|
HC UNLSTD MALE GENITAL SURG PROC
|
Facility
IP
|
$759.00
|
|
|
Service Code
|
CPT 55899
|
| Hospital Charge Code |
900501624
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$151.80 |
| Max. Negotiated Rate |
$683.10 |
| Rate for Payer: Cash Price |
$341.55
|
| Rate for Payer: Central Health Plan Commercial |
$607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.60
|
| Rate for Payer: Galaxy Health WC |
$645.15
|
| Rate for Payer: Global Benefits Group Commercial |
$455.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$683.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$506.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.80
|
| Rate for Payer: Multiplan Commercial |
$569.25
|
| Rate for Payer: Networks By Design Commercial |
$493.35
|
| Rate for Payer: Prime Health Services Commercial |
$645.15
|
|
|
HC UNLSTD PROCEDURE TRACHEA BRONC
|
Facility
OP
|
$2,546.00
|
|
|
Service Code
|
CPT 31899
|
| Hospital Charge Code |
900501511
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$247.49 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$247.49
|
| 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 |
$1,527.60
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$1,145.70
|
| Rate for Payer: Cash Price |
$1,145.70
|
| Rate for Payer: Cash Price |
$1,145.70
|
| Rate for Payer: Cash Price |
$1,145.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,036.80
|
| Rate for Payer: Cigna of CA PPO |
$1,884.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$2,164.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,527.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,291.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,909.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$247.49
|
| Rate for Payer: Innovage PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,698.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$509.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| Rate for Payer: Multiplan Commercial |
$1,909.50
|
| Rate for Payer: Networks By Design Commercial |
$1,654.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,164.10
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,527.60
|
| Rate for Payer: Riverside University Health MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,527.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,273.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,273.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,273.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC UNLSTD PROCEDURE TRACHEA BRONC
|
Facility
IP
|
$2,546.00
|
|
|
Service Code
|
CPT 31899
|
| Hospital Charge Code |
900501511
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$509.20 |
| Max. Negotiated Rate |
$2,291.40 |
| Rate for Payer: Cash Price |
$1,145.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,036.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,018.40
|
| Rate for Payer: Galaxy Health WC |
$2,164.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,527.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,291.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,698.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$509.20
|
| Rate for Payer: Multiplan Commercial |
$1,909.50
|
| Rate for Payer: Networks By Design Commercial |
$1,654.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,164.10
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
IP
|
$312.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Central Health Plan Commercial |
$249.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.80
|
| Rate for Payer: Galaxy Health WC |
$265.20
|
| Rate for Payer: Global Benefits Group Commercial |
$187.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$280.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$234.00
|
| Rate for Payer: Networks By Design Commercial |
$202.80
|
| Rate for Payer: Prime Health Services Commercial |
$265.20
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
IP
|
$312.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Central Health Plan Commercial |
$249.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.80
|
| Rate for Payer: Galaxy Health WC |
$265.20
|
| Rate for Payer: Global Benefits Group Commercial |
$187.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$280.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$234.00
|
| Rate for Payer: Networks By Design Commercial |
$202.80
|
| Rate for Payer: Prime Health Services Commercial |
$265.20
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
OP
|
$312.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$62.40 |
| 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 |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$187.20
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Central Health Plan Commercial |
$249.60
|
| Rate for Payer: Cigna of CA PPO |
$230.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$265.20
|
| Rate for Payer: Global Benefits Group Commercial |
$187.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$280.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$234.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$234.00
|
| Rate for Payer: Networks By Design Commercial |
$202.80
|
| Rate for Payer: Prime Health Services Commercial |
$265.20
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$187.20
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.00
|
| Rate for Payer: United Healthcare All Other HMO |
$156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$156.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$156.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC UNLSTD PROC PALATE/UVULA
|
Facility
OP
|
$312.00
|
|
|
Service Code
|
CPT 42299
|
| Hospital Charge Code |
900501745
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$189.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$187.20
|
| Rate for Payer: Blue Shield of California Commercial |
$196.25
|
| Rate for Payer: Blue Shield of California EPN |
$152.57
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Central Health Plan Commercial |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$199.68
|
| Rate for Payer: Cigna of CA PPO |
$230.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$265.20
|
| Rate for Payer: Global Benefits Group Commercial |
$187.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$280.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$234.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$503.56
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$208.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$234.00
|
| Rate for Payer: Networks By Design Commercial |
$202.80
|
| Rate for Payer: Prime Health Services Commercial |
$265.20
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$187.20
