|
HC ADMIN VACCINE INFLUENZA 6-35 MON
|
Facility
|
OP
|
$41.00
|
|
| Hospital Charge Code |
908600539
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.08
|
| Rate for Payer: Blue Shield of California Commercial |
$25.05
|
| Rate for Payer: Blue Shield of California EPN |
$16.36
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: Cigna of CA HMO |
$26.24
|
| Rate for Payer: Cigna of CA PPO |
$30.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: InnovAge PACE Commercial |
$20.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
| Rate for Payer: Riverside University Health System MISP |
$16.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20.50
|
| Rate for Payer: United Healthcare HMO Rider |
$20.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.85
|
| Rate for Payer: Vantage Medical Group Senior |
$34.85
|
|
|
HC ADMIN VACCINE INFLUENZA 6-35 MON
|
Facility
|
IP
|
$41.00
|
|
| Hospital Charge Code |
908600539
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Cash Price |
$22.55
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16.40
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
|
|
HC ADMIN VACCINE INFLUENZA ADMIN GT 3 YR
|
Facility
|
OP
|
$40.00
|
|
| Hospital Charge Code |
908600536
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.49
|
| Rate for Payer: Blue Shield of California Commercial |
$24.44
|
| Rate for Payer: Blue Shield of California EPN |
$15.96
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: Cigna of CA HMO |
$25.60
|
| Rate for Payer: Cigna of CA PPO |
$29.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Senior |
$16.00
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: InnovAge PACE Commercial |
$20.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
| Rate for Payer: Riverside University Health System MISP |
$16.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20.00
|
| Rate for Payer: United Healthcare HMO Rider |
$20.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.00
|
| Rate for Payer: Vantage Medical Group Senior |
$34.00
|
|
|
HC ADMIN VACCINE INFLUENZA ADMIN GT 3 YR
|
Facility
|
IP
|
$40.00
|
|
| Hospital Charge Code |
908600536
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Cash Price |
$22.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Senior |
$16.00
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
|
|
HC ADMIN VACCINE INFLUENZA GT 3 YR
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 90656
|
| Hospital Charge Code |
908702039
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Adventist Health Commercial |
$12.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.23
|
| Rate for Payer: Blue Shield of California Commercial |
$25.88
|
| Rate for Payer: Blue Shield of California EPN |
$23.53
|
| Rate for Payer: Cash Price |
$33.55
|
| Rate for Payer: Cash Price |
$33.55
|
| Rate for Payer: Central Health Plan Commercial |
$48.80
|
| Rate for Payer: Cigna of CA HMO |
$42.70
|
| Rate for Payer: Cigna of CA PPO |
$42.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.40
|
| Rate for Payer: EPIC Health Plan Senior |
$24.40
|
| Rate for Payer: Galaxy Health WC |
$51.85
|
| Rate for Payer: Global Benefits Group Commercial |
$36.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.35
|
| Rate for Payer: InnovAge PACE Commercial |
$30.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.70
|
| Rate for Payer: Multiplan Commercial |
$45.75
|
| Rate for Payer: Networks By Design Commercial |
$30.50
|
| Rate for Payer: Prime Health Services Commercial |
$51.85
|
| Rate for Payer: Riverside University Health System MISP |
$24.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.89
|
| Rate for Payer: United Healthcare All Other HMO |
$22.28
|
| Rate for Payer: United Healthcare HMO Rider |
$21.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.85
|
| Rate for Payer: Vantage Medical Group Senior |
$51.85
|
|
|
HC ADMIN VACCINE INFLUENZA GT 3 YR
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 90656
|
| Hospital Charge Code |
908702039
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Adventist Health Commercial |
$12.20
|
| Rate for Payer: Blue Shield of California Commercial |
$47.15
|
| Rate for Payer: Blue Shield of California EPN |
$30.74
|
| Rate for Payer: Cash Price |
$33.55
|
| Rate for Payer: Central Health Plan Commercial |
$48.80
|
| Rate for Payer: Cigna of CA HMO |
$42.70
|
| Rate for Payer: Cigna of CA PPO |
$42.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.40
|
| Rate for Payer: EPIC Health Plan Senior |
$24.40
|
| Rate for Payer: Galaxy Health WC |
$51.85
|
| Rate for Payer: Global Benefits Group Commercial |
$36.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.20
|
| Rate for Payer: Multiplan Commercial |
$45.75
|
| Rate for Payer: Networks By Design Commercial |
$30.50
|
| Rate for Payer: Prime Health Services Commercial |
$51.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.89
|
| Rate for Payer: United Healthcare All Other HMO |
$22.28
|
| Rate for Payer: United Healthcare HMO Rider |
$21.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.98
|
|
|
HC ADMIN VACCINE INFLUENZA GT 3YR
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
943100151
|
|
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 INFLUENZA GT 3YR
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
943100151
|
|
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 INFLUENZA MEDI-CAL HEMOPH
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 90648
|
| Hospital Charge Code |
908603031
|
|
Hospital Revenue Code
|
510
|
| 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 INFLUENZA MEDI-CAL HEMOPH
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 90648
|
| Hospital Charge Code |
908603031
|
|
Hospital Revenue Code
|
510
|
| 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 MEDI-CAL HEP B PEDS ADULT
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
908603023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Adventist Health Commercial |
$21.00
|
| Rate for Payer: Cash Price |
$57.75
|
| Rate for Payer: Central Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.00
|
| Rate for Payer: EPIC Health Plan Senior |
$42.00
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Multiplan Commercial |
$78.75
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
|
|
HC ADMIN VACCINE MEDI-CAL HEP B PEDS ADULT
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
908603023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Adventist Health Commercial |
$21.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.75
|
