|
HC ANCR CATH UMBILICAL UMB-E
|
Facility
|
IP
|
$22.63
|
|
| Hospital Charge Code |
901603825
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$20.37 |
| Rate for Payer: Adventist Health Commercial |
$4.53
|
| Rate for Payer: Cash Price |
$10.18
|
| Rate for Payer: Central Health Plan Commercial |
$18.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.05
|
| Rate for Payer: EPIC Health Plan Senior |
$9.05
|
| Rate for Payer: Galaxy Health WC |
$19.24
|
| Rate for Payer: Global Benefits Group Commercial |
$13.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
| Rate for Payer: Multiplan Commercial |
$16.97
|
| Rate for Payer: Networks By Design Commercial |
$14.71
|
| Rate for Payer: Prime Health Services Commercial |
$19.24
|
|
|
HC ANESTHESIA LEVEL I 1ST 15MIN
|
Facility
|
OP
|
$871.00
|
|
| Hospital Charge Code |
904900400
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$174.20 |
| Max. Negotiated Rate |
$783.90 |
| Rate for Payer: Adventist Health Commercial |
$174.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$528.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$740.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$479.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$653.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$421.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$511.54
|
| Rate for Payer: Blue Shield of California Commercial |
$532.18
|
| Rate for Payer: Blue Shield of California EPN |
$347.53
|
| Rate for Payer: Cash Price |
$391.95
|
| Rate for Payer: Central Health Plan Commercial |
$696.80
|
| Rate for Payer: Cigna of CA HMO |
$557.44
|
| Rate for Payer: Cigna of CA PPO |
$644.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$740.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$740.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$740.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.40
|
| Rate for Payer: EPIC Health Plan Senior |
$348.40
|
| Rate for Payer: Galaxy Health WC |
$740.35
|
| Rate for Payer: Global Benefits Group Commercial |
$522.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$783.90
|
| Rate for Payer: InnovAge PACE Commercial |
$435.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$580.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$539.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$609.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$609.70
|
| Rate for Payer: Multiplan Commercial |
$653.25
|
| Rate for Payer: Networks By Design Commercial |
$566.15
|
| Rate for Payer: Prime Health Services Commercial |
$740.35
|
| Rate for Payer: Riverside University Health System MISP |
$348.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$522.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$522.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$435.50
|
| Rate for Payer: United Healthcare All Other HMO |
$435.50
|
| Rate for Payer: United Healthcare HMO Rider |
$435.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$435.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$740.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$740.35
|
| Rate for Payer: Vantage Medical Group Senior |
$740.35
|
|
|
HC ANESTHESIA LEVEL I 1ST 15MIN
|
Facility
|
IP
|
$871.00
|
|
| Hospital Charge Code |
904900400
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$174.20 |
| Max. Negotiated Rate |
$783.90 |
| Rate for Payer: Adventist Health Commercial |
$174.20
|
| Rate for Payer: Cash Price |
$391.95
|
| Rate for Payer: Central Health Plan Commercial |
$696.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.40
|
| Rate for Payer: EPIC Health Plan Senior |
$348.40
|
| Rate for Payer: Galaxy Health WC |
$740.35
|
| Rate for Payer: Global Benefits Group Commercial |
$522.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$783.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$580.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$539.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.20
|
| Rate for Payer: Multiplan Commercial |
$653.25
|
| Rate for Payer: Networks By Design Commercial |
$566.15
|
| Rate for Payer: Prime Health Services Commercial |
$740.35
|
|
|
HC ANESTHESIA LEVEL I ADD'L 15MIN
|
Facility
|
OP
|
$217.00
|
|
| Hospital Charge Code |
904900401
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$184.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$119.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$162.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.44
|
| Rate for Payer: Blue Shield of California Commercial |
$132.59
|
| Rate for Payer: Blue Shield of California EPN |
$86.58
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: Cigna of CA HMO |
$138.88
|
| Rate for Payer: Cigna of CA PPO |
$160.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$184.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$184.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$184.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: InnovAge PACE Commercial |
$108.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$151.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$151.90
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
| Rate for Payer: Riverside University Health System MISP |
$86.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$130.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$130.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$108.50
|
| Rate for Payer: United Healthcare All Other HMO |
$108.50
|
| Rate for Payer: United Healthcare HMO Rider |
$108.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$108.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$184.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$184.45
|
| Rate for Payer: Vantage Medical Group Senior |
$184.45
|
|
|
HC ANESTHESIA LEVEL I ADD'L 15MIN
|
Facility
|
IP
|
$217.00
|
|
| Hospital Charge Code |
904900401
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$195.30 |
| Rate for Payer: Adventist Health Commercial |
$43.40
|
| Rate for Payer: Cash Price |
$97.65
|
| Rate for Payer: Central Health Plan Commercial |
$173.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.80
|
| Rate for Payer: EPIC Health Plan Senior |
$86.80
|
| Rate for Payer: Galaxy Health WC |
$184.45
|
| Rate for Payer: Global Benefits Group Commercial |
$130.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$195.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$82.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$134.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.40
|
| Rate for Payer: Multiplan Commercial |
$162.75
|
| Rate for Payer: Networks By Design Commercial |
$141.05
|
| Rate for Payer: Prime Health Services Commercial |
$184.45
|
|
|
HC ANESTHESIA LEVEL II 1ST 15MIN
|
Facility
|
IP
|
$1,824.00
|
|
| Hospital Charge Code |
904900402
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$364.80 |
| Max. Negotiated Rate |
$1,641.60 |
| Rate for Payer: Adventist Health Commercial |
$364.80
|
| Rate for Payer: Cash Price |
