|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
IP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
900501576
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$522.00 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Cash Price |
$1,435.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,740.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$994.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,615.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
OP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
900501576
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$87.07 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,585.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,435.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,957.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,532.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,584.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,036.17
|
| Rate for Payer: Cash Price |
$1,435.50
|
| Rate for Payer: Cash Price |
$1,435.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: Cigna of CA HMO |
$1,670.40
|
| Rate for Payer: Cigna of CA PPO |
$1,931.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,218.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,218.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,305.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,740.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,615.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,827.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,827.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,044.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,566.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,566.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,305.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,218.50
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
IP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
901200046
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$522.00 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Cash Price |
$1,435.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,740.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$994.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,615.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
|
|
HC US GUIDE NEEDLE PLACEMENT
|
Facility
|
OP
|
$2,610.00
|
|
|
Service Code
|
CPT 76942
|
| Hospital Charge Code |
906601444
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$87.07 |
| Max. Negotiated Rate |
$2,349.00 |
| Rate for Payer: Adventist Health Commercial |
$522.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,585.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,435.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,957.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$316.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,532.85
|
| Rate for Payer: Blue Shield of California Commercial |
$1,584.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,036.17
|
| Rate for Payer: Cash Price |
$1,435.50
|
| Rate for Payer: Cash Price |
$1,435.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,088.00
|
| Rate for Payer: Cigna of CA HMO |
$1,670.40
|
| Rate for Payer: Cigna of CA PPO |
$1,931.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,218.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,218.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,044.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,044.00
|
| Rate for Payer: Galaxy Health WC |
$2,218.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,566.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,349.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,305.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,740.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,615.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$522.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,827.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,827.00
|
| Rate for Payer: Multiplan Commercial |
$1,957.50
|
| Rate for Payer: Networks By Design Commercial |
$1,696.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,218.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,044.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,566.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,566.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,305.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,305.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,218.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,218.50
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
OP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
901200114
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,462.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,324.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,806.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,414.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,462.26
|
| Rate for Payer: Blue Shield of California EPN |
$956.37
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Cigna of CA HMO |
$1,541.76
|
| Rate for Payer: Cigna of CA PPO |
$1,782.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,047.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,047.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,204.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,606.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,491.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,686.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,686.30
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
| Rate for Payer: Riverside University Health System MISP |
$963.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,445.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,445.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,204.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,204.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,204.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,204.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
OP
|
$2,155.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
906820091
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$1,939.50 |
| Rate for Payer: Adventist Health Commercial |
$431.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,308.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,831.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,185.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,616.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,265.63
|
| Rate for Payer: Blue Shield of California Commercial |
$1,308.09
|
| Rate for Payer: Blue Shield of California EPN |
$855.53
|
| Rate for Payer: Cash Price |
$1,185.25
|
| Rate for Payer: Cash Price |
$1,185.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,724.00
|
| Rate for Payer: Cigna of CA HMO |
$1,379.20
|
| Rate for Payer: Cigna of CA PPO |
$1,594.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,831.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,831.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,831.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.00
|
| Rate for Payer: EPIC Health Plan Senior |
$862.00
|
| Rate for Payer: Galaxy Health WC |
$1,831.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,293.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,939.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,077.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,437.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,333.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$431.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,508.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,508.50
|
| Rate for Payer: Multiplan Commercial |
$1,616.25
|
| Rate for Payer: Networks By Design Commercial |
$1,400.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,831.75
|
| Rate for Payer: Riverside University Health System MISP |
$862.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,293.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,293.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,077.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,077.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,077.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,077.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,831.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,831.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,831.75
