|
HC WART DESTRUCTION SINGLE
|
Facility
|
OP
|
$10,053.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
910400033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$310.32 |
| Max. Negotiated Rate |
$9,047.70 |
| Rate for Payer: Adventist Health Commercial |
$2,010.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,324.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,703.23
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,529.15
|
| Rate for Payer: Cash Price |
$5,529.15
|
| Rate for Payer: Cash Price |
$5,529.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,042.40
|
| Rate for Payer: Cigna of CA HMO |
$6,433.92
|
| Rate for Payer: Cigna of CA PPO |
$7,439.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.22
|
| Rate for Payer: Galaxy Health WC |
$8,545.05
|
| Rate for Payer: Global Benefits Group Commercial |
$6,031.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,047.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,811.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$310.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: InnovAge PACE Commercial |
$3,486.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,705.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,010.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,114.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.45
|
| Rate for Payer: Multiplan Commercial |
$7,539.75
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Networks By Design Commercial |
$6,534.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Preferred Health Network WC |
$3,778.81
|
| Rate for Payer: Prime Health Services Commercial |
$8,545.05
|
| Rate for Payer: Prime Health Services Medicare |
$2,463.67
|
| Rate for Payer: Prime Health Services WC |
$3,665.45
|
| Rate for Payer: Riverside University Health System MISP |
$2,556.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,031.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,324.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC WART DESTRUCTION SINGLE
|
Facility
|
IP
|
$10,053.00
|
|
|
Service Code
|
CPT 56501
|
| Hospital Charge Code |
910400033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,010.60 |
| Max. Negotiated Rate |
$9,047.70 |
| Rate for Payer: Adventist Health Commercial |
$2,010.60
|
| Rate for Payer: Cash Price |
$5,529.15
|
| Rate for Payer: Central Health Plan Commercial |
$8,042.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,021.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,021.20
|
| Rate for Payer: Galaxy Health WC |
$8,545.05
|
| Rate for Payer: Global Benefits Group Commercial |
$6,031.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,047.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,705.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,830.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,222.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,010.60
|
| Rate for Payer: Multiplan Commercial |
$7,539.75
|
| Rate for Payer: Networks By Design Commercial |
$6,534.45
|
| Rate for Payer: Prime Health Services Commercial |
$8,545.05
|
|
|
HC WASHING OF COMPONENTS RBC
|
Facility
|
IP
|
$397.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904568
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$357.30 |
| Rate for Payer: Adventist Health Commercial |
$79.40
|
| Rate for Payer: Cash Price |
$218.35
|
| Rate for Payer: Central Health Plan Commercial |
$317.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$158.80
|
| Rate for Payer: EPIC Health Plan Senior |
$158.80
|
| Rate for Payer: Galaxy Health WC |
$337.45
|
| Rate for Payer: Global Benefits Group Commercial |
$238.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$357.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$264.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$245.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.40
|
| Rate for Payer: Multiplan Commercial |
$297.75
|
| Rate for Payer: Networks By Design Commercial |
$258.05
|
| Rate for Payer: Prime Health Services Commercial |
$337.45
|
|
|
HC WASHING OF COMPONENTS RBC
|
Facility
|
OP
|
$397.00
|
|
|
Service Code
|
CPT 86999
|
| Hospital Charge Code |
900904568
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.44 |
| Max. Negotiated Rate |
$357.30 |
| Rate for Payer: Adventist Health Commercial |
$79.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$31.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$241.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$192.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.16
|
| Rate for Payer: Blue Shield of California Commercial |
$240.98
|
| Rate for Payer: Blue Shield of California EPN |
$157.61
|
| Rate for Payer: Cash Price |
$218.35
|
| Rate for Payer: Cash Price |
$218.35
|
| Rate for Payer: Central Health Plan Commercial |
$317.60
|
| Rate for Payer: Cigna of CA HMO |
$254.08
|
| Rate for Payer: Cigna of CA PPO |
$293.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.01
|
| Rate for Payer: EPIC Health Plan Senior |
$31.12
|
| Rate for Payer: Galaxy Health WC |
$337.45
|
| Rate for Payer: Global Benefits Group Commercial |
$238.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$357.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$51.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31.12
|
| Rate for Payer: InnovAge PACE Commercial |
$46.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$264.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$79.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.70
