|
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
|
|
|
HC ANESTHESIA LEVEL III ADD'L 15MIN
|
Facility
|
OP
|
$529.00
|
|
| Hospital Charge Code |
904900405
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$105.80 |
| Max. Negotiated Rate |
$476.10 |
| Rate for Payer: Adventist Health Commercial |
$105.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$321.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$449.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$396.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$256.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$307.72
|
| Rate for Payer: Blue Shield of California Commercial |
$335.39
|
| Rate for Payer: Blue Shield of California EPN |
$211.07
|
| Rate for Payer: Cash Price |
$238.05
|
| Rate for Payer: Central Health Plan Commercial |
$423.20
|
| Rate for Payer: Cigna of CA HMO |
$338.56
|
| Rate for Payer: Cigna of CA PPO |
$391.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$449.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$449.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$370.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.60
|
| Rate for Payer: EPIC Health Plan Senior |
$211.60
|
| Rate for Payer: Galaxy Health WC |
$449.65
|
| Rate for Payer: Global Benefits Group Commercial |
$317.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$476.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$312.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$370.30
|
| Rate for Payer: Multiplan Commercial |
$396.75
|
| Rate for Payer: Networks By Design Commercial |
$343.85
|
| Rate for Payer: Prime Health Services Commercial |
$449.65
|
| Rate for Payer: Riverside University Health System MISP |
$211.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$317.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$317.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$264.50
|
| Rate for Payer: United Healthcare All Other HMO |
$264.50
|
| Rate for Payer: United Healthcare HMO Rider |
$264.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$264.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$449.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.65
|
| Rate for Payer: Vantage Medical Group Senior |
$449.65
|
|
|
HC ANESTHESIA LEVEL III ADD'L 15MIN
|
Facility
|
IP
|
$529.00
|
|
| Hospital Charge Code |
904900405
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$105.80 |
| Max. Negotiated Rate |
$476.10 |
| Rate for Payer: Adventist Health Commercial |
$105.80
|
| Rate for Payer: Cash Price |
$238.05
|
| Rate for Payer: Central Health Plan Commercial |
$423.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$370.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.60
|
| Rate for Payer: EPIC Health Plan Senior |
$211.60
|
| Rate for Payer: Galaxy Health WC |
$449.65
|
| Rate for Payer: Global Benefits Group Commercial |
$317.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$476.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$335.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$312.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.80
|
| Rate for Payer: Multiplan Commercial |
$396.75
|
| Rate for Payer: Networks By Design Commercial |
$343.85
|
| Rate for Payer: Prime Health Services Commercial |
$449.65
|
|
|
HC ANESTHESIA LEVEL IV 1ST 15MIN
|
Facility
|
OP
|
$4,157.00
|
|
| Hospital Charge Code |
904900406
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$831.40 |
| Max. Negotiated Rate |
$3,741.30 |
| Rate for Payer: Adventist Health Commercial |
$831.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,524.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,533.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,286.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,117.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,012.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,418.13
|
| Rate for Payer: Blue Shield of California Commercial |
$2,635.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,658.64
|
| Rate for Payer: Cash Price |
$1,870.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,325.60
|
| Rate for Payer: Cigna of CA HMO |
$2,660.48
|
| Rate for Payer: Cigna of CA PPO |
$3,076.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,533.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,533.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,533.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,909.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,662.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,662.80
|
| Rate for Payer: Galaxy Health WC |
$3,533.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,494.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,741.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,639.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,508.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,452.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,909.90
|
| Rate for Payer: Multiplan Commercial |
$3,117.75
|
| Rate for Payer: Networks By Design Commercial |
$2,702.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,533.45
|
| Rate for Payer: Riverside University Health System MISP |
$1,662.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,494.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,494.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,078.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,078.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,078.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,078.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,533.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,533.45
|
| Rate for Payer: Vantage Medical Group Senior |
$3,533.45
|
|
|
HC ANESTHESIA LEVEL IV 1ST 15MIN
|
Facility
|
IP
|
$4,157.00
|
|
| Hospital Charge Code |
904900406
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$831.40 |
| Max. Negotiated Rate |
$3,741.30 |
| Rate for Payer: Adventist Health Commercial |
$831.40
|
| Rate for Payer: Cash Price |
$1,870.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,325.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,909.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,662.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,662.80
|
| Rate for Payer: Galaxy Health WC |
$3,533.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,494.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,741.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,639.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,452.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.40
