|
HC TRIGLYCERIDES BODY FLUID
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900912247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$50.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.78
|
| Rate for Payer: BCBS Transplant Transplant |
$10.20
|
| Rate for Payer: Blue Shield of California Commercial |
$10.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Caremore Medicare Advantage |
$5.74
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Cash Price |
$7.65
|
| Rate for Payer: Central Health Plan Commercial |
$13.60
|
| Rate for Payer: Cigna of CA HMO |
$10.88
|
| Rate for Payer: Cigna of CA PPO |
$12.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$14.45
|
| Rate for Payer: Global Benefits Group Commercial |
$10.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: IEHP medi-cal |
$9.47
|
| Rate for Payer: IEHP Medicare Advantage |
$5.74
|
| Rate for Payer: Innovage PACE Commercial |
$8.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$12.75
|
| Rate for Payer: Networks By Design Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$6.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: Riverside University Health MISP |
$6.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
|
|
HC TRIGLYCERIDES BODY FLUID
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900912247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC TRIGLYCERIDES INDIVIDUAL
|
Facility
OP
|
$19.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910526
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$50.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$41.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.78
|
| Rate for Payer: BCBS Transplant Transplant |
$11.40
|
| Rate for Payer: Blue Shield of California Commercial |
$11.74
|
| Rate for Payer: Blue Shield of California EPN |
$9.23
|
| Rate for Payer: Caremore Medicare Advantage |
$5.74
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Cash Price |
$8.55
|
| Rate for Payer: Central Health Plan Commercial |
$15.20
|
| Rate for Payer: Cigna of CA HMO |
$12.16
|
| Rate for Payer: Cigna of CA PPO |
$14.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$16.15
|
| Rate for Payer: Global Benefits Group Commercial |
$11.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: IEHP medi-cal |
$9.47
|
| Rate for Payer: IEHP Medicare Advantage |
$5.74
|
| Rate for Payer: Innovage PACE Commercial |
$8.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$14.25
|
| Rate for Payer: Networks By Design Commercial |
$12.35
|
| Rate for Payer: Prime Health Services Commercial |
$16.15
|
| Rate for Payer: Prime Health Services Medicare |
$6.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: Riverside University Health MISP |
$6.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
|
|
HC TRIGLYCERIDES INDIVIDUAL
|
Facility
IP
|
$89.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910526
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Central Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.60
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.80
|
| Rate for Payer: Multiplan Commercial |
$66.75
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
|
|
HC TRIIODOTHYRONINE, FREE
|
Facility
IP
|
$276.00
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
900912135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$248.40 |
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Central Health Plan Commercial |
$220.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.40
|
| Rate for Payer: Galaxy Health WC |
$234.60
|
| Rate for Payer: Global Benefits Group Commercial |
$165.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$248.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$184.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.20
|
| Rate for Payer: Multiplan Commercial |
$207.00
|
| Rate for Payer: Networks By Design Commercial |
$179.40
|
| Rate for Payer: Prime Health Services Commercial |
$234.60
|
|
|
HC TRIIODOTHYRONINE, FREE
|
Facility
OP
|
$65.00
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
900912135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$150.37 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$124.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$123.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$150.37
|
| Rate for Payer: BCBS Transplant Transplant |
$39.00
|
| Rate for Payer: Blue Shield of California Commercial |
$40.17
|
| Rate for Payer: Blue Shield of California EPN |
$31.59
|
| Rate for Payer: Caremore Medicare Advantage |
$16.94
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Cash Price |
$29.25
|
| Rate for Payer: Central Health Plan Commercial |
$52.00
|
| Rate for Payer: Cigna of CA HMO |
$41.60
|
| Rate for Payer: Cigna of CA PPO |
$48.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.94
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.94
|
| Rate for Payer: Galaxy Health WC |
$55.25
|
| Rate for Payer: Global Benefits Group Commercial |
$39.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$48.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.78
|
| Rate for Payer: IEHP medi-cal |
$27.95
|
| Rate for Payer: IEHP Medicare Advantage |
$16.94
|
| Rate for Payer: Innovage PACE Commercial |
$25.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.70
|
| Rate for Payer: Multiplan Commercial |
$48.75
|
| Rate for Payer: Networks By Design Commercial |
$42.25
|
| Rate for Payer: Prime Health Services Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Medicare |
$17.96
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$39.00
|
| Rate for Payer: Riverside University Health MISP |
$18.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.72
|
| Rate for Payer: United Healthcare All Other HMO |
$13.72
|
| Rate for Payer: United Healthcare HMO Rider |
$13.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: Vantage Medical Group Senior |
$16.94
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
IP
|
$332.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$298.80 |
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Central Health Plan Commercial |
$265.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.80
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.40
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
OP
|
$332.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$2,696.00 |
| 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 |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| 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 |
$199.20
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Central Health Plan Commercial |
$265.60
|
| Rate for Payer: Cigna of CA PPO |
