$7,375.50 |
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,278.00
|
| Rate for Payer: Galaxy Health WC |
$6,965.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,375.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,466.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.00
|
| Rate for Payer: Multiplan Commercial |
$6,146.25
|
| Rate for Payer: Networks By Design Commercial |
$5,326.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,965.75
|
|
|
HC TREAT INCOMPLETE ABORTION SURG
|
Facility
OP
|
$8,195.00
|
|
|
Service Code
|
CPT 59812
|
| Hospital Charge Code |
900501515
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,639.00 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,906.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,917.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$3,906.18
|
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Cash Price |
$3,687.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Cigna of CA PPO |
$6,064.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Galaxy Health WC |
$6,965.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,917.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,375.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,146.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: IEHP medi-cal |
$6,445.20
|
| Rate for Payer: IEHP Medicare Advantage |
$3,906.18
|
| Rate for Payer: Innovage PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,466.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,639.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Multiplan Commercial |
$6,146.25
|
| Rate for Payer: Networks By Design Commercial |
$5,326.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,965.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,917.00
|
| Rate for Payer: Riverside University Health MISP |
$4,296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,917.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC TREATMENT EA ADDL 15 MIN
|
Facility
OP
|
$162.00
|
|
| Hospital Charge Code |
903204112
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$56.70 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$98.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$137.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$89.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$89.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$97.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Central Health Plan Commercial |
$129.60
|
| Rate for Payer: Cigna of CA HMO |
$103.68
|
| Rate for Payer: Cigna of CA PPO |
$119.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$137.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$64.80
|
| Rate for Payer: Galaxy Health WC |
$137.70
|
| Rate for Payer: Global Benefits Group Commercial |
$97.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$145.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$121.50
|
| Rate for Payer: IEHP medi-cal |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.42
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
| Rate for Payer: Networks By Design Commercial |
$105.30
|
| Rate for Payer: Prime Health Services Commercial |
$137.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$97.20
|
| Rate for Payer: Riverside University Health MISP |
$64.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$97.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$97.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$137.70
|
| Rate for Payer: Vantage Medical Group Senior |
$137.70
|
|
|
HC TREATMENT EA ADDL 15 MIN
|
Facility
IP
|
$162.00
|
|
| Hospital Charge Code |
903204112
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$145.80 |
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Central Health Plan Commercial |
$129.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.80
|
| Rate for Payer: Galaxy Health WC |
$137.70
|
| Rate for Payer: Global Benefits Group Commercial |
$97.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$145.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.40
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
| Rate for Payer: Networks By Design Commercial |
$105.30
|
| Rate for Payer: Prime Health Services Commercial |
$137.70
|
|
|
HC TREATMENT EA ADDL 15 MIN
|
Facility
OP
|
$120.00
|
|
| Hospital Charge Code |
905104315
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$72.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$102.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$66.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$66.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$72.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Cigna of CA HMO |
$76.80
|
| Rate for Payer: Cigna of CA PPO |
$88.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$90.00
|
| Rate for Payer: IEHP medi-cal |
$42.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: Riverside University Health MISP |
$48.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.00
|
| Rate for Payer: Vantage Medical Group Senior |
$102.00
|
|
|
HC TREATMENT EA ADDL 15 MIN
|
Facility
IP
|
$120.00
|
|
| Hospital Charge Code |
905104315
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
|
|
HC TREATMENT INITIAL 30 MIN
|
Facility
IP
|
$269.00
|
|
| Hospital Charge Code |
905104314
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$53.80 |
| Max. Negotiated Rate |
$242.10 |
| Rate for Payer: Cash Price |
$121.05
|
| Rate for Payer: Central Health Plan Commercial |
$215.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.60
|
| Rate for Payer: Galaxy Health WC |
$228.65
|
| Rate for Payer: Global Benefits Group Commercial |
$161.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$242.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$179.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.80
|
| Rate for Payer: Multiplan Commercial |
$201.75
|
| Rate for Payer: Networks By Design Commercial |
$174.85
|
| Rate for Payer: Prime Health Services Commercial |
$228.65
|
|