$820.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$729.60
|
| Rate for Payer: Galaxy Health WC |
$1,550.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,094.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,641.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,216.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$694.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,129.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.80
|
| Rate for Payer: Multiplan Commercial |
$1,368.00
|
| Rate for Payer: Networks By Design Commercial |
$1,185.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,550.40
|
|
|
HC ANESTHESIA LEVEL II 1ST 15MIN
|
Facility
|
OP
|
$1,824.00
|
|
| Hospital Charge Code |
904900402
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$364.80 |
| Max. Negotiated Rate |
$1,641.60 |
| Rate for Payer: Adventist Health Commercial |
$364.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,107.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,550.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,003.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,368.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$883.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,071.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1,114.46
|
| Rate for Payer: Blue Shield of California EPN |
$727.78
|
| Rate for Payer: Cash Price |
$820.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,459.20
|
| Rate for Payer: Cigna of CA HMO |
$1,167.36
|
| Rate for Payer: Cigna of CA PPO |
$1,349.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,550.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,550.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,550.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$729.60
|
| Rate for Payer: Galaxy Health WC |
$1,550.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,094.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,641.60
|
| Rate for Payer: InnovAge PACE Commercial |
$912.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,216.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$694.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,129.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$364.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,276.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,276.80
|
| Rate for Payer: Multiplan Commercial |
$1,368.00
|
| Rate for Payer: Networks By Design Commercial |
$1,185.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,550.40
|
| Rate for Payer: Riverside University Health System MISP |
$729.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,094.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,094.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$912.00
|
| Rate for Payer: United Healthcare All Other HMO |
$912.00
|
| Rate for Payer: United Healthcare HMO Rider |
$912.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$912.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,550.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,550.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,550.40
|
|
|
HC ANESTHESIA LEVEL II ADD'L 15MIN
|
Facility
|
IP
|
$301.00
|
|
| Hospital Charge Code |
904900403
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
|
|
HC ANESTHESIA LEVEL II ADD'L 15MIN
|
Facility
|
OP
|
$301.00
|
|
| Hospital Charge Code |
904900403
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$60.20 |
| Max. Negotiated Rate |
$270.90 |
| Rate for Payer: Adventist Health Commercial |
$60.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$182.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$165.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$225.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$145.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$176.78
|
| Rate for Payer: Blue Shield of California Commercial |
$183.91
|
| Rate for Payer: Blue Shield of California EPN |
$120.10
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Central Health Plan Commercial |
$240.80
|
| Rate for Payer: Cigna of CA HMO |
$192.64
|
| Rate for Payer: Cigna of CA PPO |
$222.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$255.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$255.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.40
|
| Rate for Payer: EPIC Health Plan Senior |
$120.40
|
| Rate for Payer: Galaxy Health WC |
$255.85
|
| Rate for Payer: Global Benefits Group Commercial |
$180.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$270.90
|
| Rate for Payer: InnovAge PACE Commercial |
$150.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$200.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$210.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$210.70
|
| Rate for Payer: Multiplan Commercial |
$225.75
|
| Rate for Payer: Networks By Design Commercial |
$195.65
|
| Rate for Payer: Prime Health Services Commercial |
$255.85
|
| Rate for Payer: Riverside University Health System MISP |
$120.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$180.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$180.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.50
|
| Rate for Payer: United Healthcare All Other HMO |
$150.50
|
| Rate for Payer: United Healthcare HMO Rider |
$150.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$255.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$255.85
|
| Rate for Payer: Vantage Medical Group Senior |
$255.85
|
|
|
HC ANESTHESIA LEVEL III 1ST 15MIN
|
Facility
|
IP
|
$3,120.00
|
|
| Hospital Charge Code |
904900404
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$624.00 |
| Max. Negotiated Rate |
$2,808.00 |
| Rate for Payer: Adventist Health Commercial |
$624.00
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,496.00
|
| Rate for Payer: 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 Permanente of CA Commercial/Self Funded |
$2,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,188.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,931.28
|
| 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 1ST 15MIN
|
Facility
|
OP
|
$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: Aetna of CA HMO/PPO |
$1,894.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,716.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,340.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,510.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,832.38
|
| Rate for Payer: Blue Shield of California Commercial |
$1,906.32
|
| Rate for Payer: Blue Shield of California EPN |
$1,244.88
|
| Rate for Payer: Cash Price |
$1,404.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,496.00
|
| Rate for Payer: Cigna of CA HMO |
$1,996.80
|
| Rate for Payer: Cigna of CA PPO |
$2,308.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,652.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,652.00
|
| 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: InnovAge PACE Commercial |