|
| Rate for Payer: Multiplan Commercial |
$297.75
|
| Rate for Payer: Networks By Design Commercial |
$258.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$31.12
|
| Rate for Payer: Prime Health Services Commercial |
$337.45
|
| Rate for Payer: Prime Health Services Medicare |
$32.99
|
| Rate for Payer: Riverside University Health System MISP |
$34.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$238.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$238.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.44
|
| Rate for Payer: United Healthcare All Other HMO |
$20.44
|
| Rate for Payer: United Healthcare HMO Rider |
$20.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.44
|
| Rate for Payer: Upland Medical Group Pediatric |
$31.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$46.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.23
|
| Rate for Payer: Vantage Medical Group Senior |
$31.12
|
|
|
HC WASP VENOM IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913640
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.34
|
| Rate for Payer: Blue Shield of California Commercial |
$40.06
|
| Rate for Payer: Blue Shield of California EPN |
$26.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: InnovAge PACE Commercial |
$7.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC WASP VENOM IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913640
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC WATCHMAN B/S ACCESS SHEATH
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
906812701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC WATCHMAN B/S ACCESS SHEATH
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
906812701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| 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 |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,290.47
|
| Rate for Payer: Blue Shield of California Commercial |
$2,382.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| 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 |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 WATCHMAN B/S CLOSURE DEVICE
|
Facility
|
IP
|
$35,250.00
|
|
| Hospital Charge Code |
906812700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,050.00 |
| Max. Negotiated Rate |
$31,725.00 |
| Rate for Payer: Adventist Health Commercial |
$7,050.00
|
| Rate for Payer: Cash Price |
$19,387.50
|
| Rate for Payer: Central Health Plan Commercial |
$28,200.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14,100.00
|
| Rate for Payer: Galaxy Health WC |
$29,962.50
|
| Rate for Payer: Global Benefits Group Commercial |
$21,150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,725.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,511.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,430.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,819.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,050.00
|
| Rate for Payer: Multiplan Commercial |
$26,437.50
|
| Rate for Payer: Networks By Design Commercial |
$22,912.50
|
| Rate for Payer: Prime Health Services Commercial |
$29,962.50
|
|
|
HC WATCHMAN B/S CLOSURE DEVICE
|
Facility
|
OP
|
$35,250.00
|
|
| Hospital Charge Code |
906812700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,050.00 |
| Max. Negotiated Rate |
$31,725.00 |
| Rate for Payer: Adventist Health Commercial |
$7,050.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21,407.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29,962.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19,387.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26,437.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,068.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20,702.33
|
| Rate for Payer: Blue Shield of California Commercial |
$21,537.75
|
| Rate for Payer: Blue Shield of California EPN |
$14,064.75
|
| Rate for Payer: Cash Price |
$19,387.50
|
| Rate for Payer: Central Health Plan Commercial |
$28,200.00
|
| Rate for Payer: Cigna of CA HMO |
$22,560.00
|
| Rate for Payer: Cigna of CA PPO |
$26,085.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29,962.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$29,962.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29,962.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14,100.00
|
| Rate for Payer: Galaxy Health WC |
$29,962.50
|
| Rate for Payer: Global Benefits Group Commercial |
$21,150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,725.00
|
| Rate for Payer: InnovAge PACE Commercial |
$17,625.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,511.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,430.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,819.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,050.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24,675.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24,675.00
|
| Rate for Payer: Multiplan Commercial |
$26,437.50
|
| Rate for Payer: Networks By Design Commercial |
$22,912.50
|
| Rate for Payer: Prime Health Services Commercial |
$29,962.50
|
| Rate for Payer: Riverside University Health System MISP |
$14,100.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21,150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,625.00
|
| Rate for Payer: United Healthcare All Other HMO |
$17,625.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,625.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17,625.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29,962.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29,962.50