$245.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$249.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$199.20
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$199.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.00
|
| Rate for Payer: United Healthcare All Other HMO |
$166.00
|
| Rate for Payer: United Healthcare HMO Rider |
$166.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$166.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
IP
|
$332.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$298.80 |
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Central Health Plan Commercial |
$265.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.80
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.40
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
|
|
HC TRIMMING NONDYSTROPHIC NAILS
|
Facility
OP
|
$332.00
|
|
|
Service Code
|
CPT 11719
|
| Hospital Charge Code |
900501406
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$42.03 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$76.42
|
| 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 |
$199.20
|
| Rate for Payer: Blue Shield of California Commercial |
$208.83
|
| Rate for Payer: Blue Shield of California EPN |
$162.35
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Central Health Plan Commercial |
$265.60
|
| Rate for Payer: Cigna of CA HMO |
$212.48
|
| Rate for Payer: Cigna of CA PPO |
$245.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$249.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: IEHP medi-cal |
$126.09
|
| Rate for Payer: IEHP Medicare Advantage |
$76.42
|
| Rate for Payer: Innovage PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$199.20
|
| Rate for Payer: Riverside University Health MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$199.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$199.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.00
|
| Rate for Payer: United Healthcare All Other HMO |
$166.00
|
| Rate for Payer: United Healthcare HMO Rider |
$166.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$166.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC TRIM SKIN LESION, 2 TO 4
|
Facility
OP
|
$420.00
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
902890346
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$250.14
|
| 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 |
$252.00
|
| Rate for Payer: Blue Shield of California Commercial |
$264.18
|
| Rate for Payer: Blue Shield of California EPN |
$205.38
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Central Health Plan Commercial |
$336.00
|
| Rate for Payer: Cigna of CA HMO |
$268.80
|
| Rate for Payer: Cigna of CA PPO |
$310.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$378.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$315.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: IEHP medi-cal |
$412.73
|
| Rate for Payer: IEHP Medicare Advantage |
$250.14
|
| Rate for Payer: Innovage PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$280.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$315.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$252.00
|
| Rate for Payer: Riverside University Health MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$252.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$252.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$210.00
|
| Rate for Payer: United Healthcare All Other HMO |
$210.00
|
| Rate for Payer: United Healthcare HMO Rider |
$210.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$210.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC TRIM SKIN LESION, 2 TO 4
|
Facility
IP
|
$420.00
|
|
|
Service Code
|
CPT 11056
|
| Hospital Charge Code |
902890346
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Central Health Plan Commercial |
$336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.00
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$378.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$280.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$315.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
|
|
HC TRIM SKIN LESION MORE THAN 4
|
Facility
OP
|
$583.00
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
900101494
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$282.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$344.44
|
| Rate for Payer: BCBS Transplant Transplant |
$349.80
|
| Rate for Payer: Blue Shield of California Commercial |
$366.71
|
| Rate for Payer: Blue Shield of California EPN |
$285.09
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$262.35
|
| Rate for Payer: Cash Price |
$262.35
|
| Rate for Payer: Central Health Plan Commercial |
$466.40
|
| Rate for Payer: Cigna of CA HMO |
$373.12
|
| Rate for Payer: Cigna of CA PPO |
$431.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$495.55
|
| Rate for Payer: Global Benefits Group Commercial |
$349.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$524.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$437.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: IEHP medi-cal |
$412.73
|
| Rate for Payer: IEHP Medicare Advantage |
$250.14
|
| Rate for Payer: Innovage PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$388.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$437.25
|
| Rate for Payer: Networks By Design Commercial |
$378.95
|
| Rate for Payer: Prime Health Services Commercial |
$495.55
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$349.80
|
| Rate for Payer: Riverside University Health MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$349.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$349.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$291.50
|
| Rate for Payer: United Healthcare All Other HMO |
$291.50
|
| Rate for Payer: United Healthcare HMO Rider |
$291.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$291.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC TRIM SKIN LESION MORE THAN 4
|
Facility
IP
|
$583.00
|
|
|
Service Code
|
CPT 11057
|
| Hospital Charge Code |
900101494
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$116.60 |
| Max. Negotiated Rate |
$524.70 |
| Rate for Payer: Cash Price |
$262.35
|
| Rate for Payer: Central Health Plan Commercial |
$466.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.20
|
| Rate for Payer: Galaxy Health WC |
$495.55
|
| Rate for Payer: Global Benefits Group Commercial |
$349.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$524.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$388.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.60
|
| Rate for Payer: Multiplan Commercial |
$437.25
|
| Rate for Payer: Networks By Design Commercial |
