|
HC TREAT SPLIT WOUND CLOS, SIMP
|
Facility
|
OP
|
$1,965.00
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
900501539
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$393.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$855.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$777.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,239.24
|
| Rate for Payer: Cash Price |
$1,080.75
|
| Rate for Payer: Cash Price |
$1,080.75
|
| Rate for Payer: Cash Price |
$1,080.75
|
| Rate for Payer: Cash Price |
$1,080.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,572.00
|
| Rate for Payer: Cigna of CA HMO |
$1,257.60
|
| Rate for Payer: Cigna of CA PPO |
$1,454.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$855.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$777.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,049.99
|
| Rate for Payer: EPIC Health Plan Senior |
$777.77
|
| Rate for Payer: Galaxy Health WC |
$1,670.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,179.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,768.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,275.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$777.77
|
| Rate for Payer: InnovAge PACE Commercial |
$1,166.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,310.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$777.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,042.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,042.21
|
| Rate for Payer: Multiplan Commercial |
$1,473.75
|
| Rate for Payer: Multiplan WC |
$1,239.24
|
| Rate for Payer: Networks By Design Commercial |
$1,277.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$777.77
|
| Rate for Payer: Preferred Health Network WC |
$1,264.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,670.25
|
| Rate for Payer: Prime Health Services Medicare |
$824.44
|
| Rate for Payer: Prime Health Services WC |
$1,226.59
|
| Rate for Payer: Riverside University Health System MISP |
$855.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,179.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$982.50
|
| Rate for Payer: United Healthcare All Other HMO |
$982.50
|
| Rate for Payer: United Healthcare HMO Rider |
$982.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$982.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$777.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$855.55
|
| Rate for Payer: Vantage Medical Group Senior |
$777.77
|
|
|
HC TREAT SPLIT WOUND CLOS, SIMP
|
Facility
|
IP
|
$1,965.00
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
900501539
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$1,768.50 |
| Rate for Payer: Adventist Health Commercial |
$393.00
|
| Rate for Payer: Cash Price |
$1,080.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,572.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$786.00
|
| Rate for Payer: EPIC Health Plan Senior |
$786.00
|
| Rate for Payer: Galaxy Health WC |
$1,670.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,179.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,768.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,310.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$748.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,216.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.00
|
| Rate for Payer: Multiplan Commercial |
$1,473.75
|
| Rate for Payer: Networks By Design Commercial |
$1,277.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,670.25
|
|
|
HC TREAT SPLIT WOUND CLOS, SIMP
|
Facility
|
OP
|
$1,965.00
|
|
|
Service Code
|
CPT 12020
|
| Hospital Charge Code |
900501539
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$393.00 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$393.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$777.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$855.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$777.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,239.24
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,080.75
|
| Rate for Payer: Cash Price |
$1,080.75
|
| Rate for Payer: Cash Price |
$1,080.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,572.00
|
| Rate for Payer: Cigna of CA HMO |
$1,257.60
|
| Rate for Payer: Cigna of CA PPO |
$1,454.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$855.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$777.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,049.99
|
| Rate for Payer: EPIC Health Plan Senior |
$777.77
|
| Rate for Payer: Galaxy Health WC |
$1,670.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,179.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,768.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,275.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$478.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$777.77
|
| Rate for Payer: InnovAge PACE Commercial |
$1,166.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,310.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$528.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$777.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$393.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,042.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,042.21
|
| Rate for Payer: Multiplan Commercial |
$1,473.75
|
| Rate for Payer: Multiplan WC |
$1,239.24
|
| Rate for Payer: Networks By Design Commercial |
$1,277.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$777.77
|
| Rate for Payer: Preferred Health Network WC |
$1,264.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,670.25
|
| Rate for Payer: Prime Health Services Medicare |
$824.44
|
| Rate for Payer: Prime Health Services WC |
$1,226.59
|
| Rate for Payer: Riverside University Health System MISP |
$855.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,179.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$777.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,166.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$855.55
|
| Rate for Payer: Vantage Medical Group Senior |
$777.77
|
|
|
HC TREAT SPLIT WOUND CLOS, W/PACK
|
Facility
|
OP
|
$1,613.00
|
|
|
Service Code
|
CPT 12021
|
| Hospital Charge Code |
900501577
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$239.10 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$322.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,290.40
|
| Rate for Payer: Cigna of CA HMO |
$1,032.32
|
| Rate for Payer: Cigna of CA PPO |
$1,193.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$1,371.05
|
| Rate for Payer: Global Benefits Group Commercial |
$967.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,451.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,075.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,209.75
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,048.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.05