|
| Rate for Payer: Vantage Medical Group Senior |
$29,962.50
|
|
|
HC WC ELECT STIM UNATTEND WOUND CARE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT G0282
|
| Hospital Charge Code |
900400045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
|
|
HC WC ELECT STIM UNATTEND WOUND CARE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT G0282
|
| Hospital Charge Code |
900400045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.15 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$27.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Central Health Plan Commercial |
$52.80
|
| Rate for Payer: Cigna of CA HMO |
$42.24
|
| Rate for Payer: Cigna of CA PPO |
$48.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.10
|
| Rate for Payer: Global Benefits Group Commercial |
$39.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.40
|
| Rate for Payer: InnovAge PACE Commercial |
$33.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.20
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: Networks By Design Commercial |
$42.90
|
| Rate for Payer: Prime Health Services Commercial |
$56.10
|
| Rate for Payer: Riverside University Health System MISP |
$26.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.10
|
| Rate for Payer: Vantage Medical Group Senior |
$56.10
|
|
|
HC WC EVAL RX SPEECH DVC 1ST HR
|
Facility
|
OP
|
$560.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000018
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$165.07 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Adventist Health Commercial |
$229.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$340.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$476.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$308.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$420.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Central Health Plan Commercial |
$448.00
|
| Rate for Payer: Cigna of CA HMO |
$358.40
|
| Rate for Payer: Cigna of CA PPO |
$414.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$476.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$476.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$476.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.00
|
| Rate for Payer: EPIC Health Plan Senior |
$224.00
|
| Rate for Payer: Galaxy Health WC |
$476.00
|
| Rate for Payer: Global Benefits Group Commercial |
$336.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$165.07
|
| Rate for Payer: InnovAge PACE Commercial |
$280.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$373.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$346.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$392.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$392.00
|
| Rate for Payer: Multiplan Commercial |
$420.00
|
| Rate for Payer: Networks By Design Commercial |
$364.00
|
| Rate for Payer: Prime Health Services Commercial |
$476.00
|
| Rate for Payer: Riverside University Health System MISP |
$224.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$336.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$336.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$476.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$476.00
|
| Rate for Payer: Vantage Medical Group Senior |
$476.00
|
|
|
HC WC EVAL RX SPEECH DVC 1ST HR
|
Facility
|
IP
|
$560.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000018
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Adventist Health Commercial |
$112.00
|
| Rate for Payer: Cash Price |
$308.00
|
| Rate for Payer: Central Health Plan Commercial |
$448.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.00
|
| Rate for Payer: EPIC Health Plan Senior |
$224.00
|
| Rate for Payer: Galaxy Health WC |
$476.00
|
| Rate for Payer: Global Benefits Group Commercial |
$336.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$373.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$213.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$346.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.00
|
| Rate for Payer: Multiplan Commercial |
$420.00
|
| Rate for Payer: Networks By Design Commercial |
$364.00
|
| Rate for Payer: Prime Health Services Commercial |
$476.00
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
OP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
915356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5,780.56 |
| Max. Negotiated Rate |
$16,176.60 |
| Rate for Payer: Adventist Health Commercial |
$7,369.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,885.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,480.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,556.13
|
| Rate for Payer: Blue Shield of California Commercial |
$13,893.90
|
| Rate for Payer: Blue Shield of California EPN |
$9,058.90
|
| Rate for Payer: Cash Price |
$9,885.70
|
| Rate for Payer: Cash Price |
$9,885.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,379.20
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,277.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,277.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,176.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,780.56
|
| Rate for Payer: InnovAge PACE Commercial |
$8,987.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,988.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,385.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,125.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,369.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,581.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,581.80