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$187.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.00
|
| Rate for Payer: United Healthcare All Other HMO |
$156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$156.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$156.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC UNLSTD TEAR DUCT SYSTEM SURGRY
|
Facility
IP
|
$837.00
|
|
|
Service Code
|
CPT 68899
|
| Hospital Charge Code |
900501716
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$167.40 |
| Max. Negotiated Rate |
$753.30 |
| Rate for Payer: Cash Price |
$376.65
|
| Rate for Payer: Central Health Plan Commercial |
$669.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.80
|
| Rate for Payer: Galaxy Health WC |
$711.45
|
| Rate for Payer: Global Benefits Group Commercial |
$502.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$558.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.40
|
| Rate for Payer: Multiplan Commercial |
$627.75
|
| Rate for Payer: Networks By Design Commercial |
$544.05
|
| Rate for Payer: Prime Health Services Commercial |
$711.45
|
|
|
HC UNLSTD TEAR DUCT SYSTEM SURGRY
|
Facility
OP
|
$837.00
|
|
|
Service Code
|
CPT 68899
|
| Hospital Charge Code |
900501716
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$167.40 |
| Max. Negotiated Rate |
$1,834.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$363.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$508.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$545.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$400.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$363.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$405.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$494.50
|
| Rate for Payer: BCBS Transplant Transplant |
$502.20
|
| Rate for Payer: Blue Shield of California Commercial |
$526.47
|
| Rate for Payer: Blue Shield of California EPN |
$409.29
|
| Rate for Payer: Caremore Medicare Advantage |
$363.98
|
| Rate for Payer: Cash Price |
$376.65
|
| Rate for Payer: Cash Price |
$376.65
|
| Rate for Payer: Central Health Plan Commercial |
$669.60
|
| Rate for Payer: Cigna of CA PPO |
$619.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$545.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$491.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$363.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$363.98
|
| Rate for Payer: Galaxy Health WC |
$711.45
|
| Rate for Payer: Global Benefits Group Commercial |
$502.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$753.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$627.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$596.93
|
| Rate for Payer: IEHP medi-cal |
$600.57
|
| Rate for Payer: IEHP Medicare Advantage |
$363.98
|
| Rate for Payer: Innovage PACE Commercial |
$545.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$558.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$363.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$167.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$487.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$487.73
|
| Rate for Payer: Multiplan Commercial |
$627.75
|
| Rate for Payer: Networks By Design Commercial |
$544.05
|
| Rate for Payer: Prime Health Services Commercial |
$711.45
|
| Rate for Payer: Prime Health Services Medicare |
$385.82
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$502.20
|
| Rate for Payer: Riverside University Health MISP |
$400.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$502.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$502.20
|
| 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 Commercial/Exchange |
$545.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$400.38
|
| Rate for Payer: Vantage Medical Group Senior |
$363.98
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
OP
|
$516.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.20 |
| Max. Negotiated Rate |
$1,834.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$196.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$313.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$249.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$304.85
|
| Rate for Payer: BCBS Transplant Transplant |
$309.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$196.87
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Central Health Plan Commercial |
$412.80
|
| Rate for Payer: Cigna of CA PPO |
$381.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$196.87
|
| Rate for Payer: Galaxy Health WC |
$438.60
|
| Rate for Payer: Global Benefits Group Commercial |
$309.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$464.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$387.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$322.87
|
| Rate for Payer: IEHP medi-cal |
$324.84
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Innovage PACE Commercial |
$295.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$344.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.81
|
| Rate for Payer: Multiplan Commercial |
$387.00
|
| Rate for Payer: Networks By Design Commercial |
$335.40
|
| Rate for Payer: Prime Health Services Commercial |
$438.60
|
| Rate for Payer: Prime Health Services Medicare |
$208.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$309.60
|
| Rate for Payer: Riverside University Health MISP |
$216.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$309.60
|
| 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 Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
OP
|
$516.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.20 |
| 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 |
$295.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$196.87
|
| 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 |
$309.60
|
| Rate for Payer: Caremore Medicare Advantage |
$196.87
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Central Health Plan Commercial |
$412.80
|
| Rate for Payer: Cigna of CA PPO |
$381.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$196.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$196.87
|
| Rate for Payer: Galaxy Health WC |
$438.60
|
| Rate for Payer: Global Benefits Group Commercial |
$309.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$464.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$387.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$322.87
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$196.87
|
| Rate for Payer: Innovage PACE Commercial |
$295.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$344.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$196.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.81
|
| Rate for Payer: Multiplan Commercial |
$387.00
|
| Rate for Payer: Networks By Design Commercial |
$335.40
|