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$967.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$806.50
|
| Rate for Payer: United Healthcare All Other HMO |
$806.50
|
| Rate for Payer: United Healthcare HMO Rider |
$806.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$806.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC TREAT SPLIT WOUND CLOS, W/PACK
|
Facility
|
IP
|
$1,613.00
|
|
|
Service Code
|
CPT 12021
|
| Hospital Charge Code |
900501577
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$322.60 |
| Max. Negotiated Rate |
$1,451.70 |
| Rate for Payer: Adventist Health Commercial |
$322.60
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,290.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$645.20
|
| Rate for Payer: EPIC Health Plan Senior |
$645.20
|
| Rate for Payer: Galaxy Health WC |
$1,371.05
|
| Rate for Payer: Global Benefits Group Commercial |
$967.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,451.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,075.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$614.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$998.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.60
|
| Rate for Payer: Multiplan Commercial |
$1,209.75
|
| Rate for Payer: Networks By Design Commercial |
$1,048.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.05
|
|
|
HC TREAT SPLIT WOUND CLOS, W/PACK
|
Facility
|
IP
|
$1,613.00
|
|
|
Service Code
|
CPT 12021
|
| Hospital Charge Code |
900501577
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$322.60 |
| Max. Negotiated Rate |
$1,451.70 |
| Rate for Payer: Adventist Health Commercial |
$322.60
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,290.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$645.20
|
| Rate for Payer: EPIC Health Plan Senior |
$645.20
|
| Rate for Payer: Galaxy Health WC |
$1,371.05
|
| Rate for Payer: Global Benefits Group Commercial |
$967.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,451.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,075.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$614.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$998.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.60
|
| Rate for Payer: Multiplan Commercial |
$1,209.75
|
| Rate for Payer: Networks By Design Commercial |
$1,048.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.05
|
|
|
HC TREAT SPLIT WOUND CLOS, W/PACK
|
Facility
|
OP
|
$1,613.00
|
|
|
Service Code
|
CPT 12021
|
| Hospital Charge Code |
900501577
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$216.44 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$322.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$507.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$985.54
|
| Rate for Payer: Blue Shield of California EPN |
$643.59
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,290.40
|
| Rate for Payer: Cigna of CA HMO |
$1,032.32
|
| Rate for Payer: Cigna of CA PPO |
$1,193.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$1,371.05
|
| Rate for Payer: Global Benefits Group Commercial |
$967.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,451.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$216.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,075.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,209.75
|
| Rate for Payer: Networks By Design Commercial |
$1,048.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.05
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$967.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$967.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC TREAT SPLIT WOUND CLOS, W/PACK
|
Facility
|
IP
|
$1,613.00
|
|
|
Service Code
|
CPT 12021
|
| Hospital Charge Code |
900501577
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$322.60 |
| Max. Negotiated Rate |
$1,451.70 |
| Rate for Payer: Adventist Health Commercial |
$322.60
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,290.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$645.20
|
| Rate for Payer: EPIC Health Plan Senior |
$645.20
|
| Rate for Payer: Galaxy Health WC |
$1,371.05
|
| Rate for Payer: Global Benefits Group Commercial |
$967.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,451.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,075.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$614.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$998.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.60
|
| Rate for Payer: Multiplan Commercial |
$1,209.75
|
| Rate for Payer: Networks By Design Commercial |
$1,048.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.05
|
|
|
HC TREAT SPLIT WOUND CLOS, W/PACK
|
Facility
|
OP
|
$1,613.00
|
|
|
Service Code
|
CPT 12021
|
| Hospital Charge Code |
900501577
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.44 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$322.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$507.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Cash Price |
$887.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,290.40
|
| Rate for Payer: Cigna of CA HMO |
$1,032.32
|
| Rate for Payer: Cigna of CA PPO |
$1,193.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$1,371.05
|
| Rate for Payer: Global Benefits Group Commercial |
$967.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,451.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$216.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,075.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$322.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$1,209.75
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,048.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,371.05
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$967.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
|
HC TREAT TARSAL BONE FX, W/O MANI
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
900501478
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$1,169.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,418.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$810.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,315.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC TREAT TARSAL BONE FX, W/O MANI
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 28450
|
| Hospital Charge Code |
900501478
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$274.40 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,169.30
|
| Rate for Payer: Cash Price |
$1,169.30
|
| Rate for Payer: Cash Price |
$1,169.30
|
| Rate for Payer: Cash Price |
$1,169.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: InnovAge PACE Commercial |
$457.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,418.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$274.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.79