|
| Rate for Payer: Multiplan Commercial |
$13,480.50
|
| Rate for Payer: Networks By Design Commercial |
$8,987.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: Riverside University Health System MISP |
$7,189.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,784.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Senior |
$15,277.90
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
OP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
905356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$5,780.56 |
| Max. Negotiated Rate |
$16,176.60 |
| Rate for Payer: Adventist Health Commercial |
$7,369.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,885.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,480.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,556.13
|
| Rate for Payer: Blue Shield of California Commercial |
$13,893.90
|
| Rate for Payer: Blue Shield of California EPN |
$9,058.90
|
| Rate for Payer: Cash Price |
$9,885.70
|
| Rate for Payer: Cash Price |
$9,885.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,379.20
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,277.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,277.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,176.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,780.56
|
| Rate for Payer: InnovAge PACE Commercial |
$8,987.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,988.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,385.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,125.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,369.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,581.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,581.80
|
| Rate for Payer: Multiplan Commercial |
$13,480.50
|
| Rate for Payer: Networks By Design Commercial |
$8,987.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: Riverside University Health System MISP |
$7,189.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,784.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,277.90
|
| Rate for Payer: Vantage Medical Group Senior |
$15,277.90
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
IP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
905356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,594.80 |
| Max. Negotiated Rate |
$16,176.60 |
| Rate for Payer: Adventist Health Commercial |
$3,594.80
|
| Rate for Payer: Blue Shield of California Commercial |
$13,893.90
|
| Rate for Payer: Blue Shield of California EPN |
$9,058.90
|
| Rate for Payer: Cash Price |
$9,885.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,379.20
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,176.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,988.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,848.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,125.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,594.80
|
| Rate for Payer: Multiplan Commercial |
$13,480.50
|
| Rate for Payer: Networks By Design Commercial |
$11,683.10
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
|
|
HC WD EXTERN POWER SWITCH CONTROL
|
Facility
|
IP
|
$17,974.00
|
|
|
Service Code
|
CPT L6920
|
| Hospital Charge Code |
915356920
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,594.80 |
| Max. Negotiated Rate |
$16,176.60 |
| Rate for Payer: Adventist Health Commercial |
$3,594.80
|
| Rate for Payer: Blue Shield of California Commercial |
$13,893.90
|
| Rate for Payer: Blue Shield of California EPN |
$9,058.90
|
| Rate for Payer: Cash Price |
$9,885.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,379.20
|
| Rate for Payer: Cigna of CA HMO |
$12,581.80
|
| Rate for Payer: Cigna of CA PPO |
$12,581.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,189.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,189.60
|
| Rate for Payer: Galaxy Health WC |
$15,277.90
|
| Rate for Payer: Global Benefits Group Commercial |
$10,784.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,176.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,988.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,848.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,125.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,594.80
|
| Rate for Payer: Multiplan Commercial |
$13,480.50
|
| Rate for Payer: Networks By Design Commercial |
$11,683.10
|
| Rate for Payer: Prime Health Services Commercial |
$15,277.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,745.64
|
| Rate for Payer: United Healthcare All Other HMO |
$6,565.90
|
| Rate for Payer: United Healthcare HMO Rider |
$6,423.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,886.48
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
IP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
915356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,069.40 |
| Max. Negotiated Rate |
$18,312.30 |
| Rate for Payer: Adventist Health Commercial |
$4,069.40
|
| Rate for Payer: Blue Shield of California Commercial |
$15,728.23
|
| Rate for Payer: Blue Shield of California EPN |
$10,254.89
|
| Rate for Payer: Cash Price |
$11,190.85
|
| Rate for Payer: Central Health Plan Commercial |
$16,277.60
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,312.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,571.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,752.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,594.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,069.40
