|
HC ABDUCTION BAR ADDITION LE
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT L2300
|
| Hospital Charge Code |
915352300
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$703.80 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Blue Shield of California Commercial |
$627.16
|
| Rate for Payer: Blue Shield of California EPN |
$394.13
|
| Rate for Payer: Cash Price |
$351.90
|
| Rate for Payer: Central Health Plan Commercial |
$625.60
|
| Rate for Payer: Cigna of CA HMO |
$547.40
|
| Rate for Payer: Cigna of CA PPO |
$547.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$547.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$703.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$496.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$461.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.40
|
| Rate for Payer: Multiplan Commercial |
$586.50
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$293.48
|
| Rate for Payer: United Healthcare All Other HMO |
$285.66
|
| Rate for Payer: United Healthcare HMO Rider |
$279.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$256.11
|
|
|
HC ABDUCTION BAR STRAIGHT ADDITION LE
|
Facility
|
IP
|
$430.00
|
|
|
Service Code
|
CPT L2310
|
| Hospital Charge Code |
915352310
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Adventist Health Commercial |
$86.00
|
| Rate for Payer: Blue Shield of California Commercial |
$344.86
|
| Rate for Payer: Blue Shield of California EPN |
$216.72
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Central Health Plan Commercial |
$344.00
|
| Rate for Payer: Cigna of CA HMO |
$301.00
|
| Rate for Payer: Cigna of CA PPO |
$301.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$301.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.00
|
| Rate for Payer: EPIC Health Plan Senior |
$172.00
|
| Rate for Payer: Galaxy Health WC |
$365.50
|
| Rate for Payer: Global Benefits Group Commercial |
$258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$273.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$253.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.00
|
| Rate for Payer: Multiplan Commercial |
$322.50
|
| Rate for Payer: Networks By Design Commercial |
$279.50
|
| Rate for Payer: Prime Health Services Commercial |
$365.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.38
|
| Rate for Payer: United Healthcare All Other HMO |
$157.08
|
| Rate for Payer: United Healthcare HMO Rider |
$153.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.82
|
|
|
HC ABDUCTION BAR STRAIGHT ADDITION LE
|
Facility
|
IP
|
$430.00
|
|
|
Service Code
|
CPT L2310
|
| Hospital Charge Code |
905352310
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Adventist Health Commercial |
$86.00
|
| Rate for Payer: Blue Shield of California Commercial |
$344.86
|
| Rate for Payer: Blue Shield of California EPN |
$216.72
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Central Health Plan Commercial |
$344.00
|
| Rate for Payer: Cigna of CA HMO |
$301.00
|
| Rate for Payer: Cigna of CA PPO |
$301.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$301.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.00
|
| Rate for Payer: EPIC Health Plan Senior |
$172.00
|
| Rate for Payer: Galaxy Health WC |
$365.50
|
| Rate for Payer: Global Benefits Group Commercial |
$258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$273.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$253.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.00
|
| Rate for Payer: Multiplan Commercial |
$322.50
|
| Rate for Payer: Networks By Design Commercial |
$279.50
|
| Rate for Payer: Prime Health Services Commercial |
$365.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.38
|
| Rate for Payer: United Healthcare All Other HMO |
$157.08
|
| Rate for Payer: United Healthcare HMO Rider |
$153.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.82
|
|
|
HC ABDUCTION BAR STRAIGHT ADDITION LE
|
Facility
|
OP
|
$430.00
|
|
|
Service Code
|
CPT L2310
|
| Hospital Charge Code |
915352310
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$140.82 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Adventist Health Commercial |
$176.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$365.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$236.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$322.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$250.13
|
| Rate for Payer: Blue Shield of California Commercial |
$344.86
|
| Rate for Payer: Blue Shield of California EPN |
$216.72
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Central Health Plan Commercial |
$344.00
|
| Rate for Payer: Cigna of CA HMO |
$301.00
|
| Rate for Payer: Cigna of CA PPO |
$301.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$365.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$365.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$365.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$301.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.00
|
| Rate for Payer: EPIC Health Plan Senior |
$172.00
|
| Rate for Payer: Galaxy Health WC |
$365.50
|
| Rate for Payer: Global Benefits Group Commercial |
$258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$169.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$273.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$187.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$253.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$301.00
|
| Rate for Payer: Multiplan Commercial |
$322.50
|
| Rate for Payer: Networks By Design Commercial |
$215.00
|
| Rate for Payer: Prime Health Services Commercial |
$365.50
|
| Rate for Payer: Riverside University Health System MISP |
$172.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$258.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$258.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.38
|
| Rate for Payer: United Healthcare All Other HMO |
$157.08
|
| Rate for Payer: United Healthcare HMO Rider |
$153.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$365.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$365.50
|
| Rate for Payer: Vantage Medical Group Senior |
$365.50
|
|
|
HC ABDUCTION BAR STRAIGHT ADDITION LE
|
Facility
|
OP
|
$430.00
|
|
|
Service Code
|
CPT L2310
|
| Hospital Charge Code |
905352310
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$140.82 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Adventist Health Commercial |
