|
HC AMYLASE URINE RANDOM
|
Facility
|
IP
|
$258.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912193
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.60 |
| Max. Negotiated Rate |
$232.20 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Central Health Plan Commercial |
$206.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$103.20
|
| Rate for Payer: Galaxy Health WC |
$219.30
|
| Rate for Payer: Global Benefits Group Commercial |
$154.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$163.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.60
|
| Rate for Payer: Multiplan Commercial |
$193.50
|
| Rate for Payer: Networks By Design Commercial |
$167.70
|
| Rate for Payer: Prime Health Services Commercial |
$219.30
|
|
|
HC AMYLASE URINE RANDOM
|
Facility
|
OP
|
$258.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
900912193
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$232.20 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Adventist Health Commercial |
$11.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.64
|
| Rate for Payer: Blue Shield of California Commercial |
$35.28
|
| Rate for Payer: Blue Shield of California Commercial |
$162.54
|
| Rate for Payer: Blue Shield of California EPN |
$22.23
|
| Rate for Payer: Blue Shield of California EPN |
$102.43
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Central Health Plan Commercial |
$206.40
|
| Rate for Payer: Central Health Plan Commercial |
$44.80
|
| Rate for Payer: Cigna of CA HMO |
$35.84
|
| Rate for Payer: Cigna of CA HMO |
$165.12
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Cigna of CA PPO |
$190.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$180.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.69
|
| Rate for Payer: EPIC Health Plan Senior |
$7.13
|
| Rate for Payer: EPIC Health Plan Senior |
$7.13
|
| Rate for Payer: Galaxy Health WC |
$47.60
|
| Rate for Payer: Galaxy Health WC |
$219.30
|
| Rate for Payer: Global Benefits Group Commercial |
$33.60
|
| Rate for Payer: Global Benefits Group Commercial |
$154.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$232.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$163.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$193.50
|
| Rate for Payer: Networks By Design Commercial |
$167.70
|
| Rate for Payer: Networks By Design Commercial |
$36.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.48
|
| Rate for Payer: Prime Health Services Commercial |
$47.60
|
| Rate for Payer: Prime Health Services Commercial |
$219.30
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Prime Health Services Medicare |
$6.87
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Riverside University Health System MISP |
$7.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$154.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$154.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
| Rate for Payer: Vantage Medical Group Senior |
$6.48
|
|
|
HC ANAEROBIC MIC PANEL
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912405
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Blue Shield of California Commercial |
$197.19
|
| Rate for Payer: Blue Shield of California Commercial |
$55.44
|
| Rate for Payer: Blue Shield of California EPN |
$34.94
|
| Rate for Payer: Blue Shield of California EPN |
$124.26
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC ANAEROBIC MIC PANEL
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912405
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC ANALYSIS PROG PUMP
|
Facility
|
OP
|
$2,053.00
|
|
|
Service Code
|
CPT 62367
|
| Hospital Charge Code |
911801005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$410.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$135.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,293.39
|
| Rate for Payer: Blue Shield of California EPN |
$815.04
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,642.40
|
| Rate for Payer: Cigna of CA HMO |
$1,313.92
|
| Rate for Payer: Cigna of CA PPO |
$1,519.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,437.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.80
|
| Rate for Payer: EPIC Health Plan Senior |
$434.53
|
| Rate for Payer: Galaxy Health WC |
$1,745.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,231.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,847.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,303.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$553.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$410.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.34
|
| Rate for Payer: Multiplan Commercial |
$1,539.75
|
| Rate for Payer: Networks By Design Commercial |
$1,334.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.03
|
| Rate for Payer: Prime Health Services Commercial |
$1,745.05
|
| Rate for Payer: Prime Health Services Medicare |
$418.73
|
| Rate for Payer: Riverside University Health System MISP |
$434.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,231.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,231.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.53
|
| Rate for Payer: Vantage Medical Group Senior |
$395.03
|
|
|
HC ANALYSIS PROG PUMP
|
Facility
|
IP
|
$2,053.00
|
|
|
Service Code
|
CPT 62367
|
| Hospital Charge Code |
911801005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$410.60 |
| Max. Negotiated Rate |
$1,847.70 |
| Rate for Payer: Adventist Health Commercial |
$410.60
|
| Rate for Payer: Cash Price |
$923.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,642.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,437.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$821.20
|
| Rate for Payer: EPIC Health Plan Senior |
$821.20
|
| Rate for Payer: Galaxy Health WC |
$1,745.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,231.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,847.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,303.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,211.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$410.60
|
| Rate for Payer: Multiplan Commercial |
$1,539.75
|
| Rate for Payer: Networks By Design Commercial |
$1,334.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,745.05
|
|
|
HC ANALYSIS PUMP W/REPROGRAM
|
Facility
|
IP
|
$1,827.00
|
|
|
Service Code
|
CPT 62368
|
| Hospital Charge Code |
911801006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$365.40 |
| Max. Negotiated Rate |