|
| Rate for Payer: Multiplan Commercial |
$15,260.25
|
| Rate for Payer: Networks By Design Commercial |
$13,225.55
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
IP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
905356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,069.40 |
| Max. Negotiated Rate |
$18,312.30 |
| Rate for Payer: Adventist Health Commercial |
$4,069.40
|
| Rate for Payer: Blue Shield of California Commercial |
$15,728.23
|
| Rate for Payer: Blue Shield of California EPN |
$10,254.89
|
| Rate for Payer: Cash Price |
$11,190.85
|
| Rate for Payer: Central Health Plan Commercial |
$16,277.60
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,312.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,571.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,752.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,594.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,069.40
|
| Rate for Payer: Multiplan Commercial |
$15,260.25
|
| Rate for Payer: Networks By Design Commercial |
$13,225.55
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
OP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
905356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6,588.60 |
| Max. Negotiated Rate |
$18,312.30 |
| Rate for Payer: Adventist Health Commercial |
$8,342.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,190.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,260.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,949.79
|
| Rate for Payer: Blue Shield of California Commercial |
$15,728.23
|
| Rate for Payer: Blue Shield of California EPN |
$10,254.89
|
| Rate for Payer: Cash Price |
$11,190.85
|
| Rate for Payer: Cash Price |
$11,190.85
|
| Rate for Payer: Central Health Plan Commercial |
$16,277.60
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,294.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,294.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,312.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,588.60
|
| Rate for Payer: InnovAge PACE Commercial |
$10,173.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,571.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,278.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,594.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,342.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,242.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,242.90
|
| Rate for Payer: Multiplan Commercial |
$15,260.25
|
| Rate for Payer: Networks By Design Commercial |
$10,173.50
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: Riverside University Health System MISP |
$8,138.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,208.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,208.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Senior |
$17,294.95
|
|
|
HC WD EXT POWER MYOELECTR CONTROL
|
Facility
|
OP
|
$20,347.00
|
|
|
Service Code
|
CPT L6925
|
| Hospital Charge Code |
915356925
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6,588.60 |
| Max. Negotiated Rate |
$18,312.30 |
| Rate for Payer: Adventist Health Commercial |
$8,342.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,190.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,260.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,949.79
|
| Rate for Payer: Blue Shield of California Commercial |
$15,728.23
|
| Rate for Payer: Blue Shield of California EPN |
$10,254.89
|
| Rate for Payer: Cash Price |
$11,190.85
|
| Rate for Payer: Cash Price |
$11,190.85
|
| Rate for Payer: Central Health Plan Commercial |
$16,277.60
|
| Rate for Payer: Cigna of CA HMO |
$14,242.90
|
| Rate for Payer: Cigna of CA PPO |
$14,242.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,294.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,294.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,138.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,138.80
|
| Rate for Payer: Galaxy Health WC |
$17,294.95
|
| Rate for Payer: Global Benefits Group Commercial |
$12,208.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,312.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,588.60
|
| Rate for Payer: InnovAge PACE Commercial |
$10,173.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,571.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,278.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,594.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,342.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,242.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,242.90
|
| Rate for Payer: Multiplan Commercial |
$15,260.25
|
| Rate for Payer: Networks By Design Commercial |
$10,173.50
|
| Rate for Payer: Prime Health Services Commercial |
$17,294.95
|
| Rate for Payer: Riverside University Health System MISP |
$8,138.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,208.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,208.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,636.23
|
| Rate for Payer: United Healthcare All Other HMO |
$7,432.76
|
| Rate for Payer: United Healthcare HMO Rider |
$7,272.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,663.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,294.95
|
| Rate for Payer: Vantage Medical Group Senior |
$17,294.95
|
|
|
HC WEAK ACIDIC DRUG CONF & ID
|
Facility
|
IP
|