| Rate for Payer: Prime Health Services Commercial |
$438.60
|
| Rate for Payer: Prime Health Services Medicare |
$208.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$309.60
|
| Rate for Payer: Riverside University Health MISP |
$216.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$309.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$258.00
|
| Rate for Payer: United Healthcare All Other HMO |
$258.00
|
| Rate for Payer: United Healthcare HMO Rider |
$258.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$258.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$216.56
|
| Rate for Payer: Vantage Medical Group Senior |
$196.87
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
IP
|
$516.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.20 |
| Max. Negotiated Rate |
$464.40 |
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Central Health Plan Commercial |
$412.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$206.40
|
| Rate for Payer: Galaxy Health WC |
$438.60
|
| Rate for Payer: Global Benefits Group Commercial |
$309.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$464.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$344.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.20
|
| Rate for Payer: Multiplan Commercial |
$387.00
|
| Rate for Payer: Networks By Design Commercial |
$335.40
|
| Rate for Payer: Prime Health Services Commercial |
$438.60
|
|
|
HC UNLST PROC CASTING/STRAPPING
|
Facility
IP
|
$516.00
|
|
|
Service Code
|
CPT 29799
|
| Hospital Charge Code |
900501651
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.20 |
| Max. Negotiated Rate |
$464.40 |
| Rate for Payer: Cash Price |
$232.20
|
| Rate for Payer: Central Health Plan Commercial |
$412.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$206.40
|
| Rate for Payer: Galaxy Health WC |
$438.60
|
| Rate for Payer: Global Benefits Group Commercial |
$309.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$464.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$344.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.20
|
| Rate for Payer: Multiplan Commercial |
$387.00
|
| Rate for Payer: Networks By Design Commercial |
$335.40
|
| Rate for Payer: Prime Health Services Commercial |
$438.60
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
IP
|
$607.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$121.40 |
| Max. Negotiated Rate |
$546.30 |
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Central Health Plan Commercial |
$485.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.80
|
| Rate for Payer: Galaxy Health WC |
$515.95
|
| Rate for Payer: Global Benefits Group Commercial |
$364.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$546.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$404.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.40
|
| Rate for Payer: Multiplan Commercial |
$455.25
|
| Rate for Payer: Networks By Design Commercial |
$394.55
|
| Rate for Payer: Prime Health Services Commercial |
$515.95
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
OP
|
$607.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$121.40 |
| 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 |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$364.20
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Central Health Plan Commercial |
$485.60
|
| Rate for Payer: Cigna of CA PPO |
$449.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$515.95
|
| Rate for Payer: Global Benefits Group Commercial |
$364.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$546.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$455.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$404.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$455.25
|
| Rate for Payer: Networks By Design Commercial |
$394.55
|
| Rate for Payer: Prime Health Services Commercial |
$515.95
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$364.20
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$364.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$303.50
|
| Rate for Payer: United Healthcare All Other HMO |
$303.50
|
| Rate for Payer: United Healthcare HMO Rider |
$303.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$303.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
IP
|
$607.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$121.40 |
| Max. Negotiated Rate |
$546.30 |
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Central Health Plan Commercial |
$485.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$242.80
|
| Rate for Payer: Galaxy Health WC |
$515.95
|
| Rate for Payer: Global Benefits Group Commercial |
$364.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$546.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$404.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.40
|
| Rate for Payer: Multiplan Commercial |
$455.25
|
| Rate for Payer: Networks By Design Commercial |
$394.55
|
| Rate for Payer: Prime Health Services Commercial |
$515.95
|
|
|
HC UNLST PROC TONGUE FLOOR OF MOUTH
|
Facility
OP
|
$607.00
|
|
|
Service Code
|
CPT 41599
|
| Hospital Charge Code |
900501220
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$121.40 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$368.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$364.20
|
| Rate for Payer: Blue Shield of California Commercial |
$381.80
|
| Rate for Payer: Blue Shield of California EPN |
$296.82
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Cash Price |
$273.15
|
| Rate for Payer: Central Health Plan Commercial |
$485.60
|
| Rate for Payer: Cigna of CA HMO |
$388.48
|
| Rate for Payer: Cigna of CA PPO |
$449.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$515.95
|
| Rate for Payer: Global Benefits Group Commercial |
$364.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$546.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$455.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$503.56
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$404.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$455.25
|
| Rate for Payer: Networks By Design Commercial |
$394.55
|
| Rate for Payer: Prime Health Services Commercial |
$515.95
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$364.20
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$364.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$364.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$303.50
|
| Rate for Payer: United Healthcare All Other HMO |
$303.50
|
| Rate for Payer: United Healthcare HMO Rider |
$303.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$303.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC UNOS REGISTRATION HEART
|
Facility
IP
|
$1,264.00
|
|
| Hospital Charge Code |
902200120
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,264.00 |