| Rate for Payer: Blue Shield of California Commercial |
$64.16
|
| Rate for Payer: Blue Shield of California EPN |
$41.90
|
| Rate for Payer: Cash Price |
$57.75
|
| Rate for Payer: Cash Price |
$57.75
|
| Rate for Payer: Central Health Plan Commercial |
$84.00
|
| Rate for Payer: Cigna of CA HMO |
$67.20
|
| Rate for Payer: Cigna of CA PPO |
$77.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.00
|
| Rate for Payer: EPIC Health Plan Senior |
$42.00
|
| Rate for Payer: Galaxy Health WC |
$89.25
|
| Rate for Payer: Global Benefits Group Commercial |
$63.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$94.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.67
|
| Rate for Payer: InnovAge PACE Commercial |
$52.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$78.75
|
| Rate for Payer: Networks By Design Commercial |
$68.25
|
| Rate for Payer: Prime Health Services Commercial |
$89.25
|
| Rate for Payer: Riverside University Health System MISP |
$42.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.50
|
| Rate for Payer: United Healthcare All Other HMO |
$52.50
|
| Rate for Payer: United Healthcare HMO Rider |
$52.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.25
|
| Rate for Payer: Vantage Medical Group Senior |
$89.25
|
|
|
HC ADMIN VACCINE MEDI-CAL MMR
|
Facility
|
OP
|
$83.96
|
|
|
Service Code
|
CPT 90707
|
| Hospital Charge Code |
908603007
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$16.79 |
| Max. Negotiated Rate |
$208.52 |
| Rate for Payer: Adventist Health Commercial |
$16.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$208.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.00
|
| Rate for Payer: Blue Shield of California Commercial |
$51.30
|
| Rate for Payer: Blue Shield of California EPN |
$33.50
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Central Health Plan Commercial |
$67.17
|
| Rate for Payer: Cigna of CA HMO |
$53.73
|
| Rate for Payer: Cigna of CA PPO |
$62.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$71.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.58
|
| Rate for Payer: EPIC Health Plan Senior |
$33.58
|
| Rate for Payer: Galaxy Health WC |
$71.37
|
| Rate for Payer: Global Benefits Group Commercial |
$50.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$167.55
|
| Rate for Payer: InnovAge PACE Commercial |
$41.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$185.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58.77
|
| Rate for Payer: Multiplan Commercial |
$62.97
|
| Rate for Payer: Networks By Design Commercial |
$54.57
|
| Rate for Payer: Prime Health Services Commercial |
$71.37
|
| Rate for Payer: Riverside University Health System MISP |
$33.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.98
|
| Rate for Payer: United Healthcare All Other HMO |
$41.98
|
| Rate for Payer: United Healthcare HMO Rider |
$41.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.37
|
| Rate for Payer: Vantage Medical Group Senior |
$71.37
|
|
|
HC ADMIN VACCINE MEDI-CAL MMR
|
Facility
|
IP
|
$83.96
|
|
|
Service Code
|
CPT 90707
|
| Hospital Charge Code |
908603007
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$16.79 |
| Max. Negotiated Rate |
$75.56 |
| Rate for Payer: Adventist Health Commercial |
$16.79
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Central Health Plan Commercial |
$67.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.58
|
| Rate for Payer: EPIC Health Plan Senior |
$33.58
|
| Rate for Payer: Galaxy Health WC |
$71.37
|
| Rate for Payer: Global Benefits Group Commercial |
$50.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$51.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.79
|
| Rate for Payer: Multiplan Commercial |
$62.97
|
| Rate for Payer: Networks By Design Commercial |
$54.57
|
| Rate for Payer: Prime Health Services Commercial |
$71.37
|
|
|
HC ADMIN VACCINE MEDI-CAL PNEUMOCOCCAL
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
908710321
|
|
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 MEDI-CAL PNEUMOCOCCAL
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
908710321
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$262.07 |
| 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 |
$257.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.02
|
| 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 |
$133.47
|
| 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 |
$262.07
|
| 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 MEDI-CAL PNEUMOCOCCAL
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
908710321
|
|
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 MEDI-CAL PNEUMOCOCCAL
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
908710321
|
|
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 |
$79.02
|
| 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 |
$262.07
|
| 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 MEDI-CAL PNEUMOCOCCAL GT 2YR
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
908600179
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$262.07 |
| 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 |
$257.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.02
|
| 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 |
$133.47
|
| 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 |
$262.07
|
| 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 MEDI-CAL PNEUMOCOCCAL GT 2YR
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
908600179
|
|
Hospital Revenue Code
|
510
|
| 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 MENINGOCOCCAL
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
911890734
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$366.41 |
| 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 |
$366.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.45
|
| 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 |
$289.75
|
| 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 |
$320.07
|
| 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 MENINGOCOCCAL
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
911890734
|
|
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 MMR
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
907200501
|
|
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 MMR
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
907200501
|
|
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 MONKEYPOX 1ST
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
CPT 90471
|
| Hospital Charge Code |
948000204
|
|
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
|
|