$518.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910512
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.60 |
| Max. Negotiated Rate |
$466.20 |
| Rate for Payer: Adventist Health Commercial |
$103.60
|
| Rate for Payer: Cash Price |
$284.90
|
| Rate for Payer: Central Health Plan Commercial |
$414.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$207.20
|
| Rate for Payer: EPIC Health Plan Senior |
$207.20
|
| Rate for Payer: Galaxy Health WC |
$440.30
|
| Rate for Payer: Global Benefits Group Commercial |
$310.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$466.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$345.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$197.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$320.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.60
|
| Rate for Payer: Multiplan Commercial |
$388.50
|
| Rate for Payer: Networks By Design Commercial |
$336.70
|
| Rate for Payer: Prime Health Services Commercial |
$440.30
|
|
|
HC WEAK ACIDIC DRUG CONF & ID
|
Facility
|
OP
|
$518.00
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
900910512
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.34 |
| Max. Negotiated Rate |
$466.20 |
| Rate for Payer: Adventist Health Commercial |
$103.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$62.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$314.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$448.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.98
|
| Rate for Payer: Blue Shield of California Commercial |
$314.43
|
| Rate for Payer: Blue Shield of California EPN |
$205.65
|
| Rate for Payer: Cash Price |
$284.90
|
| Rate for Payer: Cash Price |
$284.90
|
| Rate for Payer: Central Health Plan Commercial |
$414.40
|
| Rate for Payer: Cigna of CA HMO |
$331.52
|
| Rate for Payer: Cigna of CA PPO |
$383.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$62.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.89
|
| Rate for Payer: EPIC Health Plan Senior |
$62.14
|
| Rate for Payer: Galaxy Health WC |
$440.30
|
| Rate for Payer: Global Benefits Group Commercial |
$310.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$466.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$101.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$74.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$62.14
|
| Rate for Payer: InnovAge PACE Commercial |
$93.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$345.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$83.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.27
|
| Rate for Payer: Multiplan Commercial |
$388.50
|
| Rate for Payer: Networks By Design Commercial |
$336.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$62.14
|
| Rate for Payer: Prime Health Services Commercial |
$440.30
|
| Rate for Payer: Prime Health Services Medicare |
$65.87
|
| Rate for Payer: Riverside University Health System MISP |
$68.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$310.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$310.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.34
|
| Rate for Payer: United Healthcare All Other HMO |
$50.34
|
| Rate for Payer: United Healthcare HMO Rider |
$50.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.34
|
| Rate for Payer: Upland Medical Group Pediatric |
$62.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.35
|
| Rate for Payer: Vantage Medical Group Senior |
$62.14
|
|
|
HC WEDGE EX OF SKIN OF NAIL FOLD
|
Facility
|
OP
|
$1,103.00
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
900501019
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$100.45 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$452.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$507.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$647.79
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$606.65
|
| Rate for Payer: Cash Price |
$606.65
|
| Rate for Payer: Cash Price |
$606.65
|
| Rate for Payer: Cash Price |
$606.65
|
| Rate for Payer: Central Health Plan Commercial |
$882.40
|
| Rate for Payer: Cigna of CA HMO |
$705.92
|
| Rate for Payer: Cigna of CA PPO |
$816.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$558.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$685.31
|
| Rate for Payer: EPIC Health Plan Senior |
$507.64
|
| Rate for Payer: Galaxy Health WC |
$937.55
|
| Rate for Payer: Global Benefits Group Commercial |
$661.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$992.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$832.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$507.64
|
| Rate for Payer: InnovAge PACE Commercial |
$761.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$507.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$680.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$680.24
|
| Rate for Payer: Multiplan Commercial |
$827.25
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$716.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$507.64
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$937.55
|
| Rate for Payer: Prime Health Services Medicare |
$538.10
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$558.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$661.80
|
| 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 |
$507.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$761.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$558.40
|
| Rate for Payer: Vantage Medical Group Senior |
$507.64
|
|
