|
HC VEEG EA 12-26HR CONT MNTRD
|
Facility
|
IP
|
$4,485.00
|
|
|
Service Code
|
CPT 95716
|
| Hospital Charge Code |
900605716
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$897.00 |
| Max. Negotiated Rate |
$4,036.50 |
| Rate for Payer: Adventist Health Commercial |
$897.00
|
| Rate for Payer: Cash Price |
$2,466.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,588.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,794.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,794.00
|
| Rate for Payer: Galaxy Health WC |
$3,812.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,691.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,036.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,991.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,708.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,776.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$897.00
|
| Rate for Payer: Multiplan Commercial |
$3,363.75
|
| Rate for Payer: Networks By Design Commercial |
$2,915.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,812.25
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
|
IP
|
$2,290.45
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$458.09 |
| Max. Negotiated Rate |
$2,061.41 |
| Rate for Payer: Adventist Health Commercial |
$458.09
|
| Rate for Payer: Cash Price |
$1,259.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$916.18
|
| Rate for Payer: EPIC Health Plan Senior |
$916.18
|
| Rate for Payer: Galaxy Health WC |
$1,946.88
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$872.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,417.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.09
|
| Rate for Payer: Multiplan Commercial |
$1,717.84
|
| Rate for Payer: Networks By Design Commercial |
$1,488.79
|
| Rate for Payer: Prime Health Services Commercial |
$1,946.88
|
|
|
HC VEEG EA 12-26HR INTMT MNTRD
|
Facility
|
OP
|
$2,290.45
|
|
|
Service Code
|
CPT 95715
|
| Hospital Charge Code |
900605715
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$458.09 |
| Max. Negotiated Rate |
$7,371.92 |
| Rate for Payer: Adventist Health Commercial |
$458.09
|
| Rate for Payer: Adventist Health Medi-Cal |
$674.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,390.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,371.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,345.18
|
| Rate for Payer: Blue Shield of California Commercial |
$1,390.30
|
| Rate for Payer: Blue Shield of California EPN |
$909.31
|
| Rate for Payer: Cash Price |
$1,259.75
|
| Rate for Payer: Cash Price |
$1,259.75
|
| Rate for Payer: Cash Price |
$1,259.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.36
|
| Rate for Payer: Cigna of CA HMO |
$1,465.89
|
| Rate for Payer: Cigna of CA PPO |
$1,694.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$1,946.88
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,123.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: InnovAge PACE Commercial |
$1,011.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,241.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$903.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$1,717.84
|
| Rate for Payer: Networks By Design Commercial |
$1,488.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$674.18
|
| Rate for Payer: Prime Health Services Commercial |
$1,946.88
|
| Rate for Payer: Prime Health Services Medicare |
$714.63
|
| Rate for Payer: Riverside University Health System MISP |
$741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,374.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,374.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
|
IP
|
$2,389.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$477.80 |
| Max. Negotiated Rate |
$2,150.10 |
| Rate for Payer: Adventist Health Commercial |
$477.80
|
| Rate for Payer: Cash Price |
$1,313.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,911.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$955.60
|
| Rate for Payer: EPIC Health Plan Senior |
$955.60
|
| Rate for Payer: Galaxy Health WC |
$2,030.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,433.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,150.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,593.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$910.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,478.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$477.80
|
| Rate for Payer: Multiplan Commercial |
$1,791.75
|
| Rate for Payer: Networks By Design Commercial |
$1,552.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,030.65
|
|
|
HC VEEG EA 12-26HR UNMNTRD
|
Facility
|
OP
|
$2,389.00
|
|
|
Service Code
|
CPT 95714
|
| Hospital Charge Code |
900605714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$455.92 |
| Max. Negotiated Rate |
$2,150.10 |
| Rate for Payer: Adventist Health Commercial |
$477.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$674.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,450.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$674.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,624.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,403.06
|
| Rate for Payer: Blue Shield of California Commercial |
$1,450.12
|
| Rate for Payer: Blue Shield of California EPN |
$948.43
|
| Rate for Payer: Cash Price |
$1,313.95
|
| Rate for Payer: Cash Price |
$1,313.95
|
| Rate for Payer: Cash Price |
$1,313.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,911.20
|
| Rate for Payer: Cigna of CA HMO |
$1,528.96
|
| Rate for Payer: Cigna of CA PPO |
$1,767.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$674.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.14
|
| Rate for Payer: EPIC Health Plan Senior |
$674.18
|
| Rate for Payer: Galaxy Health WC |
$2,030.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,433.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,150.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,105.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$455.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$674.18
|
| Rate for Payer: InnovAge PACE Commercial |