|
| Rate for Payer: Multiplan Commercial |
$3,117.75
|
| Rate for Payer: Networks By Design Commercial |
$2,702.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,533.45
|
|
|
HC ANESTHESIA LEVEL IV ADD'L 15MIN
|
Facility
|
IP
|
$730.00
|
|
| Hospital Charge Code |
904900407
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$146.00 |
| Max. Negotiated Rate |
$657.00 |
| Rate for Payer: Adventist Health Commercial |
$146.00
|
| Rate for Payer: Cash Price |
$328.50
|
| Rate for Payer: Central Health Plan Commercial |
$584.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$511.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$292.00
|
| Rate for Payer: EPIC Health Plan Senior |
$292.00
|
| Rate for Payer: Galaxy Health WC |
$620.50
|
| Rate for Payer: Global Benefits Group Commercial |
$438.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$657.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$463.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$430.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.00
|
| Rate for Payer: Multiplan Commercial |
$547.50
|
| Rate for Payer: Networks By Design Commercial |
$474.50
|
| Rate for Payer: Prime Health Services Commercial |
$620.50
|
|
|
HC ANESTHESIA LEVEL IV ADD'L 15MIN
|
Facility
|
OP
|
$730.00
|
|
| Hospital Charge Code |
904900407
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$146.00 |
| Max. Negotiated Rate |
$657.00 |
| Rate for Payer: Adventist Health Commercial |
$146.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$443.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$620.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$401.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$547.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$353.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$424.64
|
| Rate for Payer: Blue Shield of California Commercial |
$462.82
|
| Rate for Payer: Blue Shield of California EPN |
$291.27
|
| Rate for Payer: Cash Price |
$328.50
|
| Rate for Payer: Central Health Plan Commercial |
$584.00
|
| Rate for Payer: Cigna of CA HMO |
$467.20
|
| Rate for Payer: Cigna of CA PPO |
$540.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$620.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$620.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$620.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$511.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$292.00
|
| Rate for Payer: EPIC Health Plan Senior |
$292.00
|
| Rate for Payer: Galaxy Health WC |
$620.50
|
| Rate for Payer: Global Benefits Group Commercial |
$438.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$657.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$463.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$264.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$430.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$511.00
|
| Rate for Payer: Multiplan Commercial |
$547.50
|
| Rate for Payer: Networks By Design Commercial |
$474.50
|
| Rate for Payer: Prime Health Services Commercial |
$620.50
|
| Rate for Payer: Riverside University Health System MISP |
$292.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$438.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$438.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$365.00
|
| Rate for Payer: United Healthcare All Other HMO |
$365.00
|
| Rate for Payer: United Healthcare HMO Rider |
$365.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$365.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$620.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$620.50
|
| Rate for Payer: Vantage Medical Group Senior |
$620.50
|
|
|
HC ANESTHESIA LEVEL V 1ST 15MIN
|
Facility
|
IP
|
$5,184.00
|
|
| Hospital Charge Code |
904900408
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,036.80 |
| Max. Negotiated Rate |
$4,665.60 |
| Rate for Payer: Adventist Health Commercial |
$1,036.80
|
| Rate for Payer: Cash Price |
$2,332.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,147.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,628.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,073.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,073.60
|
| Rate for Payer: Galaxy Health WC |
$4,406.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,110.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,665.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,291.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,058.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,036.80
|
| Rate for Payer: Multiplan Commercial |
$3,888.00
|
| Rate for Payer: Networks By Design Commercial |
$3,369.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,406.40
|
|
|
HC ANESTHESIA LEVEL V 1ST 15MIN
|
Facility
|
OP
|
$5,184.00
|
|
| Hospital Charge Code |
904900408
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,036.80 |
| Max. Negotiated Rate |
$4,665.60 |
| Rate for Payer: Adventist Health Commercial |
$1,036.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,148.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,406.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,851.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,888.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,510.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,015.53
|
| Rate for Payer: Blue Shield of California Commercial |
$3,286.66
|
| Rate for Payer: Blue Shield of California EPN |
$2,068.42
|
| Rate for Payer: Cash Price |
$2,332.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,147.20
|
| Rate for Payer: Cigna of CA HMO |
$3,317.76
|
| Rate for Payer: Cigna of CA PPO |
$3,836.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,406.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,406.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,406.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,628.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,073.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,073.60
|
| Rate for Payer: Galaxy Health WC |
$4,406.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,110.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,665.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,291.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,881.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,058.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,036.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,628.80
|
| Rate for Payer: Multiplan Commercial |
$3,888.00
|