$378.95
|
| Rate for Payer: Prime Health Services Commercial |
$495.55
|
|
|
HC TRIM SKIN LESION, SINGLE
|
Facility
IP
|
$411.00
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
902890267
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$82.20 |
| Max. Negotiated Rate |
$369.90 |
| Rate for Payer: Cash Price |
$184.95
|
| Rate for Payer: Central Health Plan Commercial |
$328.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$164.40
|
| Rate for Payer: Galaxy Health WC |
$349.35
|
| Rate for Payer: Global Benefits Group Commercial |
$246.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$369.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$274.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.20
|
| Rate for Payer: Multiplan Commercial |
$308.25
|
| Rate for Payer: Networks By Design Commercial |
$267.15
|
| Rate for Payer: Prime Health Services Commercial |
$349.35
|
|
|
HC TRIM SKIN LESION, SINGLE
|
Facility
OP
|
$411.00
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
902890267
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$82.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$250.14
|
| 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 |
$246.60
|
| Rate for Payer: Blue Shield of California Commercial |
$258.52
|
| Rate for Payer: Blue Shield of California EPN |
$200.98
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$184.95
|
| Rate for Payer: Cash Price |
$184.95
|
| Rate for Payer: Cash Price |
$184.95
|
| Rate for Payer: Central Health Plan Commercial |
$328.80
|
| Rate for Payer: Cigna of CA HMO |
$263.04
|
| Rate for Payer: Cigna of CA PPO |
$304.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$349.35
|
| Rate for Payer: Global Benefits Group Commercial |
$246.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$369.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$308.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: IEHP medi-cal |
$412.73
|
| Rate for Payer: IEHP Medicare Advantage |
$250.14
|
| Rate for Payer: Innovage PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$274.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$308.25
|
| Rate for Payer: Networks By Design Commercial |
$267.15
|
| Rate for Payer: Prime Health Services Commercial |
$349.35
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$246.60
|
| Rate for Payer: Riverside University Health MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$246.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$246.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$205.50
|
| Rate for Payer: United Healthcare All Other HMO |
$205.50
|
| Rate for Payer: United Healthcare HMO Rider |
$205.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$205.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
IP
|
$13,062.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
906820285
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,612.40 |
| Max. Negotiated Rate |
$11,755.80 |
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Central Health Plan Commercial |
$10,449.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,224.80
|
| Rate for Payer: Galaxy Health WC |
$11,102.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,837.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,755.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,712.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,612.40
|
| Rate for Payer: Multiplan Commercial |
$9,796.50
|
| Rate for Payer: Networks By Design Commercial |
$8,490.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,102.70
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
OP
|
$13,062.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
906820285
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$11,755.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11,102.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,184.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,184.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,837.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Central Health Plan Commercial |
$10,449.60
|
| Rate for Payer: Cigna of CA PPO |
$9,665.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,102.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,224.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,224.80
|
| Rate for Payer: Galaxy Health WC |
$11,102.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,837.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,755.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,796.50
|
| Rate for Payer: IEHP medi-cal |
$4,571.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,712.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,612.40
|
| Rate for Payer: Multiplan Commercial |
$9,796.50
|
| Rate for Payer: Networks By Design Commercial |
$8,490.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,102.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,837.20
|
| Rate for Payer: Riverside University Health MISP |
$5,224.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,837.20
|
| 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 |
$11,102.70
|
| Rate for Payer: Vantage Medical Group Senior |
$11,102.70
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
IP
|
$13,062.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
909037247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,612.40 |
| Max. Negotiated Rate |
$11,755.80 |
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Central Health Plan Commercial |
$10,449.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,224.80
|
| Rate for Payer: Galaxy Health WC |
$11,102.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,837.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,755.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,712.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,612.40
|
| Rate for Payer: Multiplan Commercial |
$9,796.50
|
| Rate for Payer: Networks By Design Commercial |
$8,490.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,102.70
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
OP
|
$13,062.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
909037247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$11,755.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11,102.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,184.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,184.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,837.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Cash Price |
$5,877.90
|
| Rate for Payer: Central Health Plan Commercial |
$10,449.60
|
| Rate for Payer: Cigna of CA PPO |