$1,011.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,593.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$503.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$674.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$477.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$903.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$903.40
|
| Rate for Payer: Multiplan Commercial |
$1,791.75
|
| Rate for Payer: Networks By Design Commercial |
$1,552.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$674.18
|
| Rate for Payer: Prime Health Services Commercial |
$2,030.65
|
| Rate for Payer: Prime Health Services Medicare |
$714.63
|
| Rate for Payer: Riverside University Health System MISP |
$741.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,433.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,433.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,896.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,389.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,272.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$674.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,011.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.60
|
| Rate for Payer: Vantage Medical Group Senior |
$674.18
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.51 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$245.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA HMO |
$209.28
|
| Rate for Payer: Cigna of CA PPO |
$241.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$163.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$202.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$228.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$228.90
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
| Rate for Payer: Riverside University Health System MISP |
$130.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.50
|
| Rate for Payer: United Healthcare All Other HMO |
$163.50
|
| Rate for Payer: United Healthcare HMO Rider |
$163.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$163.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$202.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$44.82 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$245.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$158.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$192.05
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA HMO |
$209.28
|
| Rate for Payer: Cigna of CA PPO |
$241.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$44.82
|
| Rate for Payer: InnovAge PACE Commercial |
$163.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$202.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$228.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$228.90
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
| Rate for Payer: Riverside University Health System MISP |
$130.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC VEIN NEEDLE INTRACATH EACH
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 36000
|
| Hospital Charge Code |
909081307
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Adventist Health Commercial |
$65.40
|
| Rate for Payer: Cash Price |
$179.85
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Senior |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$202.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
|
IP
|
$797.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.40 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.80
|
| Rate for Payer: EPIC Health Plan Senior |
$318.80
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$531.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$303.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$493.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
|
|
HC VELOPHARYNGEAL STUDY
|
Facility
|
OP
|
$797.00
|
|
|
Service Code
|
CPT 70371
|
| Hospital Charge Code |
909001252
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$87.56 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$307.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$484.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$431.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.56
|
| Rate for Payer: Blue Shield of California Commercial |
$483.78
|
| Rate for Payer: Blue Shield of California EPN |
$316.41
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: Cigna of CA HMO |
$510.08
|
| Rate for Payer: Cigna of CA PPO |
$589.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.63
|
| Rate for Payer: EPIC Health Plan Senior |
$307.13
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$307.13
|
| Rate for Payer: InnovAge PACE Commercial |
$460.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$531.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$303.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$307.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$411.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.55
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$307.13
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
| Rate for Payer: Prime Health Services Medicare |
$325.56
|
| Rate for Payer: Riverside University Health System MISP |
$337.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$478.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$478.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$307.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Vantage Medical Group Senior |
$307.13
|
|
|
HC VENA CAVA FILTER
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,159.43
|
| Rate for Payer: Blue Shield of California Commercial |
$3,014.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC VENA CAVA FILTER
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1880
|
| Hospital Charge Code |
909081250
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,014.70
|
| Rate for Payer: Blue Shield of California EPN |
$1,965.60
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
OP
|
$813.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$113.89 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$162.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$807.84
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Central Health Plan Commercial |
$650.40
|
| Rate for Payer: Cigna of CA HMO |
$520.32
|
| Rate for Payer: Cigna of CA PPO |
$601.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$760.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$557.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$684.48