$1,560.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,188.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,931.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$624.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,184.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,184.00
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$1,248.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,872.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,872.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,560.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,560.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,560.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,560.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,652.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,652.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,652.00
|
|
|
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: 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 Permanente of CA Commercial/Self Funded |
$352.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$327.45
|
| 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 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 |
$310.68
|
| Rate for Payer: Blue Shield of California Commercial |
$323.22
|
| 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: 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: InnovAge PACE Commercial |
$264.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$352.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$327.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$370.30
|
| Rate for Payer: Molina Healthcare of CA 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 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 |
$2,441.41
|
| Rate for Payer: Blue Shield of California Commercial |
$2,539.93
|
| 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: 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: InnovAge PACE Commercial |
$2,078.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,772.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,583.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,573.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$831.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,909.90
|
| Rate for Payer: Molina Healthcare of CA 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: 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 Permanente of CA Commercial/Self Funded |
$2,772.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,583.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,573.18
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$486.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$278.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$451.87
|
| 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 |
$428.73
|
| Rate for Payer: Blue Shield of California Commercial |
$446.03
|
| 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: 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: InnovAge PACE Commercial |
$365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$486.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$278.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$451.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$511.00
|
| Rate for Payer: Molina Healthcare of CA 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
|
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 |
$3,044.56
|
| Rate for Payer: Blue Shield of California Commercial |
$3,167.42
|
| 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: 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: InnovAge PACE Commercial |
$2,592.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,457.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,975.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,208.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,036.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,628.80
|
| Rate for Payer: Molina Healthcare of CA 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 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: 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 Permanente of CA Commercial/Self Funded |
$3,457.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,975.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,208.90
|
| 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 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: 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 Permanente of CA Commercial/Self Funded |
$622.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$578.15
|
| 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 |
$548.54
|
| Rate for Payer: Blue Shield of California Commercial |
$570.67
|
| 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: 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: InnovAge PACE Commercial |
$467.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$578.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$186.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$653.80
|
| Rate for Payer: Molina Healthcare of CA 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
|
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 |
$3,654.77
|
| Rate for Payer: Blue Shield of California Commercial |
$3,802.25
|
| 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: 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: InnovAge PACE Commercial |
$3,111.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,150.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,370.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,852.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,244.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,356.10
|
| Rate for Payer: Molina Healthcare of CA 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 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: 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 Permanente of CA Commercial/Self Funded |
$4,150.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,370.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,852.04
|
| 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 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: 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 Permanente of CA Commercial/Self Funded |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$438.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$712.47
|
| 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 |
$675.98
|
| Rate for Payer: Blue Shield of California Commercial |
$703.26
|
| 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: 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: InnovAge PACE Commercial |
$575.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$438.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$712.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$805.70
|
| Rate for Payer: Molina Healthcare of CA 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
|
|