| Rate for Payer: Networks By Design Commercial |
$3,369.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,406.40
|
| Rate for Payer: Riverside University Health System MISP |
$2,073.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,110.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,110.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,592.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,592.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,592.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,592.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,406.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,406.40
|
| Rate for Payer: Vantage Medical Group Senior |
$4,406.40
|
|
|
HC ANESTHESIA LEVEL V ADD'L 15MIN
|
Facility
|
IP
|
$934.00
|
|
| Hospital Charge Code |
904900409
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$186.80 |
| Max. Negotiated Rate |
$840.60 |
| Rate for Payer: Adventist Health Commercial |
$186.80
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Central Health Plan Commercial |
$747.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$653.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.60
|
| Rate for Payer: EPIC Health Plan Senior |
$373.60
|
| Rate for Payer: Galaxy Health WC |
$793.90
|
| Rate for Payer: Global Benefits Group Commercial |
$560.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$840.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$593.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$551.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.80
|
| Rate for Payer: Multiplan Commercial |
$700.50
|
| Rate for Payer: Networks By Design Commercial |
$607.10
|
| Rate for Payer: Prime Health Services Commercial |
$793.90
|
|
|
HC ANESTHESIA LEVEL V ADD'L 15MIN
|
Facility
|
OP
|
$934.00
|
|
| Hospital Charge Code |
904900409
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$186.80 |
| Max. Negotiated Rate |
$840.60 |
| Rate for Payer: Adventist Health Commercial |
$186.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$567.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$793.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$513.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$700.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$452.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$543.31
|
| Rate for Payer: Blue Shield of California Commercial |
$592.16
|
| Rate for Payer: Blue Shield of California EPN |
$372.67
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Central Health Plan Commercial |
$747.20
|
| Rate for Payer: Cigna of CA HMO |
$597.76
|
| Rate for Payer: Cigna of CA PPO |
$691.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$793.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$793.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$793.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$653.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.60
|
| Rate for Payer: EPIC Health Plan Senior |
$373.60
|
| Rate for Payer: Galaxy Health WC |
$793.90
|
| Rate for Payer: Global Benefits Group Commercial |
$560.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$840.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$593.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$551.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$653.80
|
| Rate for Payer: Multiplan Commercial |
$700.50
|
| Rate for Payer: Networks By Design Commercial |
$607.10
|
| Rate for Payer: Prime Health Services Commercial |
$793.90
|
| Rate for Payer: Riverside University Health System MISP |
$373.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$560.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$560.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$467.00
|
| Rate for Payer: United Healthcare All Other HMO |
$467.00
|
| Rate for Payer: United Healthcare HMO Rider |
$467.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$467.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$793.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$793.90
|
| Rate for Payer: Vantage Medical Group Senior |
$793.90
|
|
|
HC ANESTHESIA LEVEL VI 1ST 15MIN
|
Facility
|
IP
|
$6,223.00
|
|
| Hospital Charge Code |
904900410
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,244.60 |
| Max. Negotiated Rate |
$5,600.70 |
| Rate for Payer: Adventist Health Commercial |
$1,244.60
|
| Rate for Payer: Cash Price |
$2,800.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,978.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,356.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,489.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,489.20
|
| Rate for Payer: Galaxy Health WC |
$5,289.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,733.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,600.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,951.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,671.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.60
|
| Rate for Payer: Multiplan Commercial |
$4,667.25
|
| Rate for Payer: Networks By Design Commercial |
$4,044.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,289.55
|
|
|
HC ANESTHESIA LEVEL VI 1ST 15MIN
|
Facility
|
OP
|
$6,223.00
|
|
| Hospital Charge Code |
904900410
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$1,244.60 |
| Max. Negotiated Rate |
$5,600.70 |
| Rate for Payer: Adventist Health Commercial |
$1,244.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,779.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,289.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,422.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,667.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,013.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,619.92
|
| Rate for Payer: Blue Shield of California Commercial |
$3,945.38
|
| Rate for Payer: Blue Shield of California EPN |
$2,482.98
|
| Rate for Payer: Cash Price |
$2,800.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,978.40
|
| Rate for Payer: Cigna of CA HMO |
$3,982.72
|
| Rate for Payer: Cigna of CA PPO |
$4,605.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,289.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,289.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,289.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,356.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,489.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,489.20
|
| Rate for Payer: Galaxy Health WC |
