|
HC ADMIN VACCINE EA ADDIT
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
900501278
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$63.90 |
| Rate for Payer: Adventist Health Commercial |
$14.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$39.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$53.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.70
|
| Rate for Payer: Blue Shield of California Commercial |
$43.38
|
| Rate for Payer: Blue Shield of California EPN |
$28.33
|
| Rate for Payer: Cash Price |
$39.05
|
| Rate for Payer: Central Health Plan Commercial |
$56.80
|
| Rate for Payer: Cigna of CA HMO |
$45.44
|
| Rate for Payer: Cigna of CA PPO |
$52.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$60.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$60.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.40
|
| Rate for Payer: EPIC Health Plan Senior |
$28.40
|
| Rate for Payer: Galaxy Health WC |
$60.35
|
| Rate for Payer: Global Benefits Group Commercial |
$42.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.90
|
| Rate for Payer: InnovAge PACE Commercial |
$35.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.70
|
| Rate for Payer: Multiplan Commercial |
$53.25
|
| Rate for Payer: Networks By Design Commercial |
$46.15
|
| Rate for Payer: Prime Health Services Commercial |
$60.35
|
| Rate for Payer: Riverside University Health System MISP |
$28.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$35.50
|
| Rate for Payer: United Healthcare All Other HMO |
$35.50
|
| Rate for Payer: United Healthcare HMO Rider |
$35.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$60.35
|
| Rate for Payer: Vantage Medical Group Senior |
$60.35
|
|
|
HC ADMIN VACCINE EA ADDIT
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
910100171
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$63.90 |
| Rate for Payer: Adventist Health Commercial |
$14.20
|
| Rate for Payer: Cash Price |
$39.05
|
| Rate for Payer: Central Health Plan Commercial |
$56.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.40
|
| Rate for Payer: EPIC Health Plan Senior |
$28.40
|
| Rate for Payer: Galaxy Health WC |
$60.35
|
| Rate for Payer: Global Benefits Group Commercial |
$42.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.20
|
| Rate for Payer: Multiplan Commercial |
$53.25
|
| Rate for Payer: Networks By Design Commercial |
$46.15
|
| Rate for Payer: Prime Health Services Commercial |
$60.35
|
|
|
HC ADMIN VACCINE EA ADDIT
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
CPT 90472
|
| Hospital Charge Code |
910100171
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$63.90 |
| Rate for Payer: Adventist Health Commercial |
$14.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$60.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$39.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$53.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.70
|
| Rate for Payer: Blue Shield of California Commercial |
$43.38
|
| Rate for Payer: Blue Shield of California EPN |
$28.33
|
| Rate for Payer: Cash Price |
$39.05
|
| Rate for Payer: Central Health Plan Commercial |
$56.80
|
| Rate for Payer: Cigna of CA HMO |
$45.44
|
| Rate for Payer: Cigna of CA PPO |
$52.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$60.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$60.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.40
|
| Rate for Payer: EPIC Health Plan Senior |
$28.40
|
| Rate for Payer: Galaxy Health WC |
$60.35
|
| Rate for Payer: Global Benefits Group Commercial |
$42.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$63.90
|
| Rate for Payer: InnovAge PACE Commercial |
$35.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.70
|
| Rate for Payer: Multiplan Commercial |
$53.25
|
| Rate for Payer: Networks By Design Commercial |
$46.15
|
| Rate for Payer: Prime Health Services Commercial |
$60.35
|
| Rate for Payer: Riverside University Health System MISP |
$28.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$35.50
|
| Rate for Payer: United Healthcare All Other HMO |
$35.50
|
| Rate for Payer: United Healthcare HMO Rider |
$35.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$60.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$60.35
|
| Rate for Payer: Vantage Medical Group Senior |
$60.35
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
908600208
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Adventist Health Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Central Health Plan Commercial |
$96.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.40
|
| Rate for Payer: EPIC Health Plan Senior |
$48.40
|
| Rate for Payer: Galaxy Health WC |
$102.85
|
| Rate for Payer: Global Benefits Group Commercial |
$72.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$90.75
|
| Rate for Payer: Networks By Design Commercial |
$78.65
|
| Rate for Payer: Prime Health Services Commercial |
$102.85
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
908600208
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Adventist Health Commercial |