$1,644.30 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,461.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,278.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.80
|
| Rate for Payer: EPIC Health Plan Senior |
$730.80
|
| Rate for Payer: Galaxy Health WC |
$1,552.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,096.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,644.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,160.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,077.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$365.40
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Networks By Design Commercial |
$1,187.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,552.95
|
|
|
HC ANALYSIS PUMP W/REPROGRAM
|
Facility
|
OP
|
$1,827.00
|
|
|
Service Code
|
CPT 62368
|
| Hospital Charge Code |
911801006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$58.91 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$395.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$211.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,151.01
|
| Rate for Payer: Blue Shield of California EPN |
$725.32
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,461.60
|
| Rate for Payer: Cigna of CA HMO |
$1,169.28
|
| Rate for Payer: Cigna of CA PPO |
$1,351.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,278.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.80
|
| Rate for Payer: EPIC Health Plan Senior |
$434.53
|
| Rate for Payer: Galaxy Health WC |
$1,552.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,096.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,644.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,160.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$65.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$553.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$365.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.34
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Networks By Design Commercial |
$1,187.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$395.03
|
| Rate for Payer: Prime Health Services Commercial |
$1,552.95
|
| Rate for Payer: Prime Health Services Medicare |
$418.73
|
| Rate for Payer: Riverside University Health System MISP |
$434.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,096.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,096.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$395.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.53
|
| Rate for Payer: Vantage Medical Group Senior |
$395.03
|
|
|
HC ANALYZE ILR SYSTEM IHI
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 93291
|
| Hospital Charge Code |
900200311
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$37.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$101.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.35
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: Cigna of CA HMO |
$57.60
|
| Rate for Payer: Cigna of CA PPO |
$66.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.38
|
| Rate for Payer: EPIC Health Plan Senior |
$40.92
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$69.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$49.85
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$37.20
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
| Rate for Payer: Prime Health Services Medicare |
$39.43
|
| Rate for Payer: Riverside University Health System MISP |
$40.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$37.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC ANALYZE ILR SYSTEM IHI
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 93291
|
| Hospital Charge Code |
900200311
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Adventist Health Commercial |
$18.00
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.00
|
| Rate for Payer: EPIC Health Plan Senior |
$36.00
|
| Rate for Payer: Galaxy Health WC |
$76.50
|
| Rate for Payer: Global Benefits Group Commercial |
$54.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Multiplan Commercial |
$67.50
|
| Rate for Payer: Networks By Design Commercial |
$58.50
|
| Rate for Payer: Prime Health Services Commercial |
$76.50
|
|
|
HC ANA O 3 (CASHEW), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913734
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC ANA O 3 (CASHEW), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913734
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.34
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ANA PANEL
|
Facility
|
OP
|
$154.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913646
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$154.02 |
| Rate for Payer: Adventist Health Commercial |
$30.80
|
| Rate for Payer: Adventist Health Commercial |
$34.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$120.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$110.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.02
|
| Rate for Payer: Blue Shield of California Commercial |
$107.73
|
| Rate for Payer: Blue Shield of California Commercial |
$97.02
|
| Rate for Payer: Blue Shield of California EPN |
$67.89
|
| Rate for Payer: Blue Shield of California EPN |
$61.14
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: Central Health Plan Commercial |
$136.80
|
| Rate for Payer: Cigna of CA HMO |
$109.44
|
| Rate for Payer: Cigna of CA HMO |
$98.56
|
| Rate for Payer: Cigna of CA PPO |
$126.54
|
| Rate for Payer: Cigna of CA PPO |
$113.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$145.35
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$102.60
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$108.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$128.25
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Networks By Design Commercial |
$111.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$145.35
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ANA PANEL
|
Facility
|
IP
|
$171.00
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
900913646
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.20 |
| Max. Negotiated Rate |
$153.90 |
| Rate for Payer: Adventist Health Commercial |
$34.20
|
| Rate for Payer: Cash Price |
$76.95
|
| Rate for Payer: Central Health Plan Commercial |
$136.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.40
|
| Rate for Payer: EPIC Health Plan Senior |
$68.40
|
| Rate for Payer: Galaxy Health WC |
$145.35
|
| Rate for Payer: Global Benefits Group Commercial |