$5,289.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,733.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,600.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,951.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,258.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,671.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,356.10
|
| Rate for Payer: Multiplan Commercial |
$4,667.25
|
| Rate for Payer: Networks By Design Commercial |
$4,044.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,289.55
|
| Rate for Payer: Riverside University Health System MISP |
$2,489.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,733.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,733.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,111.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,111.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,111.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,111.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,289.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,289.55
|
| Rate for Payer: Vantage Medical Group Senior |
$5,289.55
|
|
|
HC ANESTHESIA LEVEL VI ADD'L 15MIN
|
Facility
|
IP
|
$1,151.00
|
|
| Hospital Charge Code |
904900411
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$230.20 |
| Max. Negotiated Rate |
$1,035.90 |
| Rate for Payer: Adventist Health Commercial |
$230.20
|
| Rate for Payer: Cash Price |
$517.95
|
| Rate for Payer: Central Health Plan Commercial |
$920.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$805.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$460.40
|
| Rate for Payer: EPIC Health Plan Senior |
$460.40
|
| Rate for Payer: Galaxy Health WC |
$978.35
|
| Rate for Payer: Global Benefits Group Commercial |
$690.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$730.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$679.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.20
|
| Rate for Payer: Multiplan Commercial |
$863.25
|
| Rate for Payer: Networks By Design Commercial |
$748.15
|
| Rate for Payer: Prime Health Services Commercial |
$978.35
|
|
|
HC ANESTHESIA LEVEL VI ADD'L 15MIN
|
Facility
|
OP
|
$1,151.00
|
|
| Hospital Charge Code |
904900411
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$230.20 |
| Max. Negotiated Rate |
$1,035.90 |
| Rate for Payer: Adventist Health Commercial |
$230.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$699.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$978.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$633.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$863.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$557.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$669.54
|
| Rate for Payer: Blue Shield of California Commercial |
$729.73
|
| Rate for Payer: Blue Shield of California EPN |
$459.25
|
| Rate for Payer: Cash Price |
$517.95
|
| Rate for Payer: Central Health Plan Commercial |
$920.80
|
| Rate for Payer: Cigna of CA HMO |
$736.64
|
| Rate for Payer: Cigna of CA PPO |
$851.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$978.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$978.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$978.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$805.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$460.40
|
| Rate for Payer: EPIC Health Plan Senior |
$460.40
|
| Rate for Payer: Galaxy Health WC |
$978.35
|
| Rate for Payer: Global Benefits Group Commercial |
$690.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$730.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$417.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$679.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$805.70
|
| Rate for Payer: Multiplan Commercial |
$863.25
|
| Rate for Payer: Networks By Design Commercial |
$748.15
|
| Rate for Payer: Prime Health Services Commercial |
$978.35
|
| Rate for Payer: Riverside University Health System MISP |
$460.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$690.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$690.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$575.50
|
| Rate for Payer: United Healthcare All Other HMO |
$575.50
|
| Rate for Payer: United Healthcare HMO Rider |
$575.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$978.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$978.35
|
| Rate for Payer: Vantage Medical Group Senior |
$978.35
|
|
|
HC ANGIO ADD'L VESSEL
|
Facility
|
OP
|
$4,364.00
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
909081284
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$129.89 |
| Max. Negotiated Rate |
$3,927.60 |
| Rate for Payer: Adventist Health Commercial |
$872.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$898.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,709.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,400.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,273.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,626.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,749.32
|
| Rate for Payer: Blue Shield of California EPN |
$1,732.51
|
| Rate for Payer: Cash Price |
$1,963.80
|
| Rate for Payer: Cash Price |
$1,963.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,491.20
|
| Rate for Payer: Cigna of CA HMO |
$2,792.96
|
| Rate for Payer: Cigna of CA PPO |
$3,229.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,709.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,709.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,709.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,054.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,745.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,745.60
|
| Rate for Payer: Galaxy Health WC |
$3,709.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,618.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,927.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$129.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,771.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$143.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,574.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$872.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,054.80
|
| Rate for Payer: Multiplan Commercial |
$3,273.00
|
| Rate for Payer: Networks By Design Commercial |
$2,836.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,709.40
|
| Rate for Payer: Riverside University Health System MISP |