$24.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$58.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.06
|
| Rate for Payer: Blue Shield of California Commercial |
$73.93
|
| Rate for Payer: Blue Shield of California EPN |
$48.28
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Central Health Plan Commercial |
$96.80
|
| Rate for Payer: Cigna of CA HMO |
$77.44
|
| Rate for Payer: Cigna of CA PPO |
$89.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.15
|
| Rate for Payer: EPIC Health Plan Senior |
$58.63
|
| Rate for Payer: Galaxy Health WC |
$102.85
|
| Rate for Payer: Global Benefits Group Commercial |
$72.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$96.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.63
|
| Rate for Payer: InnovAge PACE Commercial |
$87.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.56
|
| Rate for Payer: Multiplan Commercial |
$90.75
|
| Rate for Payer: Networks By Design Commercial |
$78.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$58.63
|
| Rate for Payer: Prime Health Services Commercial |
$102.85
|
| Rate for Payer: Prime Health Services Medicare |
$62.15
|
| Rate for Payer: Riverside University Health System MISP |
$64.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.50
|
| Rate for Payer: United Healthcare All Other HMO |
$60.50
|
| Rate for Payer: United Healthcare HMO Rider |
$60.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Vantage Medical Group Senior |
$58.63
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
942100151
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Adventist Health Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Central Health Plan Commercial |
$96.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.40
|
| Rate for Payer: EPIC Health Plan Senior |
$48.40
|
| Rate for Payer: Galaxy Health WC |
$102.85
|
| Rate for Payer: Global Benefits Group Commercial |
$72.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$90.75
|
| Rate for Payer: Networks By Design Commercial |
$78.65
|
| Rate for Payer: Prime Health Services Commercial |
$102.85
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
942100151
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Adventist Health Commercial |
$24.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$58.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.06
|
| Rate for Payer: Blue Shield of California Commercial |
$73.93
|
| Rate for Payer: Blue Shield of California EPN |
$48.28
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Central Health Plan Commercial |
$96.80
|
| Rate for Payer: Cigna of CA HMO |
$77.44
|
| Rate for Payer: Cigna of CA PPO |
$89.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.15
|
| Rate for Payer: EPIC Health Plan Senior |
$58.63
|
| Rate for Payer: Galaxy Health WC |
$102.85
|
| Rate for Payer: Global Benefits Group Commercial |
$72.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$96.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.63
|
| Rate for Payer: InnovAge PACE Commercial |
$87.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.56
|
| Rate for Payer: Multiplan Commercial |
$90.75
|
| Rate for Payer: Networks By Design Commercial |
$78.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$58.63
|
| Rate for Payer: Prime Health Services Commercial |
$102.85
|
| Rate for Payer: Prime Health Services Medicare |
$62.15
|
| Rate for Payer: Riverside University Health System MISP |
$64.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.50
|
| Rate for Payer: United Healthcare All Other HMO |
$60.50
|
| Rate for Payer: United Healthcare HMO Rider |
$60.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Vantage Medical Group Senior |
$58.63
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
941000151
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Adventist Health Commercial |
$24.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$58.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.06
|
| Rate for Payer: Blue Shield of California Commercial |
$73.93
|
| Rate for Payer: Blue Shield of California EPN |
$48.28
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Central Health Plan Commercial |
$96.80
|
| Rate for Payer: Cigna of CA HMO |
$77.44
|
| Rate for Payer: Cigna of CA PPO |
$89.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$58.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$79.15
|
| Rate for Payer: EPIC Health Plan Senior |
$58.63
|
| Rate for Payer: Galaxy Health WC |
$102.85
|
| Rate for Payer: Global Benefits Group Commercial |
$72.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$96.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$58.63
|
| Rate for Payer: InnovAge PACE Commercial |
$87.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.56
|
| Rate for Payer: Multiplan Commercial |
$90.75
|
| Rate for Payer: Networks By Design Commercial |
$78.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$58.63
|
| Rate for Payer: Prime Health Services Commercial |
$102.85
|
| Rate for Payer: Prime Health Services Medicare |