$176.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$365.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$236.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$322.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$250.13
|
| Rate for Payer: Blue Shield of California Commercial |
$344.86
|
| Rate for Payer: Blue Shield of California EPN |
$216.72
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Central Health Plan Commercial |
$344.00
|
| Rate for Payer: Cigna of CA HMO |
$301.00
|
| Rate for Payer: Cigna of CA PPO |
$301.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$365.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$365.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$365.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$301.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.00
|
| Rate for Payer: EPIC Health Plan Senior |
$172.00
|
| Rate for Payer: Galaxy Health WC |
$365.50
|
| Rate for Payer: Global Benefits Group Commercial |
$258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$169.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$273.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$187.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$253.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$301.00
|
| Rate for Payer: Multiplan Commercial |
$322.50
|
| Rate for Payer: Networks By Design Commercial |
$215.00
|
| Rate for Payer: Prime Health Services Commercial |
$365.50
|
| Rate for Payer: Riverside University Health System MISP |
$172.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$258.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$258.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.38
|
| Rate for Payer: United Healthcare All Other HMO |
$157.08
|
| Rate for Payer: United Healthcare HMO Rider |
$153.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$140.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$365.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$365.50
|
| Rate for Payer: Vantage Medical Group Senior |
$365.50
|
|
|
HC ABLAT CERV/THORAC EA ADD LEVEL
|
Facility
|
IP
|
$4,370.00
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
909000265
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$874.00 |
| Max. Negotiated Rate |
$3,933.00 |
| Rate for Payer: Adventist Health Commercial |
$874.00
|
| Rate for Payer: Cash Price |
$1,966.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,496.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,059.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,748.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,748.00
|
| Rate for Payer: Galaxy Health WC |
$3,714.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,622.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,933.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,774.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,578.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$874.00
|
| Rate for Payer: Multiplan Commercial |
$3,277.50
|
| Rate for Payer: Networks By Design Commercial |
$2,840.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,714.50
|
|
|
HC ABLAT CERV/THORAC EA ADD LEVEL
|
Facility
|
OP
|
$4,370.00
|
|
|
Service Code
|
CPT 64634
|
| Hospital Charge Code |
909000265
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$101.17 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$874.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,714.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,403.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,277.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,966.50
|
| Rate for Payer: Cash Price |
$1,966.50
|
| Rate for Payer: Cash Price |
$1,966.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,496.00
|
| Rate for Payer: Cigna of CA HMO |
$2,796.80
|
| Rate for Payer: Cigna of CA PPO |
$3,233.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,714.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,714.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,714.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,059.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,748.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,748.00
|
| Rate for Payer: Galaxy Health WC |
$3,714.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,622.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,933.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$101.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,774.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,578.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$874.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,059.00
|
| Rate for Payer: Multiplan Commercial |
$3,277.50
|
| Rate for Payer: Networks By Design Commercial |
$2,840.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,714.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,748.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,622.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,185.00
|
| 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 |
$3,714.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,714.50
|
| Rate for Payer: Vantage Medical Group Senior |
$3,714.50
|
|
|
HC ABLAT CERV/THORAC NERVE SNGL L
|
Facility
|
IP
|
$7,192.00
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
909000264
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,438.40 |
| Max. Negotiated Rate |
$6,472.80 |
| Rate for Payer: Adventist Health Commercial |
$1,438.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,753.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,034.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,876.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,876.80
|
| Rate for Payer: Galaxy Health WC |
$6,113.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,315.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,472.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,566.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,243.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.40
|
| Rate for Payer: Multiplan Commercial |
$5,394.00
|
| Rate for Payer: Networks By Design Commercial |
$4,674.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,113.20
|
|
|
HC ABLAT CERV/THORAC NERVE SNGL L
|
Facility
|
OP
|
$7,192.00
|
|
|
Service Code
|
CPT 64633
|
| Hospital Charge Code |
909000264