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
IP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
901200114
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$481.80 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,606.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$917.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,491.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
OP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
910100008
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,462.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,324.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,806.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,414.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,462.26
|
| Rate for Payer: Blue Shield of California EPN |
$956.37
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Cigna of CA HMO |
$1,541.76
|
| Rate for Payer: Cigna of CA PPO |
$1,782.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,047.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,047.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,204.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,606.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,491.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,686.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,686.30
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
| Rate for Payer: Riverside University Health System MISP |
$963.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,445.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,445.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,204.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,204.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,204.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,204.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
IP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
910100008
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$481.80 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,606.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$917.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,491.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
OP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
909001488
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,462.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,324.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,806.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,414.81
|
| Rate for Payer: Blue Shield of California Commercial |
$1,462.26
|
| Rate for Payer: Blue Shield of California EPN |
$956.37
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: Cigna of CA HMO |
$1,541.76
|
| Rate for Payer: Cigna of CA PPO |
$1,782.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,047.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,047.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,204.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,606.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,491.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,686.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,686.30
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
| Rate for Payer: Riverside University Health System MISP |
$963.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,445.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,445.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,204.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,204.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,204.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,204.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,047.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,047.65
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
IP
|
$2,155.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
906820091
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$431.00 |
| Max. Negotiated Rate |
$1,939.50 |
| Rate for Payer: Adventist Health Commercial |
$431.00
|
| Rate for Payer: Cash Price |
$1,185.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,724.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.00
|
| Rate for Payer: EPIC Health Plan Senior |
$862.00
|
| Rate for Payer: Galaxy Health WC |
$1,831.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,293.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,939.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,437.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$821.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,333.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$431.00
|
| Rate for Payer: Multiplan Commercial |
$1,616.25
|
| Rate for Payer: Networks By Design Commercial |
$1,400.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,831.75
|
|
|
HC US GUIDE VASCULAR ACCESS
|
Facility
|
IP
|
$2,409.00
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
909001488
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$481.80 |
| Max. Negotiated Rate |
$2,168.10 |
| Rate for Payer: Adventist Health Commercial |
$481.80
|
| Rate for Payer: Cash Price |
$1,324.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,927.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$963.60
|
| Rate for Payer: EPIC Health Plan Senior |
$963.60
|
| Rate for Payer: Galaxy Health WC |
$2,047.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,445.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,168.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,606.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$917.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,491.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$481.80
|
| Rate for Payer: Multiplan Commercial |
$1,806.75
|
| Rate for Payer: Networks By Design Commercial |
$1,565.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,047.65
|
|
|
HC US GUIDE VISCERAL TISS ABLATN
|
Facility
|
OP
|
$14,482.00
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
909001920
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$240.28 |
| Max. Negotiated Rate |
$13,033.80 |
| Rate for Payer: Adventist Health Commercial |
$2,896.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,794.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,309.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,965.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,861.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$352.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,505.28
|
| Rate for Payer: Blue Shield of California Commercial |
$8,790.57
|
| Rate for Payer: Blue Shield of California EPN |
$5,749.35
|
| Rate for Payer: Cash Price |
$7,965.10
|
| Rate for Payer: Cash Price |
$7,965.10
|
| Rate for Payer: Central Health Plan Commercial |
$11,585.60
|
| Rate for Payer: Cigna of CA HMO |
$9,268.48
|
| Rate for Payer: Cigna of CA PPO |
$10,716.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,309.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,309.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12,309.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,792.80
|
| Rate for Payer: Galaxy Health WC |
$12,309.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,689.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,033.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$240.28
|
| Rate for Payer: InnovAge PACE Commercial |
$7,241.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,659.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$265.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,964.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,896.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,137.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,137.40
|
| Rate for Payer: Multiplan Commercial |
$10,861.50
|
| Rate for Payer: Networks By Design Commercial |
$9,413.30
|
| Rate for Payer: Prime Health Services Commercial |
$12,309.70
|
| Rate for Payer: Riverside University Health System MISP |