$1,745.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,618.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,618.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,182.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,182.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,182.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,709.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,709.40
|
| Rate for Payer: Vantage Medical Group Senior |
$3,709.40
|
|
|
HC ANGIO ADD'L VESSEL
|
Facility
|
IP
|
$4,364.00
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
909081284
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$872.80 |
| Max. Negotiated Rate |
$3,927.60 |
| Rate for Payer: Adventist Health Commercial |
$872.80
|
| Rate for Payer: Cash Price |
$1,963.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,491.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,054.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,745.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,745.60
|
| Rate for Payer: Galaxy Health WC |
$3,709.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,618.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,927.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,771.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,574.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$872.80
|
| Rate for Payer: Multiplan Commercial |
$3,273.00
|
| Rate for Payer: Networks By Design Commercial |
$2,836.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,709.40
|
|
|
HC ANGIO CORONARY
|
Facility
|
OP
|
$2,575.00
|
|
|
Service Code
|
CPT 93563
|
| Hospital Charge Code |
906811412
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$80.67 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$515.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,188.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,416.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,931.25
|
| 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 |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,158.75
|
| Rate for Payer: Cash Price |
$1,158.75
|
| Rate for Payer: Cash Price |
$1,158.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,060.00
|
| Rate for Payer: Cigna of CA HMO |
$1,673.75
|
| Rate for Payer: Cigna of CA PPO |
$1,905.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,188.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,188.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,188.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,802.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,030.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,030.00
|
| Rate for Payer: Galaxy Health WC |
$2,188.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,545.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,317.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$80.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,635.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$89.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,519.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$515.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,802.50
|
| Rate for Payer: Multiplan Commercial |
$1,931.25
|
| Rate for Payer: Networks By Design Commercial |
$1,673.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,188.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,030.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,545.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,545.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,287.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,188.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,188.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,188.75
|
|
|
HC ANGIO CORONARY
|
Facility
|
IP
|
$2,575.00
|
|
|
Service Code
|
CPT 93563
|
| Hospital Charge Code |
906811412
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$515.00 |
| Max. Negotiated Rate |
$2,317.50 |
| Rate for Payer: Adventist Health Commercial |
$515.00
|
| Rate for Payer: Cash Price |
$1,158.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,060.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,802.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,030.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,030.00
|
| Rate for Payer: Galaxy Health WC |
$2,188.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,545.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,317.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,635.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,519.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$515.00
|
| Rate for Payer: Multiplan Commercial |
$1,931.25
|
| Rate for Payer: Networks By Design Commercial |
$1,673.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,188.75
|
|
|
HC ANGIOGRAPH ADRENAL BILAT
|
Facility
|
OP
|
$12,140.00
|
|
|
Service Code
|
CPT 75733
|
| Hospital Charge Code |
909081624
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$266.24 |
| Max. Negotiated Rate |
$10,926.00 |
| Rate for Payer: Adventist Health Commercial |
$2,428.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,294.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,646.08
|
| Rate for Payer: Blue Shield of California Commercial |
$7,648.20
|
| Rate for Payer: Blue Shield of California EPN |
$4,819.58
|
| Rate for Payer: Cash Price |
$5,463.00
|
| Rate for Payer: Cash Price |
$5,463.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,712.00
|
| Rate for Payer: Cigna of CA HMO |
$7,769.60
|
| Rate for Payer: Cigna of CA PPO |
$8,983.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,498.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$10,319.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,284.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,926.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$266.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,708.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$294.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,428.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$9,105.00
|
| Rate for Payer: Networks By Design Commercial |
$7,891.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Prime Health Services Commercial |
$10,319.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,284.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,284.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH ADRENAL BILAT
|
Facility
|
IP
|
$12,140.00
|
|
|
Service Code
|
CPT 75733
|
| Hospital Charge Code |
909081624
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,428.00 |
| Max. Negotiated Rate |
$10,926.00 |
| Rate for Payer: Adventist Health Commercial |
$2,428.00
|
| Rate for Payer: Cash Price |
