|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$12,454.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
946100102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$515.48 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,490.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$567.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$567.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$885.06
|
| 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 |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,963.20
|
| Rate for Payer: Cigna of CA HMO |
$7,970.56
|
| Rate for Payer: Cigna of CA PPO |
$9,215.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$851.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$624.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,717.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.24
|
| Rate for Payer: EPIC Health Plan Senior |
$624.16
|
| Rate for Payer: Galaxy Health WC |
$10,585.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,472.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,208.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$930.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$515.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$567.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,908.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$794.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$760.34
|
| Rate for Payer: Multiplan Commercial |
$9,340.50
|
| Rate for Payer: Multiplan WC |
$885.06
|
| Rate for Payer: Networks By Design Commercial |
$8,095.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$567.42
|
| Rate for Payer: Preferred Health Network WC |
$903.12
|
| Rate for Payer: Prime Health Services Commercial |
$10,585.90
|
| Rate for Payer: Prime Health Services Medicare |
$601.47
|
| Rate for Payer: Prime Health Services WC |
$876.03
|
| Rate for Payer: Riverside University Health System MISP |
$624.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,472.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,227.00
|
| 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: Upland Medical Group Pediatric |
$567.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Vantage Medical Group Senior |
$567.42
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$12,454.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945000102
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$11,208.60 |
| Rate for Payer: Vantage Medical Group Senior |
$567.42
|
| Rate for Payer: Adventist Health Commercial |
$2,490.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$567.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$580.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$567.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,895.84
|
| Rate for Payer: Blue Shield of California EPN |
$4,969.15
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,963.20
|
| Rate for Payer: Cigna of CA HMO |
$7,970.56
|
| Rate for Payer: Cigna of CA PPO |
$9,215.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$851.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$624.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,717.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.24
|
| Rate for Payer: EPIC Health Plan Senior |
$624.16
|
| Rate for Payer: Galaxy Health WC |
$10,585.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,472.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,208.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$930.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$515.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$567.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,908.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$794.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$760.34
|
| Rate for Payer: Multiplan Commercial |
$9,340.50
|
| Rate for Payer: Networks By Design Commercial |
$8,095.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$567.42
|
| Rate for Payer: Prime Health Services Commercial |
$10,585.90
|
| Rate for Payer: Prime Health Services Medicare |
$601.47
|
| Rate for Payer: Riverside University Health System MISP |
$624.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,472.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,472.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$567.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$624.16
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
IP
|
$12,454.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
946100102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,490.80 |
| Max. Negotiated Rate |
$11,208.60 |
| Rate for Payer: Adventist Health Commercial |
$2,490.80
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,963.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,717.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,981.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,981.60
|
| Rate for Payer: Galaxy Health WC |
$10,585.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,472.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,208.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,908.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,347.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.80
|
| Rate for Payer: Multiplan Commercial |
$9,340.50
|
| Rate for Payer: Networks By Design Commercial |
$8,095.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,585.90
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
946100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| 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 |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,423.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$540.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,144.36
|
| Rate for Payer: Blue Shield of California EPN |
$5,125.55
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| 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 |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,423.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| 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 |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,423.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,579.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,579.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
946100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,579.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,579.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| 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 |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,423.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,579.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| 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 |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,423.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,579.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
946100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,579.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$550.92
|
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,144.36
|
| Rate for Payer: Blue Shield of California EPN |
$5,125.55
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
946100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| 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 |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,423.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$5,780.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,992.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,157.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,579.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS W SEL ABS FILT REINF ADULT
|
Facility
|
OP
|
$14,213.00
|
|
|
Service Code
|
CPT 36516
|
| Hospital Charge Code |
945003651
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$12,791.70 |
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Adventist Health Commercial |
$2,842.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$5,601.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$397.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,402.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,162.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,601.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,011.04
|
| Rate for Payer: Blue Shield of California EPN |
$5,670.99
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,370.40
|
| Rate for Payer: Cigna of CA HMO |
$9,096.32
|
| Rate for Payer: Cigna of CA PPO |