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$343.23 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,438.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,511.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,511.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,953.34
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,753.60
|
| Rate for Payer: Cigna of CA HMO |
$4,602.88
|
| Rate for Payer: Cigna of CA PPO |
$5,322.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,762.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,511.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,034.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,144.02
|
| Rate for Payer: EPIC Health Plan Senior |
$2,762.68
|
| Rate for Payer: Galaxy Health WC |
$6,113.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,315.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,472.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,118.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$343.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,566.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$379.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,516.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,365.45
|
| Rate for Payer: Multiplan Commercial |
$5,394.00
|
| Rate for Payer: Multiplan WC |
$3,953.34
|
| Rate for Payer: Networks By Design Commercial |
$4,674.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Preferred Health Network WC |
$4,034.02
|
| Rate for Payer: Prime Health Services Commercial |
$6,113.20
|
| Rate for Payer: Prime Health Services Medicare |
$2,662.22
|
| Rate for Payer: Prime Health Services WC |
$3,913.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,762.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,315.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,596.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,511.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,511.53
|
|
|
HC ABLATION,1 OR MORE LIVER TUM
|
Facility
|
IP
|
$29,517.00
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
909000246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,903.40 |
| Max. Negotiated Rate |
$26,565.30 |
| Rate for Payer: Adventist Health Commercial |
$5,903.40
|
| Rate for Payer: Cash Price |
$13,282.65
|
| Rate for Payer: Central Health Plan Commercial |
$23,613.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,661.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,806.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,806.80
|
| Rate for Payer: Galaxy Health WC |
$25,089.45
|
| Rate for Payer: Global Benefits Group Commercial |
$17,710.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,565.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,743.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,415.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,903.40
|
| Rate for Payer: Multiplan Commercial |
$22,137.75
|
| Rate for Payer: Networks By Design Commercial |
$19,186.05
|
| Rate for Payer: Prime Health Services Commercial |
$25,089.45
|
|
|
HC ABLATION,1 OR MORE LIVER TUM
|
Facility
|
OP
|
$29,517.00
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
909000246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$952.85 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$5,903.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,775.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,553.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,775.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,811.52
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$13,282.65
|
| Rate for Payer: Cash Price |
$13,282.65
|
| Rate for Payer: Cash Price |
$13,282.65
|
| Rate for Payer: Central Health Plan Commercial |
$23,613.60
|
| Rate for Payer: Cigna of CA HMO |
$18,890.88
|
| Rate for Payer: Cigna of CA PPO |
$21,842.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,553.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,775.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,661.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,829.67
|
| Rate for Payer: EPIC Health Plan Senior |
$8,553.12
|
| Rate for Payer: Galaxy Health WC |
$25,089.45
|
| Rate for Payer: Global Benefits Group Commercial |
$17,710.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,565.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,751.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$952.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,775.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,743.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,052.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,885.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,903.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,419.25
|
| Rate for Payer: Multiplan Commercial |
$22,137.75
|
| Rate for Payer: Multiplan WC |
$11,811.52
|
| Rate for Payer: Networks By Design Commercial |
$19,186.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,775.56
|
| Rate for Payer: Preferred Health Network WC |
$12,052.57
|
| Rate for Payer: Prime Health Services Commercial |
$25,089.45
|
| Rate for Payer: Prime Health Services Medicare |
$8,242.09
|
| Rate for Payer: Prime Health Services WC |
$11,690.99
|
| Rate for Payer: Riverside University Health System MISP |
$8,553.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,710.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,758.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,775.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,553.12
|
| Rate for Payer: Vantage Medical Group Senior |
$7,775.56
|
|
|
HC ABLATION CRYO SPRAY
|
Facility
|
OP
|
$4,875.00
|
|
| Hospital Charge Code |
900800272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,960.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,681.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,656.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,360.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,835.79
|
| Rate for Payer: Blue Shield of California Commercial |
$3,090.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,945.12
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Cigna of CA HMO |
$3,120.00
|
| Rate for Payer: Cigna of CA PPO |
$3,607.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,143.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,143.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,095.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,769.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,876.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,412.50