|
| Rate for Payer: EPIC Health Plan Senior |
$507.02
|
| Rate for Payer: Galaxy Health WC |
$691.05
|
| Rate for Payer: Global Benefits Group Commercial |
$487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$831.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.02
|
| Rate for Payer: InnovAge PACE Commercial |
$760.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$542.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$679.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$679.41
|
| Rate for Payer: Multiplan Commercial |
$609.75
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$528.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.02
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$691.05
|
| Rate for Payer: Prime Health Services Medicare |
$537.44
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$557.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$406.50
|
| Rate for Payer: United Healthcare All Other HMO |
$406.50
|
| Rate for Payer: United Healthcare HMO Rider |
$406.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$406.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Vantage Medical Group Senior |
$507.02
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
IP
|
$813.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$731.70 |
| Rate for Payer: Adventist Health Commercial |
$162.60
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Central Health Plan Commercial |
$650.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$325.20
|
| Rate for Payer: EPIC Health Plan Senior |
$325.20
|
| Rate for Payer: Galaxy Health WC |
$691.05
|
| Rate for Payer: Global Benefits Group Commercial |
$487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$542.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$309.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$503.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.60
|
| Rate for Payer: Multiplan Commercial |
$609.75
|
| Rate for Payer: Networks By Design Commercial |
$528.45
|
| Rate for Payer: Prime Health Services Commercial |
$691.05
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
OP
|
$813.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$113.89 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$333.33
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$807.84
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Central Health Plan Commercial |
$650.40
|
| Rate for Payer: Cigna of CA HMO |
$520.32
|
| Rate for Payer: Cigna of CA PPO |
$601.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$760.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$557.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$684.48
|
| Rate for Payer: EPIC Health Plan Senior |
$507.02
|
| Rate for Payer: Galaxy Health WC |
$691.05
|
| Rate for Payer: Global Benefits Group Commercial |
$487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$831.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.02
|
| Rate for Payer: InnovAge PACE Commercial |
$760.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$542.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$679.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$679.41
|
| Rate for Payer: Multiplan Commercial |
$609.75
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$528.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.02
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$691.05
|
| Rate for Payer: Prime Health Services Medicare |
$537.44
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$557.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$487.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$487.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$507.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$760.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$557.72
|
| Rate for Payer: Vantage Medical Group Senior |
$507.02
|
|
|
HC VENIPUNCTURECUTDOWN GT 1YR
|
Facility
|
IP
|
$813.00
|
|
|
Service Code
|
CPT 36425
|
| Hospital Charge Code |
900501336
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$162.60 |
| Max. Negotiated Rate |
$731.70 |
| Rate for Payer: Adventist Health Commercial |
$162.60
|
| Rate for Payer: Cash Price |
$447.15
|
| Rate for Payer: Central Health Plan Commercial |
$650.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$325.20
|
| Rate for Payer: EPIC Health Plan Senior |
$325.20
|
| Rate for Payer: Galaxy Health WC |
$691.05
|
| Rate for Payer: Global Benefits Group Commercial |
$487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$731.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$542.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$309.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$503.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.60
|
| Rate for Payer: Multiplan Commercial |
$609.75
|
| Rate for Payer: Networks By Design Commercial |
$528.45
|
| Rate for Payer: Prime Health Services Commercial |
$691.05
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Adventist Health Commercial |
$29.20
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Central Health Plan Commercial |
$116.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.40
|
| Rate for Payer: EPIC Health Plan Senior |
$58.40
|
| Rate for Payer: Galaxy Health WC |
$124.10
|
| Rate for Payer: Global Benefits Group Commercial |
$87.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$131.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$97.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.20
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: Networks By Design Commercial |
$94.90
|
| Rate for Payer: Prime Health Services Commercial |
$124.10
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Adventist Health Commercial |
$29.20
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Central Health Plan Commercial |
$116.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.40
|
| Rate for Payer: EPIC Health Plan Senior |
$58.40
|
| Rate for Payer: Galaxy Health WC |
$124.10
|
| Rate for Payer: Global Benefits Group Commercial |
$87.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$131.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$97.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$55.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.20