$10,517.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,402.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,162.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,601.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,949.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,243.14
|
| Rate for Payer: EPIC Health Plan Senior |
$6,162.09
|
| Rate for Payer: Galaxy Health WC |
$12,081.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,527.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,791.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9,187.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,090.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,601.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,025.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,623.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,842.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,842.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,506.55
|
| Rate for Payer: Multiplan Commercial |
$10,659.75
|
| Rate for Payer: Networks By Design Commercial |
$9,238.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,601.90
|
| Rate for Payer: Prime Health Services Commercial |
$12,081.05
|
| Rate for Payer: Prime Health Services Medicare |
$5,938.01
|
| Rate for Payer: Riverside University Health System MISP |
$6,162.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,527.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,527.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,601.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,402.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,162.09
|
| Rate for Payer: Vantage Medical Group Senior |
$5,601.90
|
|
|
HC APHERESIS W SEL ABS FILT REINF ADULT
|
Facility
|
IP
|
$14,213.00
|
|
|
Service Code
|
CPT 36516
|
| Hospital Charge Code |
945003651
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,842.60 |
| Max. Negotiated Rate |
$12,791.70 |
| Rate for Payer: Adventist Health Commercial |
$2,842.60
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,370.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,949.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,685.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,685.20
|
| Rate for Payer: Galaxy Health WC |
$12,081.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,527.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,791.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,025.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,385.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,842.60
|
| Rate for Payer: Multiplan Commercial |
$10,659.75
|
| Rate for Payer: Networks By Design Commercial |
$9,238.45
|
| Rate for Payer: Prime Health Services Commercial |
$12,081.05
|
|
|
HC APHERESIS W SEL ABS FILT REINF PEDS
|
Facility
|
OP
|
$14,213.00
|
|
|
Service Code
|
CPT 36516
|
| Hospital Charge Code |
945036516
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$12,791.70 |
| Rate for Payer: Adventist Health Commercial |
$2,842.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$5,601.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$397.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,402.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,162.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,601.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,011.04
|
| Rate for Payer: Blue Shield of California EPN |
$5,670.99
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,370.40
|
| Rate for Payer: Cigna of CA HMO |
$9,096.32
|
| Rate for Payer: Cigna of CA PPO |
$10,517.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,402.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,162.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,601.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,949.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,243.14
|
| Rate for Payer: EPIC Health Plan Senior |
$6,162.09
|
| Rate for Payer: Galaxy Health WC |
$12,081.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,527.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,791.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9,187.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,090.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,601.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,025.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,623.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,842.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,842.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,506.55
|
| Rate for Payer: Multiplan Commercial |
$10,659.75
|
| Rate for Payer: Networks By Design Commercial |
$9,238.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,601.90
|
| Rate for Payer: Prime Health Services Commercial |
$12,081.05
|
| Rate for Payer: Prime Health Services Medicare |
$5,938.01
|
| Rate for Payer: Riverside University Health System MISP |
$6,162.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,527.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,527.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,601.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,402.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,162.09
|
| Rate for Payer: Vantage Medical Group Senior |
$5,601.90
|
|
|
HC APHERESIS W SEL ABS FILT REINF PEDS
|
Facility
|
IP
|
$14,213.00
|
|
|
Service Code
|
CPT 36516
|
| Hospital Charge Code |
945036516
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,842.60 |
| Max. Negotiated Rate |
$12,791.70 |
| Rate for Payer: Adventist Health Commercial |
$2,842.60
|
| Rate for Payer: Cash Price |
$6,395.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,370.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,949.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,685.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,685.20
|
| Rate for Payer: Galaxy Health WC |
$12,081.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,527.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,791.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,025.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,385.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,842.60
|
| Rate for Payer: Multiplan Commercial |
$10,659.75
|
| Rate for Payer: Networks By Design Commercial |
$9,238.45
|
| Rate for Payer: Prime Health Services Commercial |
$12,081.05
|
|
|
HC API M 10 (HONEY BEE), IGE
|
Facility
|
OP
|
$16.38
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913746
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| 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 |
$12.39
|
| Rate for Payer: Blue Shield of California Commercial |
$10.32
|
| Rate for Payer: Blue Shield of California EPN |
$7.81
|
| Rate for Payer: Blue Shield of California EPN |
$6.50
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Central Health Plan Commercial |
$13.10
|
| Rate for Payer: Central Health Plan Commercial |
$15.73
|
| Rate for Payer: Cigna of CA HMO |
$12.58
|
| Rate for Payer: Cigna of CA HMO |
$10.48
|
| Rate for Payer: Cigna of CA PPO |
$14.55
|
| Rate for Payer: Cigna of CA PPO |
$12.12
|
| 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 |
$11.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| 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 |
$16.71
|
| Rate for Payer: Galaxy Health WC |
$13.92
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.74
|
| 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 |
$10.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| 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 |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| 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 |
$14.74
|
| Rate for Payer: Multiplan Commercial |
$12.29
|
| Rate for Payer: Networks By Design Commercial |
$10.65
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| 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 |
$16.71
|
| Rate for Payer: Prime Health Services Commercial |
$13.92
|
| 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 |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.83
|
| 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 API M 10 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913746
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$17.69 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Central Health Plan Commercial |
$15.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.86
|
| Rate for Payer: EPIC Health Plan Senior |
$7.86
|
| Rate for Payer: Galaxy Health WC |
$16.71
|
| Rate for Payer: Global Benefits Group Commercial |
$11.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: Networks By Design Commercial |
$12.78
|
| Rate for Payer: Prime Health Services Commercial |
$16.71
|
|