$62.15
|
| Rate for Payer: Riverside University Health System MISP |
$64.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.50
|
| Rate for Payer: United Healthcare All Other HMO |
$60.50
|
| Rate for Payer: United Healthcare HMO Rider |
$60.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$58.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.49
|
| Rate for Payer: Vantage Medical Group Senior |
$58.63
|
|
|
HC ADMIN VACCINE FLU
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
941000151
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Adventist Health Commercial |
$24.20
|
| Rate for Payer: Cash Price |
$66.55
|
| Rate for Payer: Central Health Plan Commercial |
$96.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.40
|
| Rate for Payer: EPIC Health Plan Senior |
$48.40
|
| Rate for Payer: Galaxy Health WC |
$102.85
|
| Rate for Payer: Global Benefits Group Commercial |
$72.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$90.75
|
| Rate for Payer: Networks By Design Commercial |
$78.65
|
| Rate for Payer: Prime Health Services Commercial |
$102.85
|
|
|
HC ADMIN VACCINE H1N1
|
Facility
|
IP
|
$126.00
|
|
| Hospital Charge Code |
941009141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$113.40 |
| Rate for Payer: Adventist Health Commercial |
$25.20
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.40
|
| Rate for Payer: EPIC Health Plan Senior |
$50.40
|
| Rate for Payer: Galaxy Health WC |
$107.10
|
| Rate for Payer: Global Benefits Group Commercial |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$84.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Multiplan Commercial |
$94.50
|
| Rate for Payer: Networks By Design Commercial |
$81.90
|
| Rate for Payer: Prime Health Services Commercial |
$107.10
|
|
|
HC ADMIN VACCINE H1N1
|
Facility
|
IP
|
$133.00
|
|
| Hospital Charge Code |
943109141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Cash Price |
$73.15
|
| Rate for Payer: Central Health Plan Commercial |
$106.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.20
|
| Rate for Payer: EPIC Health Plan Senior |
$53.20
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.60
|
| Rate for Payer: Multiplan Commercial |
$99.75
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
|
|
HC ADMIN VACCINE H1N1
|
Facility
|
IP
|
$133.00
|
|
| Hospital Charge Code |
949009141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Cash Price |
$73.15
|
| Rate for Payer: Central Health Plan Commercial |
$106.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.20
|
| Rate for Payer: EPIC Health Plan Senior |
$53.20
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.60
|
| Rate for Payer: Multiplan Commercial |
$99.75
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
|
|
HC ADMIN VACCINE H1N1
|
Facility
|
OP
|
$126.00
|
|
| Hospital Charge Code |
941009141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$113.40 |
| Rate for Payer: Adventist Health Commercial |
$25.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$76.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$107.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$69.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$94.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$74.00
|
| Rate for Payer: Blue Shield of California Commercial |
$76.99
|
| Rate for Payer: Blue Shield of California EPN |
$50.27
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$100.80
|
| Rate for Payer: Cigna of CA HMO |
$80.64
|
| Rate for Payer: Cigna of CA PPO |
$93.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$107.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$107.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.40
|
| Rate for Payer: EPIC Health Plan Senior |
$50.40
|
| Rate for Payer: Galaxy Health WC |
$107.10
|
| Rate for Payer: Global Benefits Group Commercial |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.40
|
| Rate for Payer: InnovAge PACE Commercial |
$63.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$84.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$88.20
|
| Rate for Payer: Multiplan Commercial |
$94.50
|
| Rate for Payer: Networks By Design Commercial |
$81.90
|
| Rate for Payer: Prime Health Services Commercial |
$107.10
|
| Rate for Payer: Riverside University Health System MISP |
$50.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.00
|
| Rate for Payer: United Healthcare All Other HMO |
$63.00
|
| Rate for Payer: United Healthcare HMO Rider |
$63.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$107.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$107.10
|
| Rate for Payer: Vantage Medical Group Senior |
$107.10
|
|
|
HC ADMIN VACCINE H1N1
|
Facility
|
OP
|
$133.00
|
|
| Hospital Charge Code |
949009141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$80.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$99.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.11
|
| Rate for Payer: Blue Shield of California Commercial |
$81.26
|
| Rate for Payer: Blue Shield of California EPN |
$53.07
|