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$3,168.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,950.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,925.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,437.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,437.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,437.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,143.75
|
|
|
HC ABLATION CRYO SPRAY
|
Facility
|
IP
|
$4,875.00
|
|
| Hospital Charge Code |
900800272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,387.50 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,900.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,387.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,095.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,876.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$3,656.25
|
| Rate for Payer: Networks By Design Commercial |
$3,168.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
|
|
HC ABLATION L/R ATRIUM AFIB
|
Facility
|
OP
|
$930.00
|
|
|
Service Code
|
CPT 93657
|
| Hospital Charge Code |
906811449
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$186.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$186.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$790.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$511.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$697.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Central Health Plan Commercial |
$744.00
|
| Rate for Payer: Cigna of CA HMO |
$604.50
|
| Rate for Payer: Cigna of CA PPO |
$688.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$790.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$790.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$790.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$651.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.00
|
| Rate for Payer: EPIC Health Plan Senior |
$372.00
|
| Rate for Payer: Galaxy Health WC |
$790.50
|
| Rate for Payer: Global Benefits Group Commercial |
$558.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$837.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$567.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$590.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$626.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$651.00
|
| Rate for Payer: Multiplan Commercial |
$697.50
|
| Rate for Payer: Networks By Design Commercial |
$604.50
|
| Rate for Payer: Prime Health Services Commercial |
$790.50
|
| Rate for Payer: Riverside University Health System MISP |
$372.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$558.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$558.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$465.00
|
| 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 |
$790.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$790.50
|
| Rate for Payer: Vantage Medical Group Senior |
$790.50
|
|
|
HC ABLATION L/R ATRIUM AFIB
|
Facility
|
IP
|
$930.00
|
|
|
Service Code
|
CPT 93657
|
| Hospital Charge Code |
906811449
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$186.00 |
| Max. Negotiated Rate |
$837.00 |
| Rate for Payer: Adventist Health Commercial |
$186.00
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Central Health Plan Commercial |
$744.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$651.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$372.00
|
| Rate for Payer: EPIC Health Plan Senior |
$372.00
|
| Rate for Payer: Galaxy Health WC |
$790.50
|
| Rate for Payer: Global Benefits Group Commercial |
$558.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$837.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$590.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.00
|
| Rate for Payer: Multiplan Commercial |
$697.50
|
| Rate for Payer: Networks By Design Commercial |
$604.50
|
| Rate for Payer: Prime Health Services Commercial |
$790.50
|
|
|
HC ABLATION SECONDARY ARRHYTHMIA
|
Facility
|
OP
|
$13,532.00
|
|
|
Service Code
|
CPT 93655
|
| Hospital Charge Code |
906811447
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$567.26 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,706.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,502.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,442.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,149.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$6,089.40
|
| Rate for Payer: Cash Price |
$6,089.40
|
| Rate for Payer: Cash Price |
$6,089.40
|
| Rate for Payer: Central Health Plan Commercial |
$10,825.60
|
| Rate for Payer: Cigna of CA HMO |
$8,795.80
|
| Rate for Payer: Cigna of CA PPO |
$10,013.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,502.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,502.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,502.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,472.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,412.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,412.80
|
| Rate for Payer: Galaxy Health WC |
$11,502.20
|
| Rate for Payer: Global Benefits Group Commercial |
$8,119.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,178.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$567.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,592.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$626.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,983.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,706.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,472.40
|
| Rate for Payer: Multiplan Commercial |
$10,149.00
|
| Rate for Payer: Networks By Design Commercial |
$8,795.80
|
| Rate for Payer: Prime Health Services Commercial |
$11,502.20
|
| Rate for Payer: Riverside University Health System MISP |
$5,412.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,119.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,119.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,766.00
|
| 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 |
$11,502.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,502.20
|
| Rate for Payer: Vantage Medical Group Senior |
$11,502.20
|
|
|
HC ABLATION SECONDARY ARRHYTHMIA
|
Facility
|
IP
|
$13,532.00
|
|
|
Service Code
|
CPT 93655
|
| Hospital Charge Code |
906811447
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,706.40 |
| Max. Negotiated Rate |
$12,178.80 |
| Rate for Payer: Adventist Health Commercial |
$2,706.40
|
| Rate for Payer: Cash Price |