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$323.08
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$335.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,063.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,063.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,063.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC TREAT TOE DISLOCATION W/ ANES
|
Facility
|
OP
|
$6,891.00
|
|
|
Service Code
|
CPT 28665
|
| Hospital Charge Code |
902890358
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$170.47 |
| Max. Negotiated Rate |
$6,201.90 |
| Rate for Payer: Adventist Health Commercial |
$2,825.31
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$537.66
|
| Rate for Payer: Cash Price |
$3,790.05
|
| Rate for Payer: Cash Price |
$3,790.05
|
| Rate for Payer: Cash Price |
$3,790.05
|
| Rate for Payer: Cash Price |
$3,790.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,512.80
|
| Rate for Payer: Cigna of CA HMO |
$4,410.24
|
| Rate for Payer: Cigna of CA PPO |
$5,099.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$5,857.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,134.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,201.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,596.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,378.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$5,168.25
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$4,479.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$5,857.35
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,134.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,134.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
|
HC TREAT TOE DISLOCATION W/ ANES
|
Facility
|
IP
|
$6,891.00
|
|
|
Service Code
|
CPT 28665
|
| Hospital Charge Code |
902890358
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,378.20 |
| Max. Negotiated Rate |
$6,201.90 |
| Rate for Payer: Adventist Health Commercial |
$1,378.20
|
| Rate for Payer: Cash Price |
$3,790.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,512.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,756.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,756.40
|
| Rate for Payer: Galaxy Health WC |
$5,857.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,134.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,201.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,596.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,625.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,265.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,378.20
|
| Rate for Payer: Multiplan Commercial |
$5,168.25
|
| Rate for Payer: Networks By Design Commercial |
$4,479.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,857.35
|
|
|
HC TREAT WRIST BONE FX, W/O MANIP
|
Facility
|
OP
|
$3,235.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
900501374
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$297.10 |
| Max. Negotiated Rate |
$2,911.50 |
| Rate for Payer: Adventist Health Commercial |
$647.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$1,779.25
|
| Rate for Payer: Cash Price |
$1,779.25
|
| Rate for Payer: Cash Price |
$1,779.25
|
| Rate for Payer: Cash Price |
$1,779.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,588.00
|
| Rate for Payer: Cigna of CA HMO |
$2,070.40
|
| Rate for Payer: Cigna of CA PPO |
$2,393.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$411.47
|
| Rate for Payer: EPIC Health Plan Senior |
$304.79
|
| Rate for Payer: Galaxy Health WC |
$2,749.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,941.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,911.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.79
|
| Rate for Payer: InnovAge PACE Commercial |
$457.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,157.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$304.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$647.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.42
|
| Rate for Payer: Multiplan Commercial |
$2,426.25
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$2,102.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.79
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,749.75
|
| Rate for Payer: Prime Health Services Medicare |
$323.08
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$335.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,941.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,617.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,617.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,617.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,617.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.27
|
| Rate for Payer: Vantage Medical Group Senior |
$304.79
|
|
|
HC TREAT WRIST BONE FX, W/O MANIP
|
Facility
|
IP
|
$3,235.00
|
|
|
Service Code
|
CPT 25622
|
| Hospital Charge Code |
900501374
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$647.00 |
| Max. Negotiated Rate |
$2,911.50 |
| Rate for Payer: Adventist Health Commercial |
$647.00
|
| Rate for Payer: Cash Price |
$1,779.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,588.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,294.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,294.00
|
| Rate for Payer: Galaxy Health WC |
$2,749.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,941.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,911.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,157.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,232.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,002.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$647.00
|
| Rate for Payer: Multiplan Commercial |
$2,426.25
|
| Rate for Payer: Networks By Design Commercial |
$2,102.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,749.75
|
|
|
HC TRICHROME TEST
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900911728
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$87.30 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Central Health Plan Commercial |
$77.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.80
|
| Rate for Payer: EPIC Health Plan Senior |
$38.80
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.40
|
| Rate for Payer: Multiplan Commercial |
$72.75
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
|
|
HC TRICHROME TEST
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
900911728
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$268.60 |
| Rate for Payer: Adventist Health Commercial |
$19.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.29
|
| Rate for Payer: Blue Shield of California Commercial |
$58.88
|
| Rate for Payer: Blue Shield of California EPN |
$38.51
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Cash Price |
$53.35
|
| Rate for Payer: Central Health Plan Commercial |
$77.60
|
| Rate for Payer: Cigna of CA HMO |
$62.08
|
| Rate for Payer: Cigna of CA PPO |