| Rate for Payer: Cash Price |
$73.15
|
| Rate for Payer: Central Health Plan Commercial |
$106.40
|
| Rate for Payer: Cigna of CA HMO |
$85.12
|
| Rate for Payer: Cigna of CA PPO |
$98.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.20
|
| Rate for Payer: EPIC Health Plan Senior |
$53.20
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.70
|
| Rate for Payer: InnovAge PACE Commercial |
$66.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93.10
|
| Rate for Payer: Multiplan Commercial |
$99.75
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
| Rate for Payer: Riverside University Health System MISP |
$53.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$66.50
|
| Rate for Payer: United Healthcare All Other HMO |
$66.50
|
| Rate for Payer: United Healthcare HMO Rider |
$66.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.05
|
| Rate for Payer: Vantage Medical Group Senior |
$113.05
|
|
|
HC ADMIN VACCINE H1N1
|
Facility
|
OP
|
$133.00
|
|
| Hospital Charge Code |
943109141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Adventist Health Commercial |
$26.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$80.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$99.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$64.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.11
|
| Rate for Payer: Blue Shield of California Commercial |
$81.26
|
| Rate for Payer: Blue Shield of California EPN |
$53.07
|
| Rate for Payer: Cash Price |
$73.15
|
| Rate for Payer: Central Health Plan Commercial |
$106.40
|
| Rate for Payer: Cigna of CA HMO |
$85.12
|
| Rate for Payer: Cigna of CA PPO |
$98.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.20
|
| Rate for Payer: EPIC Health Plan Senior |
$53.20
|
| Rate for Payer: Galaxy Health WC |
$113.05
|
| Rate for Payer: Global Benefits Group Commercial |
$79.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.70
|
| Rate for Payer: InnovAge PACE Commercial |
$66.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93.10
|
| Rate for Payer: Multiplan Commercial |
$99.75
|
| Rate for Payer: Networks By Design Commercial |
$86.45
|
| Rate for Payer: Prime Health Services Commercial |
$113.05
|
| Rate for Payer: Riverside University Health System MISP |
$53.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$66.50
|
| Rate for Payer: United Healthcare All Other HMO |
$66.50
|
| Rate for Payer: United Healthcare HMO Rider |
$66.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.05
|
| Rate for Payer: Vantage Medical Group Senior |
$113.05
|
|
|
HC ADMIN VACCINE HAEMOPHILUS FLU B
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 90648
|
| Hospital Charge Code |
911890648
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$51.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$28.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.80
|
| Rate for Payer: Blue Shield of California Commercial |
$51.32
|
| Rate for Payer: Blue Shield of California EPN |
$33.52
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$71.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Senior |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.33
|
| Rate for Payer: InnovAge PACE Commercial |
$42.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Riverside University Health System MISP |
$33.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.00
|
| Rate for Payer: United Healthcare All Other HMO |
$42.00
|
| Rate for Payer: United Healthcare HMO Rider |
$42.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.40
|
| Rate for Payer: Vantage Medical Group Senior |
$71.40
|
|
|
HC ADMIN VACCINE HAEMOPHILUS FLU B
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 90648
|
| Hospital Charge Code |
911890648
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$75.60 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Cash Price |
$46.20
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Senior |
$33.60
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 90747
|
| Hospital Charge Code |
908600203
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$42.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$77.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.34
|
| Rate for Payer: Cash Price |
$56.65
|
| Rate for Payer: Cash Price |
$56.65
|
| Rate for Payer: Cash Price |
$56.65
|
| Rate for Payer: Cash Price |
$56.65
|
| Rate for Payer: Central Health Plan Commercial |
$82.40
|
| Rate for Payer: Cigna of CA HMO |
$65.92
|
| Rate for Payer: Cigna of CA PPO |
$76.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$87.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$51.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72.10
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: Networks By Design Commercial |
$66.95
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
| Rate for Payer: Riverside University Health System MISP |
$41.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.80
|
| 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: Vantage Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.55
|