$9,665.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,102.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,224.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,224.80
|
| Rate for Payer: Galaxy Health WC |
$11,102.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,837.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,755.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,796.50
|
| Rate for Payer: IEHP medi-cal |
$4,571.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,712.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,612.40
|
| Rate for Payer: Multiplan Commercial |
$9,796.50
|
| Rate for Payer: Networks By Design Commercial |
$8,490.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,102.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,837.20
|
| Rate for Payer: Riverside University Health MISP |
$5,224.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,837.20
|
| 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 |
$11,102.70
|
| Rate for Payer: Vantage Medical Group Senior |
$11,102.70
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
IP
|
$12,759.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,551.80 |
| Max. Negotiated Rate |
$11,483.10 |
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Central Health Plan Commercial |
$10,207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,103.60
|
| Rate for Payer: Galaxy Health WC |
$10,845.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,655.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,483.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,510.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,551.80
|
| Rate for Payer: Multiplan Commercial |
$9,569.25
|
| Rate for Payer: Networks By Design Commercial |
$8,293.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,845.15
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
OP
|
$12,759.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
906820287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$11,483.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,845.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,017.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,017.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,655.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Central Health Plan Commercial |
$10,207.20
|
| Rate for Payer: Cigna of CA PPO |
$9,441.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,845.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,103.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,103.60
|
| Rate for Payer: Galaxy Health WC |
$10,845.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,655.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,483.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,569.25
|
| Rate for Payer: IEHP medi-cal |
$4,465.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,510.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,551.80
|
| Rate for Payer: Multiplan Commercial |
$9,569.25
|
| Rate for Payer: Networks By Design Commercial |
$8,293.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,845.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,655.40
|
| Rate for Payer: Riverside University Health MISP |
$5,103.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,655.40
|
| 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 |
$10,845.15
|
| Rate for Payer: Vantage Medical Group Senior |
$10,845.15
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
OP
|
$12,759.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$11,483.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,845.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,017.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,017.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,655.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Central Health Plan Commercial |
$10,207.20
|
| Rate for Payer: Cigna of CA PPO |
$9,441.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,845.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,103.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,103.60
|
| Rate for Payer: Galaxy Health WC |
$10,845.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,655.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,483.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,569.25
|
| Rate for Payer: IEHP medi-cal |
$4,465.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,510.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,551.80
|
| Rate for Payer: Multiplan Commercial |
$9,569.25
|
| Rate for Payer: Networks By Design Commercial |
$8,293.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,845.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,655.40
|
| Rate for Payer: Riverside University Health MISP |
$5,103.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,655.40
|
| 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 |
$10,845.15
|
| Rate for Payer: Vantage Medical Group Senior |
$10,845.15
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
IP
|
$12,759.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
906820287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,551.80 |
| Max. Negotiated Rate |
$11,483.10 |
| Rate for Payer: Cash Price |
$5,741.55
|
| Rate for Payer: Central Health Plan Commercial |
$10,207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,103.60
|
| Rate for Payer: Galaxy Health WC |
$10,845.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,655.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,483.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,510.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,551.80
|
| Rate for Payer: Multiplan Commercial |
$9,569.25
|
| Rate for Payer: Networks By Design Commercial |
$8,293.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,845.15
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
IP
|
$29,780.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
906820284
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,956.00 |
| Max. Negotiated Rate |
$26,802.00 |
| Rate for Payer: Cash Price |
$13,401.00
|
| Rate for Payer: Central Health Plan Commercial |
$23,824.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,912.00
|
| Rate for Payer: Galaxy Health WC |
$25,313.00
|
| Rate for Payer: Global Benefits Group Commercial |
$17,868.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,802.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,863.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,956.00
|
| Rate for Payer: Multiplan Commercial |
$22,335.00
|
| Rate for Payer: Networks By Design Commercial |
$19,357.00
|
| Rate for Payer: Prime Health Services Commercial |
$25,313.00
|
|