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: Networks By Design Commercial |
$94.90
|
| Rate for Payer: Prime Health Services Commercial |
$124.10
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.58 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Adventist Health Commercial |
$29.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$88.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$124.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$80.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$109.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.75
|
| Rate for Payer: Blue Shield of California Commercial |
$88.62
|
| Rate for Payer: Blue Shield of California EPN |
$57.96
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Central Health Plan Commercial |
$116.80
|
| Rate for Payer: Cigna of CA HMO |
$93.44
|
| Rate for Payer: Cigna of CA PPO |
$108.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$124.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$124.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.40
|
| Rate for Payer: EPIC Health Plan Senior |
$58.40
|
| Rate for Payer: Galaxy Health WC |
$124.10
|
| Rate for Payer: Global Benefits Group Commercial |
$87.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$131.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.58
|
| Rate for Payer: InnovAge PACE Commercial |
$73.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$97.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.20
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: Networks By Design Commercial |
$94.90
|
| Rate for Payer: Prime Health Services Commercial |
$124.10
|
| Rate for Payer: Riverside University Health System MISP |
$58.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$87.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$87.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$73.00
|
| Rate for Payer: United Healthcare All Other HMO |
$73.00
|
| Rate for Payer: United Healthcare HMO Rider |
$73.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$124.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.10
|
| Rate for Payer: Vantage Medical Group Senior |
$124.10
|
|
|
HC VENIPUNCTURE GT 3 YRS OLD
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
910100005
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$59.86
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$88.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$124.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$80.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$109.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.75
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Cash Price |
$80.30
|
| Rate for Payer: Central Health Plan Commercial |
$116.80
|
| Rate for Payer: Cigna of CA HMO |
$93.44
|
| Rate for Payer: Cigna of CA PPO |
$108.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$124.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$124.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.40
|
| Rate for Payer: EPIC Health Plan Senior |
$58.40
|
| Rate for Payer: Galaxy Health WC |
$124.10
|
| Rate for Payer: Global Benefits Group Commercial |
$87.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$131.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$73.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$97.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.20
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: Networks By Design Commercial |
$94.90
|
| Rate for Payer: Prime Health Services Commercial |
$124.10
|
| Rate for Payer: Riverside University Health System MISP |
$58.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$87.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$87.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$124.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.10
|
| Rate for Payer: Vantage Medical Group Senior |
$124.10
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
900510279
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.09
|
| Rate for Payer: Blue Shield of California Commercial |
$28.53
|
| Rate for Payer: Blue Shield of California EPN |
$18.66
|
| Rate for Payer: Cash Price |
$25.85
|
| Rate for Payer: Cash Price |
$25.85
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.09
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.09
|
| Rate for Payer: InnovAge PACE Commercial |
$13.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.18
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.09
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Prime Health Services Medicare |
$9.64
|
| Rate for Payer: Riverside University Health System MISP |
$10.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.00
|
| Rate for Payer: Vantage Medical Group Senior |
$9.09
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
906536415
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.09
|
| Rate for Payer: Blue Shield of California Commercial |
$28.53
|
| Rate for Payer: Blue Shield of California EPN |
$18.66
|
| Rate for Payer: Cash Price |
$25.85
|
| Rate for Payer: Cash Price |
$25.85
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.09
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.09
|
| Rate for Payer: InnovAge PACE Commercial |
$13.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.18
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.09
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Prime Health Services Medicare |
$9.64
|
| Rate for Payer: Riverside University Health System MISP |
$10.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.00
|
| Rate for Payer: Vantage Medical Group Senior |
$9.09
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
906536415
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Cash Price |
$25.85
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: EPIC Health Plan Senior |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
|
|
HC VENIPUNCTURE W SPECIMEN
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
900510279
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Cash Price |
$25.85
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.80
|
| Rate for Payer: EPIC Health Plan Senior |
$18.80
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
|