$5,792.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,689.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,689.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,241.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,241.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,241.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,241.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,309.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,309.70
|
| Rate for Payer: Vantage Medical Group Senior |
$12,309.70
|
|
|
HC US GUIDE VISCERAL TISS ABLATN
|
Facility
|
IP
|
$14,482.00
|
|
|
Service Code
|
CPT 76940
|
| Hospital Charge Code |
909001920
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$2,896.40 |
| Max. Negotiated Rate |
$13,033.80 |
| Rate for Payer: Adventist Health Commercial |
$2,896.40
|
| Rate for Payer: Cash Price |
$7,965.10
|
| Rate for Payer: Central Health Plan Commercial |
$11,585.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,792.80
|
| Rate for Payer: Galaxy Health WC |
$12,309.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,689.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,033.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,659.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,517.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,964.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,896.40
|
| Rate for Payer: Multiplan Commercial |
$10,861.50
|
| Rate for Payer: Networks By Design Commercial |
$9,413.30
|
| Rate for Payer: Prime Health Services Commercial |
$12,309.70
|
|
|
HC US INFANT HIP W/O MANIPULATION
|
Facility
|
OP
|
$2,258.00
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
906601414
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$111.88 |
| Max. Negotiated Rate |
$2,032.20 |
| Rate for Payer: Adventist Health Commercial |
$451.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,371.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$295.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,326.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,370.61
|
| Rate for Payer: Blue Shield of California EPN |
$896.43
|
| Rate for Payer: Cash Price |
$1,241.90
|
| Rate for Payer: Cash Price |
$1,241.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,806.40
|
| Rate for Payer: Cigna of CA HMO |
$1,445.12
|
| Rate for Payer: Cigna of CA PPO |
$1,670.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$1,919.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,354.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,032.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$116.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: InnovAge PACE Commercial |
$167.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,506.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$451.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$149.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$1,693.50
|
| Rate for Payer: Networks By Design Commercial |
$1,467.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.88
|
| Rate for Payer: Prime Health Services Commercial |
$1,919.30
|
| Rate for Payer: Prime Health Services Medicare |
$118.59
|
| Rate for Payer: Riverside University Health System MISP |
$123.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,354.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,354.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC US INFANT HIP W/O MANIPULATION
|
Facility
|
IP
|
$2,258.00
|
|
|
Service Code
|
CPT 76886
|
| Hospital Charge Code |
906601414
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$451.60 |
| Max. Negotiated Rate |
$2,032.20 |
| Rate for Payer: Adventist Health Commercial |
$451.60
|
| Rate for Payer: Cash Price |
$1,241.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,806.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$903.20
|
| Rate for Payer: EPIC Health Plan Senior |
$903.20
|
| Rate for Payer: Galaxy Health WC |
$1,919.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,354.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,032.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,506.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$860.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,397.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$451.60
|
| Rate for Payer: Multiplan Commercial |
$1,693.50
|
| Rate for Payer: Networks By Design Commercial |
$1,467.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,919.30
|
|
|
HC US SOFT TISS EXT COMP
|
Facility
|
IP
|
$2,247.00
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
906601419
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$449.40 |
| Max. Negotiated Rate |
$2,022.30 |
| Rate for Payer: Adventist Health Commercial |
$449.40
|
| Rate for Payer: Cash Price |
$1,235.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,797.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$898.80
|
| Rate for Payer: EPIC Health Plan Senior |
$898.80
|
| Rate for Payer: Galaxy Health WC |
$1,909.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,348.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,022.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,498.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$856.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,390.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$449.40
|
| Rate for Payer: Multiplan Commercial |
$1,685.25
|
| Rate for Payer: Networks By Design Commercial |
$1,460.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,909.95
|
|
|
HC US SOFT TISS EXT COMP
|
Facility
|
OP
|
$2,247.00
|
|
|
Service Code
|
CPT 76881
|
| Hospital Charge Code |
906601419
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$91.66 |
| Max. Negotiated Rate |
$2,022.30 |
| Rate for Payer: Adventist Health Commercial |
$449.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,364.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$500.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,319.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,363.93
|
| Rate for Payer: Blue Shield of California EPN |
$892.06
|
| Rate for Payer: Cash Price |
$1,235.85
|
| Rate for Payer: Cash Price |
$1,235.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,797.60
|
| Rate for Payer: Cigna of CA HMO |
$1,438.08
|
| Rate for Payer: Cigna of CA PPO |
$1,662.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,909.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,348.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,022.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$91.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,498.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$449.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,685.25
|
| Rate for Payer: Networks By Design Commercial |
$1,460.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,909.95
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,348.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,348.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$246.56
|
| Rate for Payer: United Healthcare All Other HMO |
$246.56
|
| Rate for Payer: United Healthcare HMO Rider |
$246.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC US SOFT TISS EXT LMTD
|
Facility
|
OP
|
$2,007.00
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
906601421
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$45.13 |
| Max. Negotiated Rate |
$1,806.30 |
| Rate for Payer: Adventist Health Commercial |
$401.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,218.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,178.71
|
| Rate for Payer: Blue Shield of California Commercial |
$1,218.25
|
| Rate for Payer: Blue Shield of California EPN |
$796.78
|
| Rate for Payer: Cash Price |
$1,103.85
|
| Rate for Payer: Cash Price |
$1,103.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,605.60
|
| Rate for Payer: Cigna of CA HMO |
$1,284.48
|
| Rate for Payer: Cigna of CA PPO |
$1,485.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,705.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,806.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$45.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,505.25
|
| Rate for Payer: Networks By Design Commercial |
$1,304.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,705.95