$102.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$108.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.20
|
| Rate for Payer: Multiplan Commercial |
$128.25
|
| Rate for Payer: Networks By Design Commercial |
$111.15
|
| Rate for Payer: Prime Health Services Commercial |
$145.35
|
|
|
HC ANCR CATH UMBILICAL UMB-E
|
Facility
|
IP
|
$22.63
|
|
| Hospital Charge Code |
901603825
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$20.37 |
| Rate for Payer: Adventist Health Commercial |
$4.53
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Central Health Plan Commercial |
$18.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
| Rate for Payer: EPIC Health Plan Senior |
$9.05
|
| Rate for Payer: Galaxy Health WC |
$19.24
|
| Rate for Payer: Global Benefits Group Commercial |
$13.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
| Rate for Payer: Multiplan Commercial |
$16.97
|
| Rate for Payer: Networks By Design Commercial |
$14.71
|
| Rate for Payer: Prime Health Services Commercial |
$19.24
|
|
|
HC ANCR CATH UMBILICAL UMB-E
|
Facility
|
OP
|
$22.63
|
|
| Hospital Charge Code |
901603825
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$20.37 |
| Rate for Payer: Adventist Health Commercial |
$4.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.16
|
| Rate for Payer: Blue Shield of California Commercial |
$14.35
|
| Rate for Payer: Blue Shield of California EPN |
$9.03
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Central Health Plan Commercial |
$18.10
|
| Rate for Payer: Cigna of CA HMO |
$14.48
|
| Rate for Payer: Cigna of CA PPO |
$16.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
| Rate for Payer: EPIC Health Plan Senior |
$9.05
|
| Rate for Payer: Galaxy Health WC |
$19.24
|
| Rate for Payer: Global Benefits Group Commercial |
$13.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.84
|
| Rate for Payer: Multiplan Commercial |
$16.97
|
| Rate for Payer: Networks By Design Commercial |
$14.71
|
| Rate for Payer: Prime Health Services Commercial |
$19.24
|
| Rate for Payer: Riverside University Health System MISP |
$9.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.31
|
| Rate for Payer: United Healthcare All Other HMO |
$11.31
|
| Rate for Payer: United Healthcare HMO Rider |
$11.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.24
|
| Rate for Payer: Vantage Medical Group Senior |
$19.24
|
|
|
HC ANESTHESIA LEVEL I 1ST 15MIN
|
Facility
|
IP
|
$871.00
|
|
| Hospital Charge Code |
904900400
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$174.20 |
| Max. Negotiated Rate |
$783.90 |
| Rate for Payer: Adventist Health Commercial |
$174.20
|
| Rate for Payer: Cash Price |
$391.95
|
| Rate for Payer: Central Health Plan Commercial |
$696.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$609.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.40
|
| Rate for Payer: EPIC Health Plan Senior |
$348.40
|
| Rate for Payer: Galaxy Health WC |
$740.35
|
| Rate for Payer: Global Benefits Group Commercial |
$522.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$783.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$553.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$513.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.20
|
| Rate for Payer: Multiplan Commercial |
$653.25
|
| Rate for Payer: Networks By Design Commercial |
$566.15
|
| Rate for Payer: Prime Health Services Commercial |
$740.35
|
|
|
HC ANESTHESIA LEVEL I 1ST 15MIN
|
Facility
|
OP
|
$871.00
|
|
| Hospital Charge Code |
904900400
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$174.20 |
| Max. Negotiated Rate |
$783.90 |
| Rate for Payer: Adventist Health Commercial |
$174.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$528.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$740.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$479.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$653.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$421.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$506.66
|
| Rate for Payer: Blue Shield of California Commercial |
$552.21
|
| Rate for Payer: Blue Shield of California EPN |
$347.53
|
| Rate for Payer: Cash Price |
$391.95
|
| Rate for Payer: Central Health Plan Commercial |
$696.80
|
| Rate for Payer: Cigna of CA HMO |
$557.44
|
| Rate for Payer: Cigna of CA PPO |
$644.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$740.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$740.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$740.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$609.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.40
|
| Rate for Payer: EPIC Health Plan Senior |
$348.40
|
| Rate for Payer: Galaxy Health WC |
$740.35
|
| Rate for Payer: Global Benefits Group Commercial |
$522.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$783.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$553.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$316.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$513.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$609.70
|
| Rate for Payer: Multiplan Commercial |
$653.25
|
| Rate for Payer: Networks By Design Commercial |
$566.15
|
| Rate for Payer: Prime Health Services Commercial |
$740.35
|
| Rate for Payer: Riverside University Health System MISP |
$348.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$522.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$522.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$435.50
|
| Rate for Payer: United Healthcare All Other HMO |
$435.50
|
| Rate for Payer: United Healthcare HMO Rider |
$435.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$435.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$740.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$740.35
|
| Rate for Payer: Vantage Medical Group Senior |
$740.35
|
|
|
HC ANESTHESIA LEVEL I ADD'L 15MIN
|
Facility
|
IP
|
$217.00
|
|
| Hospital Charge Code |
904900401
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$151.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$137.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
|
|
HC ANESTHESIA LEVEL I ADD'L 15MIN
|
Facility
|
OP
|
$217.00
|
|
| Hospital Charge Code |
904900401
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$184.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$162.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$126.23
|
| Rate for Payer: Blue Shield of California Commercial |
$137.58
|