| Rate for Payer: Vantage Medical Group Senior |
$87.55
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
907200502
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.20
|
| Rate for Payer: EPIC Health Plan Senior |
$35.20
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$54.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 90747
|
| Hospital Charge Code |
908600203
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Adventist Health Commercial |
$20.60
|
| Rate for Payer: Cash Price |
$56.65
|
| Rate for Payer: Central Health Plan Commercial |
$82.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.60
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: Networks By Design Commercial |
$66.95
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
907200502
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$7.67 |
| Max. Negotiated Rate |
$148.31 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$90.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.68
|
| Rate for Payer: Blue Shield of California Commercial |
$53.77
|
| Rate for Payer: Blue Shield of California EPN |
$35.11
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$135.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$90.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.08
|
| Rate for Payer: EPIC Health Plan Senior |
$90.43
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$148.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$90.43
|
| Rate for Payer: InnovAge PACE Commercial |
$135.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$121.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$121.18
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$90.43
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Prime Health Services Medicare |
$95.86
|
| Rate for Payer: Riverside University Health System MISP |
$99.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.00
|
| Rate for Payer: United Healthcare All Other HMO |
$44.00
|
| Rate for Payer: United Healthcare HMO Rider |
$44.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$90.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Vantage Medical Group Senior |
$90.43
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 90747
|
| Hospital Charge Code |
908600203
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Adventist Health Commercial |
$20.60
|
| Rate for Payer: Cash Price |
$56.65
|
| Rate for Payer: Central Health Plan Commercial |
$82.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.60
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: Networks By Design Commercial |
$66.95
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
|
|
HC ADMIN VACCINE HEPATITIS B
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 90747
|
| Hospital Charge Code |
908600203
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$317.17 |
| Rate for Payer: Adventist Health Commercial |
$20.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$77.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$317.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.34
|
| Rate for Payer: Blue Shield of California Commercial |
$62.93
|
| Rate for Payer: Blue Shield of California EPN |
$41.10
|
| Rate for Payer: Cash Price |
$56.65
|
| Rate for Payer: Cash Price |
$56.65
|
| Rate for Payer: Central Health Plan Commercial |
$82.40
|
| Rate for Payer: Cigna of CA HMO |
$65.92
|
| Rate for Payer: Cigna of CA PPO |
$76.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$87.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$87.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$87.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.20
|
| Rate for Payer: EPIC Health Plan Senior |
$41.20
|
| Rate for Payer: Galaxy Health WC |
$87.55
|
| Rate for Payer: Global Benefits Group Commercial |
$61.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$92.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$140.75
|
| Rate for Payer: InnovAge PACE Commercial |
$51.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72.10
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: Networks By Design Commercial |
$66.95
|
| Rate for Payer: Prime Health Services Commercial |
$87.55
|
| Rate for Payer: Riverside University Health System MISP |
$41.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.50
|
| Rate for Payer: United Healthcare All Other HMO |
$51.50
|
| Rate for Payer: United Healthcare HMO Rider |
$51.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$87.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$87.55
|
| Rate for Payer: Vantage Medical Group Senior |
$87.55
|
|
|
HC ADMIN VACCINE INFLUENZA
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890229
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.10
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: InnovAge PACE Commercial |
$12.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC ADMIN VACCINE INFLUENZA
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890229
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$13.20
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