$6,089.40
|
| Rate for Payer: Central Health Plan Commercial |
$10,825.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,472.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,412.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,412.80
|
| Rate for Payer: Galaxy Health WC |
$11,502.20
|
| Rate for Payer: Global Benefits Group Commercial |
$8,119.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,178.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,592.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,983.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,706.40
|
| Rate for Payer: Multiplan Commercial |
$10,149.00
|
| Rate for Payer: Networks By Design Commercial |
$8,795.80
|
| Rate for Payer: Prime Health Services Commercial |
$11,502.20
|
|
|
HC ABLATION SPINE OTHER
|
Facility
|
OP
|
$1,129.00
|
|
|
Service Code
|
CPT 22899
|
| Hospital Charge Code |
909022899
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$225.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$317.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$546.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$656.74
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$508.05
|
| Rate for Payer: Cash Price |
$508.05
|
| Rate for Payer: Cash Price |
$508.05
|
| Rate for Payer: Central Health Plan Commercial |
$903.20
|
| Rate for Payer: Cigna of CA HMO |
$722.56
|
| Rate for Payer: Cigna of CA PPO |
$835.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$790.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$959.65
|
| Rate for Payer: Global Benefits Group Commercial |
$677.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,016.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$716.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$846.75
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$733.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$959.65
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$677.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$564.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC ABLATION SPINE OTHER
|
Facility
|
IP
|
$1,129.00
|
|
|
Service Code
|
CPT 22899
|
| Hospital Charge Code |
909022899
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.80 |
| Max. Negotiated Rate |
$1,016.10 |
| Rate for Payer: Adventist Health Commercial |
$225.80
|
| Rate for Payer: Cash Price |
$508.05
|
| Rate for Payer: Central Health Plan Commercial |
$903.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$790.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.60
|
| Rate for Payer: EPIC Health Plan Senior |
$451.60
|
| Rate for Payer: Galaxy Health WC |
$959.65
|
| Rate for Payer: Global Benefits Group Commercial |
$677.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,016.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$716.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$666.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.80
|
| Rate for Payer: Multiplan Commercial |
$846.75
|
| Rate for Payer: Networks By Design Commercial |
$733.85
|
| Rate for Payer: Prime Health Services Commercial |
$959.65
|
|
|
HC ABLAT LUM/SAC NERVE SNGL LEVEL
|
Facility
|
IP
|
$7,192.00
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
909000262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,438.40 |
| Max. Negotiated Rate |
$6,472.80 |
| Rate for Payer: Adventist Health Commercial |
$1,438.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,753.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,034.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,876.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,876.80
|
| Rate for Payer: Galaxy Health WC |
$6,113.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,315.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,472.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,566.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,243.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.40
|
| Rate for Payer: Multiplan Commercial |
$5,394.00
|
| Rate for Payer: Networks By Design Commercial |
$4,674.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,113.20
|
|
|
HC ABLAT LUM/SAC NERVE SNGL LEVEL
|
Facility
|
OP
|
$7,192.00
|
|
|
Service Code
|
CPT 64635
|
| Hospital Charge Code |
909000262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.19 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,438.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,511.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,511.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,953.34
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,753.60
|
| Rate for Payer: Cigna of CA HMO |
$4,602.88
|
| Rate for Payer: Cigna of CA PPO |
$5,322.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,762.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,511.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,034.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,144.02
|
| Rate for Payer: EPIC Health Plan Senior |
$2,762.68
|
| Rate for Payer: Galaxy Health WC |
$6,113.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,315.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,472.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,118.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$336.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,566.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$371.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,516.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,365.45
|
| Rate for Payer: Multiplan Commercial |
$5,394.00
|
| Rate for Payer: Multiplan WC |
$3,953.34
|
| Rate for Payer: Networks By Design Commercial |
$4,674.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,511.53
|
| Rate for Payer: Preferred Health Network WC |
$4,034.02
|
| Rate for Payer: Prime Health Services Commercial |
$6,113.20
|
| Rate for Payer: Prime Health Services Medicare |
$2,662.22
|
| Rate for Payer: Prime Health Services WC |
$3,913.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,762.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,315.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,596.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,511.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,767.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,762.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,511.53
|
|
|
HC ABL IE GT 1 TMR PER ORGN INC IG
|
Facility
|
IP