| Rate for Payer: Blue Shield of California EPN |
$86.58
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Cigna of CA HMO |
$138.88
|
| Rate for Payer: Cigna of CA PPO |
$160.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$184.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$184.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$151.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$137.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$78.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$128.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$151.90
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
| Rate for Payer: Riverside University Health System MISP |
$86.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.50
|
| Rate for Payer: United Healthcare All Other HMO |
$108.50
|
| Rate for Payer: United Healthcare HMO Rider |
$108.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$184.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.45
|
| Rate for Payer: Vantage Medical Group Senior |
$184.45
|
|
|
HC ANESTHESIA LEVEL II 1ST 15MIN
|
Facility
|
IP
|
$1,824.00
|
|
| Hospital Charge Code |
904900402
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$364.80 |
| Max. Negotiated Rate |
$1,641.60 |
| Rate for Payer: Adventist Health Commercial |
$364.80
|
| Rate for Payer: Cash Price |
$820.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,459.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$729.60
|
| Rate for Payer: Galaxy Health WC |
$1,550.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,094.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,641.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,158.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,076.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.80
|
| Rate for Payer: Multiplan Commercial |
$1,368.00
|
| Rate for Payer: Networks By Design Commercial |
$1,185.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,550.40
|
|
|
HC ANESTHESIA LEVEL II 1ST 15MIN
|
Facility
|
OP
|
$1,824.00
|
|
| Hospital Charge Code |
904900402
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$364.80 |
| Max. Negotiated Rate |
$1,641.60 |
| Rate for Payer: Adventist Health Commercial |
$364.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,107.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,550.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,003.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,368.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$883.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,061.02
|
| Rate for Payer: Blue Shield of California Commercial |
$1,156.42
|
| Rate for Payer: Blue Shield of California EPN |
$727.78
|
| Rate for Payer: Cash Price |
$820.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,459.20
|
| Rate for Payer: Cigna of CA HMO |
$1,167.36
|
| Rate for Payer: Cigna of CA PPO |
$1,349.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,550.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,550.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,550.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$729.60
|
| Rate for Payer: Galaxy Health WC |
$1,550.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,094.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,641.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,158.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$662.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,076.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,276.80
|
| Rate for Payer: Multiplan Commercial |
$1,368.00
|
| Rate for Payer: Networks By Design Commercial |
$1,185.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,550.40
|
| Rate for Payer: Riverside University Health System MISP |
$729.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,094.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,094.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$912.00
|
| Rate for Payer: United Healthcare All Other HMO |
$912.00
|
| Rate for Payer: United Healthcare HMO Rider |
$912.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$912.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,550.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,550.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,550.40
|
|
|
HC ANESTHESIA LEVEL II ADD'L 15MIN
|
Facility
|
IP
|
$301.00
|
|
| Hospital Charge Code |
904900403
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC ANESTHESIA LEVEL II ADD'L 15MIN
|
Facility
|
OP
|
$301.00
|
|
| Hospital Charge Code |
904900403
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$182.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$145.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$175.09
|
| Rate for Payer: Blue Shield of California Commercial |
$190.83
|
| Rate for Payer: Blue Shield of California EPN |
$120.10
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$210.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$191.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$109.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$177.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$210.70
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Riverside University Health System MISP |
$120.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.50
|
| Rate for Payer: United Healthcare All Other HMO |
$150.50
|
| Rate for Payer: United Healthcare HMO Rider |
$150.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.85
|
| Rate for Payer: Vantage Medical Group Senior |
$255.85
|
|
|
HC ANESTHESIA LEVEL III 1ST 15MIN
|
Facility
|
IP
|
$3,120.00
|
|
| Hospital Charge Code |
904900404
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$624.00 |
| Max. Negotiated Rate |
$2,808.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,496.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,184.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,248.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,248.00
|
| Rate for Payer: Galaxy Health WC |
$2,652.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,872.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,808.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,981.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,840.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$624.00
|
| Rate for Payer: Multiplan Commercial |
$2,340.00
|
| Rate for Payer: Networks By Design Commercial |
$2,028.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,652.00
|
|