$5,463.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,712.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,498.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,856.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,856.00
|
| Rate for Payer: Galaxy Health WC |
$10,319.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,284.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,926.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,708.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,162.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,428.00
|
| Rate for Payer: Multiplan Commercial |
$9,105.00
|
| Rate for Payer: Networks By Design Commercial |
$7,891.00
|
| Rate for Payer: Prime Health Services Commercial |
$10,319.00
|
|
|
HC ANGIOGRAPH ADRENAL UNILAT
|
Facility
|
OP
|
$7,952.00
|
|
|
Service Code
|
CPT 75731
|
| Hospital Charge Code |
909081574
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$239.89 |
| Max. Negotiated Rate |
$7,156.80 |
| Rate for Payer: Adventist Health Commercial |
$1,590.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,129.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,626.13
|
| Rate for Payer: Blue Shield of California Commercial |
$5,009.76
|
| Rate for Payer: Blue Shield of California EPN |
$3,156.94
|
| Rate for Payer: Cash Price |
$3,578.40
|
| Rate for Payer: Cash Price |
$3,578.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,361.60
|
| Rate for Payer: Cigna of CA HMO |
$5,089.28
|
| Rate for Payer: Cigna of CA PPO |
$5,884.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,566.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$6,759.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,771.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,156.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$239.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,049.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$264.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,590.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,964.00
|
| Rate for Payer: Networks By Design Commercial |
$5,168.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,759.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,771.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,771.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH ADRENAL UNILAT
|
Facility
|
IP
|
$7,952.00
|
|
|
Service Code
|
CPT 75731
|
| Hospital Charge Code |
909081574
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,590.40 |
| Max. Negotiated Rate |
$7,156.80 |
| Rate for Payer: Adventist Health Commercial |
$1,590.40
|
| Rate for Payer: Cash Price |
$3,578.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,361.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,566.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,180.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,180.80
|
| Rate for Payer: Galaxy Health WC |
$6,759.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,771.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,156.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,049.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,590.40
|
| Rate for Payer: Multiplan Commercial |
$5,964.00
|
| Rate for Payer: Networks By Design Commercial |
$5,168.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,759.20
|
|
|
HC ANGIOGRAPH EXT CAROTID UNILAT
|
Facility
|
IP
|
$20,686.00
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
909081608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,137.20 |
| Max. Negotiated Rate |
$18,617.40 |
| Rate for Payer: Adventist Health Commercial |
$4,137.20
|
| Rate for Payer: Cash Price |
$9,308.70
|
| Rate for Payer: Central Health Plan Commercial |
$16,548.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,480.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,274.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,274.40
|
| Rate for Payer: Galaxy Health WC |
$17,583.10
|
| Rate for Payer: Global Benefits Group Commercial |
$12,411.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,617.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,135.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,204.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,137.20
|
| Rate for Payer: Multiplan Commercial |
$15,514.50
|
| Rate for Payer: Networks By Design Commercial |
$13,445.90
|
| Rate for Payer: Prime Health Services Commercial |
$17,583.10
|
|
|
HC ANGIOGRAPH EXT CAROTID UNILAT
|
Facility
|
OP
|
$20,686.00
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
909081608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$152.41 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$4,137.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,583.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,377.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,514.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$9,308.70
|
| Rate for Payer: Cash Price |
$9,308.70
|
| Rate for Payer: Cash Price |
$9,308.70
|
| Rate for Payer: Central Health Plan Commercial |
$16,548.80
|
| Rate for Payer: Cigna of CA HMO |
$13,239.04
|
| Rate for Payer: Cigna of CA PPO |
$15,307.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,583.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,583.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,583.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,480.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,274.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,274.40
|
| Rate for Payer: Galaxy Health WC |
$17,583.10
|
| Rate for Payer: Global Benefits Group Commercial |
$12,411.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,617.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$152.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,135.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$168.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,204.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,137.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,480.20
|
| Rate for Payer: Multiplan Commercial |
$15,514.50
|
| Rate for Payer: Networks By Design Commercial |
$13,445.90
|
| Rate for Payer: Prime Health Services Commercial |
$17,583.10
|
| Rate for Payer: Riverside University Health System MISP |
$8,274.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,411.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,343.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,583.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,583.10
|
| Rate for Payer: Vantage Medical Group Senior |
$17,583.10
|
|