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,204.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,204.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC US SOFT TISS EXT LMTD
|
Facility
|
IP
|
$2,007.00
|
|
|
Service Code
|
CPT 76882
|
| Hospital Charge Code |
906601421
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$401.40 |
| Max. Negotiated Rate |
$1,806.30 |
| Rate for Payer: Adventist Health Commercial |
$401.40
|
| Rate for Payer: Cash Price |
$1,103.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,605.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$802.80
|
| Rate for Payer: EPIC Health Plan Senior |
$802.80
|
| Rate for Payer: Galaxy Health WC |
$1,705.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,204.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,806.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,338.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$764.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,242.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$401.40
|
| Rate for Payer: Multiplan Commercial |
$1,505.25
|
| Rate for Payer: Networks By Design Commercial |
$1,304.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,705.95
|
|
|
HC US SOFT TISSUE MASS,HEAD/NECK
|
Facility
|
IP
|
$1,831.00
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
906601405
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$366.20 |
| Max. Negotiated Rate |
$1,647.90 |
| Rate for Payer: Adventist Health Commercial |
$366.20
|
| Rate for Payer: Cash Price |
$1,007.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,464.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.40
|
| Rate for Payer: EPIC Health Plan Senior |
$732.40
|
| Rate for Payer: Galaxy Health WC |
$1,556.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,098.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,647.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,221.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$697.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,133.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$366.20
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: Networks By Design Commercial |
$1,190.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,556.35
|
|
|
HC US SOFT TISSUE MASS,HEAD/NECK
|
Facility
|
OP
|
$1,831.00
|
|
|
Service Code
|
CPT 76536
|
| Hospital Charge Code |
906601405
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$102.75 |
| Max. Negotiated Rate |
$1,647.90 |
| Rate for Payer: Adventist Health Commercial |
$366.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,111.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$296.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,075.35
|
| Rate for Payer: Blue Shield of California Commercial |
$1,111.42
|
| Rate for Payer: Blue Shield of California EPN |
$726.91
|
| Rate for Payer: Cash Price |
$1,007.05
|
| Rate for Payer: Cash Price |
$1,007.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,464.80
|
| Rate for Payer: Cigna of CA HMO |
$1,171.84
|
| Rate for Payer: Cigna of CA PPO |
$1,354.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,556.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,098.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,647.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$102.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,221.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$366.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: Networks By Design Commercial |
$1,190.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,556.35
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,098.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,098.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$246.56
|
| Rate for Payer: United Healthcare All Other HMO |
$246.56
|
| Rate for Payer: United Healthcare HMO Rider |
$246.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC US TRANSRECTAL
|
Facility
|
IP
|
$2,317.00
|
|
|
Service Code
|
CPT 76872
|
| Hospital Charge Code |
906601408
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$463.40 |
| Max. Negotiated Rate |
$2,085.30 |
| Rate for Payer: Adventist Health Commercial |
$463.40
|
| Rate for Payer: Cash Price |
$1,274.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,853.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$926.80
|
| Rate for Payer: EPIC Health Plan Senior |
$926.80
|
| Rate for Payer: Galaxy Health WC |
$1,969.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,390.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,085.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,545.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$882.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,434.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$463.40
|
| Rate for Payer: Multiplan Commercial |
$1,737.75
|
| Rate for Payer: Networks By Design Commercial |
$1,506.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,969.45
|
|
|
HC US TRANSRECTAL
|
Facility
|
OP
|
$2,317.00
|
|
|
Service Code
|
CPT 76872
|
| Hospital Charge Code |
906601408
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$116.36 |
| Max. Negotiated Rate |
$2,085.30 |
| Rate for Payer: Adventist Health Commercial |
$463.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,407.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$283.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,360.77
|
| Rate for Payer: Blue Shield of California Commercial |
$1,406.42
|
| Rate for Payer: Blue Shield of California EPN |
$919.85
|
| Rate for Payer: Cash Price |
$1,274.35
|
| Rate for Payer: Cash Price |
$1,274.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,853.60
|
| Rate for Payer: Cigna of CA HMO |
$1,482.88
|
| Rate for Payer: Cigna of CA PPO |
$1,714.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,969.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,390.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,085.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$116.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,545.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$463.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,737.75
|
| Rate for Payer: Networks By Design Commercial |
$1,506.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,969.45
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,390.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$246.56
|
| Rate for Payer: United Healthcare All Other HMO |
$246.56
|
| Rate for Payer: United Healthcare HMO Rider |
$246.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC US TRGT DYN MBUBB 1ST LSN
|
Facility
|
OP
|
$652.00
|
|
|
Service Code
|
CPT 76978
|
| Hospital Charge Code |
906676978
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$130.40 |
| Max. Negotiated Rate |
$1,961.23 |
| Rate for Payer: Adventist Health Commercial |
$130.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$395.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,961.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.92
|
| Rate for Payer: Blue Shield of California Commercial |
$395.76
|
| Rate for Payer: Blue Shield of California EPN |
$258.84
|
| Rate for Payer: Cash Price |
$358.60
|
| Rate for Payer: Cash Price |
$358.60
|
| Rate for Payer: Central Health Plan Commercial |
$521.60
|
| Rate for Payer: Cigna of CA HMO |
$417.28
|
| Rate for Payer: Cigna of CA PPO |
$482.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$554.20
|
| Rate for Payer: Global Benefits Group Commercial |
$391.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$586.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$480.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$434.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$530.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$489.00
|
| Rate for Payer: Networks By Design Commercial |
$423.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$554.20
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$391.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$391.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$516.45
|
| Rate for Payer: United Healthcare All Other HMO |
$516.45
|
| Rate for Payer: United Healthcare HMO Rider |
$516.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$516.45
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