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: OptumHealth/URN Transplant Tricare |
$1,264.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
|
|
HC UNOS REGISTRATION HEART
|
Facility
OP
|
$1,264.00
|
|
| Hospital Charge Code |
902200120
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$767.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$695.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$695.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$746.77
|
| Rate for Payer: BCBS Transplant Transplant |
$758.40
|
| Rate for Payer: Blue Shield of California Commercial |
$795.06
|
| Rate for Payer: Blue Shield of California EPN |
$618.10
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Cigna of CA HMO |
$808.96
|
| Rate for Payer: Cigna of CA PPO |
$935.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,074.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$948.00
|
| Rate for Payer: IEHP medi-cal |
$442.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: Riverside University Health MISP |
$505.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$758.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.00
|
| Rate for Payer: United Healthcare All Other HMO |
$632.00
|
| Rate for Payer: United Healthcare HMO Rider |
$632.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.40
|
|
|
HC UNOS REGISTRATION KIDNEY
|
Facility
OP
|
$1,264.00
|
|
| Hospital Charge Code |
904700020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$767.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$695.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$695.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$746.77
|
| Rate for Payer: BCBS Transplant Transplant |
$758.40
|
| Rate for Payer: Blue Shield of California Commercial |
$795.06
|
| Rate for Payer: Blue Shield of California EPN |
$618.10
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Cigna of CA HMO |
$808.96
|
| Rate for Payer: Cigna of CA PPO |
$935.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,074.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$948.00
|
| Rate for Payer: IEHP medi-cal |
$442.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: Riverside University Health MISP |
$505.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$758.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.00
|
| Rate for Payer: United Healthcare All Other HMO |
$632.00
|
| Rate for Payer: United Healthcare HMO Rider |
$632.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.40
|
|
|
HC UNOS REGISTRATION KIDNEY
|
Facility
IP
|
$1,264.00
|
|
| Hospital Charge Code |
904700020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,264.00 |
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: OptumHealth/URN Transplant Tricare |
$1,264.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
|
|
HC UNOS REGISTRATION LIVER
|
Facility
OP
|
$1,264.00
|
|
| Hospital Charge Code |
904700520
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$767.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$695.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$695.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$746.77
|
| Rate for Payer: BCBS Transplant Transplant |
$758.40
|
| Rate for Payer: Blue Shield of California Commercial |
$795.06
|
| Rate for Payer: Blue Shield of California EPN |
$618.10
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Cigna of CA HMO |
$808.96
|
| Rate for Payer: Cigna of CA PPO |
$935.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,074.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$948.00
|
| Rate for Payer: IEHP medi-cal |
$442.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: Riverside University Health MISP |
$505.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$758.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.00
|
| Rate for Payer: United Healthcare All Other HMO |
$632.00
|
| Rate for Payer: United Healthcare HMO Rider |
$632.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.40
|
|
|
HC UNOS REGISTRATION LIVER
|
Facility
IP
|
$1,264.00
|
|
| Hospital Charge Code |
904700520
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,264.00 |
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: OptumHealth/URN Transplant Tricare |
$1,264.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
|
|
HC UNOS REGISTRATION PANCREAS
|
Facility
IP
|
$1,264.00
|
|
| Hospital Charge Code |
904701020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,264.00 |
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: OptumHealth/URN Transplant Tricare |
$1,264.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
|
|
HC UNOS REGISTRATION PANCREAS
|
Facility
OP
|
$1,264.00
|
|
| Hospital Charge Code |
904701020
|
|
Hospital Revenue Code
|
810
|
| Min. Negotiated Rate |
$252.80 |
| Max. Negotiated Rate |
$1,137.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$767.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,074.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$695.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$695.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$612.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$746.77
|
| Rate for Payer: BCBS Transplant Transplant |
$758.40
|
| Rate for Payer: Blue Shield of California Commercial |
$795.06
|
| Rate for Payer: Blue Shield of California EPN |
$618.10
|
| Rate for Payer: Cash Price |
$568.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,011.20
|
| Rate for Payer: Cigna of CA HMO |
$808.96
|
| Rate for Payer: Cigna of CA PPO |
$935.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,074.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$505.60
|
| Rate for Payer: Galaxy Health WC |
$1,074.40
|
| Rate for Payer: Global Benefits Group Commercial |
$758.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,137.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$948.00
|
| Rate for Payer: IEHP medi-cal |
$442.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$843.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$252.80
|
| Rate for Payer: Multiplan Commercial |
$948.00
|
| Rate for Payer: Networks By Design Commercial |
$821.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,074.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: Riverside University Health MISP |
$505.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$758.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$758.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$632.00
|
| Rate for Payer: United Healthcare All Other HMO |
$632.00
|
| Rate for Payer: United Healthcare HMO Rider |
$632.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$632.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,074.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,074.40
|
|