|
$43,984.00
|
|
|
Service Code
|
CPT 0600T
|
| Hospital Charge Code |
909000600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,796.80 |
| Max. Negotiated Rate |
$39,585.60 |
| Rate for Payer: Adventist Health Commercial |
$8,796.80
|
| Rate for Payer: Cash Price |
$19,792.80
|
| Rate for Payer: Central Health Plan Commercial |
$35,187.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,593.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,593.60
|
| Rate for Payer: Galaxy Health WC |
$37,386.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,390.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,585.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,929.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,950.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,796.80
|
| Rate for Payer: Multiplan Commercial |
$32,988.00
|
| Rate for Payer: Networks By Design Commercial |
$28,589.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,386.40
|
|
|
HC ABL IE GT 1 TMR PER ORGN INC IG
|
Facility
|
OP
|
$43,984.00
|
|
|
Service Code
|
CPT 0600T
|
| Hospital Charge Code |
909000600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$39,585.60 |
| Rate for Payer: Adventist Health Commercial |
$8,796.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,671.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,671.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,077.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$19,792.80
|
| Rate for Payer: Cash Price |
$19,792.80
|
| Rate for Payer: Cash Price |
$19,792.80
|
| Rate for Payer: Central Health Plan Commercial |
$35,187.20
|
| Rate for Payer: Cigna of CA HMO |
$28,149.76
|
| Rate for Payer: Cigna of CA PPO |
$32,548.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,038.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,671.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,558.37
|
| Rate for Payer: EPIC Health Plan Senior |
$15,038.91
|
| Rate for Payer: Galaxy Health WC |
$37,386.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,390.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,585.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,421.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,929.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,966.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19,140.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,796.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,320.13
|
| Rate for Payer: Multiplan Commercial |
$32,988.00
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: Networks By Design Commercial |
$28,589.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Preferred Health Network WC |
$21,507.40
|
| Rate for Payer: Prime Health Services Commercial |
$37,386.40
|
| Rate for Payer: Prime Health Services Medicare |
$14,492.04
|
| Rate for Payer: Prime Health Services WC |
$20,862.18
|
| Rate for Payer: Riverside University Health System MISP |
$15,038.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,390.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,992.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,671.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13,671.74
|
|
|
HC ABL IE GT 1 TMR PR ORG INC FL US
|
Facility
|
OP
|
$43,984.00
|
|
|
Service Code
|
CPT 0601T
|
| Hospital Charge Code |
909000601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$39,585.60 |
| Rate for Payer: Adventist Health Commercial |
$8,796.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,671.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,671.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,077.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$19,792.80
|
| Rate for Payer: Cash Price |
$19,792.80
|
| Rate for Payer: Cash Price |
$19,792.80
|
| Rate for Payer: Central Health Plan Commercial |
$35,187.20
|
| Rate for Payer: Cigna of CA HMO |
$28,149.76
|
| Rate for Payer: Cigna of CA PPO |
$32,548.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,038.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,671.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,558.37
|
| Rate for Payer: EPIC Health Plan Senior |
$15,038.91
|
| Rate for Payer: Galaxy Health WC |
$37,386.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,390.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,585.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,421.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,929.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,966.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19,140.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,796.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,320.13
|
| Rate for Payer: Multiplan Commercial |
$32,988.00
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: Networks By Design Commercial |
$28,589.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Preferred Health Network WC |
$21,507.40
|
| Rate for Payer: Prime Health Services Commercial |
$37,386.40
|
| Rate for Payer: Prime Health Services Medicare |
$14,492.04
|
| Rate for Payer: Prime Health Services WC |
$20,862.18
|
| Rate for Payer: Riverside University Health System MISP |
$15,038.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,390.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,992.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,671.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13,671.74
|
|
|
HC ABL IE GT 1 TMR PR ORG INC FL US
|
Facility
|
IP
|
$43,984.00
|
|
|
Service Code
|
CPT 0601T
|
| Hospital Charge Code |
909000601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,796.80 |
| Max. Negotiated Rate |
$39,585.60 |
| Rate for Payer: Adventist Health Commercial |
$8,796.80
|
| Rate for Payer: Cash Price |
$19,792.80
|
| Rate for Payer: Central Health Plan Commercial |
$35,187.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,593.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,593.60
|
| Rate for Payer: Galaxy Health WC |
$37,386.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,390.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,585.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,929.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,950.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,796.80
|
| Rate for Payer: Multiplan Commercial |
$32,988.00
|
| Rate for Payer: Networks By Design Commercial |
$28,589.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,386.40
|
|