$71.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$82.45
|
| Rate for Payer: Global Benefits Group Commercial |
$58.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$72.75
|
| Rate for Payer: Networks By Design Commercial |
$63.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$82.45
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28.00
|
| Rate for Payer: United Healthcare HMO Rider |
$28.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC TRIGLYCERIDES
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16.80
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
|
|
HC TRIGLYCERIDES
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910234
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$41.63 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care 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 |
$8.45
|
| Rate for Payer: Blue Shield of California Commercial |
$25.49
|
| Rate for Payer: Blue Shield of California EPN |
$16.67
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: InnovAge PACE Commercial |
$8.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| 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 |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.74
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Medicare |
$6.08
|
| Rate for Payer: Riverside University Health System MISP |
$6.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| 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: Upland Medical Group Pediatric |
$5.74
|
| 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
|
$54.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900912247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.60
|
| Rate for Payer: EPIC Health Plan Senior |
$21.60
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
|
|
HC TRIGLYCERIDES BODY FLUID
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900912247
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care 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 |
$8.45
|
| Rate for Payer: Blue Shield of California Commercial |
$32.78
|
| Rate for Payer: Blue Shield of California EPN |
$21.44
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: InnovAge PACE Commercial |
$8.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| 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 |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.74
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Medicare |
$6.08
|
| Rate for Payer: Riverside University Health System MISP |
$6.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| 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: Upland Medical Group Pediatric |
$5.74
|
| 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
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910526
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$41.63 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.31
|
| Rate for Payer: Alpha Care 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 |
$8.45
|
| Rate for Payer: Blue Shield of California Commercial |
$25.49
|
| Rate for Payer: Blue Shield of California EPN |
$16.67
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.75
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.74
|
| Rate for Payer: InnovAge PACE Commercial |
$8.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| 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 |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.74
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Medicare |
$6.08
|
| Rate for Payer: Riverside University Health System MISP |
$6.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| 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: Upland Medical Group Pediatric |
$5.74
|
| 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
|
$42.00
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
900910526
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16.80
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
|
|
HC TRIIODOTHYRONINE, FREE
|
Facility
|
IP
|
$173.03
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
900912135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.61 |
| Max. Negotiated Rate |
$155.73 |
| Rate for Payer: Adventist Health Commercial |
$34.61
|
| Rate for Payer: Cash Price |
$95.17
|
| Rate for Payer: Central Health Plan Commercial |
$138.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.21
|
| Rate for Payer: EPIC Health Plan Senior |
$69.21
|
| Rate for Payer: Galaxy Health WC |
$147.08
|
| Rate for Payer: Global Benefits Group Commercial |
$103.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$115.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$107.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.61
|
| Rate for Payer: Multiplan Commercial |
$129.77
|
| Rate for Payer: Networks By Design Commercial |
$112.47
|
| Rate for Payer: Prime Health Services Commercial |
$147.08
|
|
|
HC TRIIODOTHYRONINE, FREE
|
Facility
|
OP
|
$173.03
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
900912135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.72 |
| Max. Negotiated Rate |
$155.73 |
| Rate for Payer: Adventist Health Commercial |
$34.61
|
| Rate for Payer: Adventist Health Medi-Cal |
$16.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$105.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.63
|
| Rate for Payer: Alpha Care 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 |
$25.02
|
| Rate for Payer: Blue Shield of California Commercial |
$105.03
|
| Rate for Payer: Blue Shield of California EPN |
$68.69
|
| Rate for Payer: Cash Price |
$95.17
|
| Rate for Payer: Cash Price |
$95.17
|
| Rate for Payer: Central Health Plan Commercial |
$138.42
|
| Rate for Payer: Cigna of CA HMO |
$110.74
|
| Rate for Payer: Cigna of CA PPO |
$128.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.87
|
| Rate for Payer: EPIC Health Plan Senior |
$16.94
|
| Rate for Payer: Galaxy Health WC |
$147.08
|
| Rate for Payer: Global Benefits Group Commercial |
$103.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.73
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.94
|
| Rate for Payer: InnovAge PACE Commercial |
$25.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$115.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.61
|
| 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 |
$129.77
|
| Rate for Payer: Networks By Design Commercial |
$112.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16.94
|
| Rate for Payer: Prime Health Services Commercial |
$147.08
|
| Rate for Payer: Prime Health Services Medicare |
$17.96
|
| Rate for Payer: Riverside University Health System MISP |
$18.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.82
|
| 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: Upland Medical Group Pediatric |
$16.94
|
| 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
|
|
