|
HC AQUATIC THERAPY EA ADDL 15 MIN MCAL
|
Facility
|
OP
|
$108.00
|
|
| Hospital Charge Code |
900400041
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$44.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$91.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$81.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: Cigna of CA HMO |
$69.12
|
| Rate for Payer: Cigna of CA PPO |
$79.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$91.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$91.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$91.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$68.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$63.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$75.60
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
| Rate for Payer: Networks By Design Commercial |
$70.20
|
| Rate for Payer: Prime Health Services Commercial |
$91.80
|
| Rate for Payer: Riverside University Health System MISP |
$43.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$91.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$91.80
|
| Rate for Payer: Vantage Medical Group Senior |
$91.80
|
|
|
HC AQUATIC THER W/EXER 15 MIN PT
|
Facility
|
OP
|
$246.00
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
905103142
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.96 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$100.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$209.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$135.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$184.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Central Health Plan Commercial |
$196.80
|
| Rate for Payer: Cigna of CA HMO |
$157.44
|
| Rate for Payer: Cigna of CA PPO |
$182.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$209.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$209.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$209.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$172.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.40
|
| Rate for Payer: EPIC Health Plan Senior |
$98.40
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$221.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$156.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$26.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$145.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$172.20
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
| Rate for Payer: Riverside University Health System MISP |
$98.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$147.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$209.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$209.10
|
| Rate for Payer: Vantage Medical Group Senior |
$209.10
|
|
|
HC AQUATIC THER W/EXER 15 MIN PT
|
Facility
|
IP
|
$246.00
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
905103142
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$221.40 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Central Health Plan Commercial |
$196.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$172.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.40
|
| Rate for Payer: EPIC Health Plan Senior |
$98.40
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$221.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$156.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$145.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
|
|
HC AQUATIC THER W/EXER 15 MIN PT COMM MCARE
|
Facility
|
IP
|
$246.00
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
900417113
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$221.40 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Central Health Plan Commercial |
$196.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$172.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.40
|
| Rate for Payer: EPIC Health Plan Senior |
$98.40
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$221.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$156.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$145.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
|
|
HC AQUATIC THER W/EXER 15 MIN PT COMM MCARE
|
Facility
|
OP
|
$246.00
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
900417113
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.96 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$100.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$209.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$135.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$184.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Central Health Plan Commercial |
$196.80
|
| Rate for Payer: Cigna of CA HMO |
$157.44
|
| Rate for Payer: Cigna of CA PPO |
$182.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$209.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$209.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$209.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$172.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.40
|
| Rate for Payer: EPIC Health Plan Senior |
$98.40
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$221.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$156.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$26.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$145.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$100.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$172.20
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
| Rate for Payer: Riverside University Health System MISP |
$98.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$147.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$209.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$209.10
|
| Rate for Payer: Vantage Medical Group Senior |
$209.10
|
|
|
HC ARA H 1 (PEANUT), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913724
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC ARA H 1 (PEANUT), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913724
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.34
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ARA H 2 (PEANUT), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913725
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.34
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ARA H 2 (PEANUT), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913725
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC ARA H 3 (PEANUT), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913726
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC ARA H 3 (PEANUT), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913726
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.34
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ARA H 6 (PEANUT), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913727
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC ARA H 6 (PEANUT), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913727
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.34
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ARA H 8 (PEANUT), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913728
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.34
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ARA H 8 (PEANUT), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913728
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC ARA H 9 (PEANUT), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913729
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.34
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ARA H 9 (PEANUT), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913729
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC ARCH AORTA
|
Facility
|
OP
|
$9,426.00
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
909020144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$299.04 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,885.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| 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 |
$4,241.70
|
| Rate for Payer: Cash Price |
$4,241.70
|
| Rate for Payer: Cash Price |
$4,241.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,540.80
|
| Rate for Payer: Cigna of CA HMO |
$6,032.64
|
| Rate for Payer: Cigna of CA PPO |
$6,975.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,598.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$8,012.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,655.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,483.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$299.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,985.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,885.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$7,069.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,126.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$8,012.10
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,655.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,713.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ARCH AORTA
|
Facility
|
IP
|
$9,426.00
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
909020144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,885.20 |
| Max. Negotiated Rate |
$8,483.40 |
| Rate for Payer: Adventist Health Commercial |
$1,885.20
|
| Rate for Payer: Cash Price |
$4,241.70
|
| Rate for Payer: Central Health Plan Commercial |
$7,540.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,598.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,770.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,770.40
|
| Rate for Payer: Galaxy Health WC |
$8,012.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,655.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,483.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,985.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,561.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,885.20
|
| Rate for Payer: Multiplan Commercial |
$7,069.50
|
| Rate for Payer: Networks By Design Commercial |
$6,126.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,012.10
|
|
|
HC ARGON, THROMBEC CATH
|
Facility
|
OP
|
$2,827.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$565.50 |
| Max. Negotiated Rate |
$2,544.75 |
| Rate for Payer: Adventist Health Commercial |
$565.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,403.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,555.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,291.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,550.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,267.66
|
| Rate for Payer: Blue Shield of California EPN |
$1,425.06
|
| Rate for Payer: Cash Price |
$1,272.38
|
| Rate for Payer: Central Health Plan Commercial |
$2,262.00
|
| Rate for Payer: Cigna of CA HMO |
$1,979.25
|
| Rate for Payer: Cigna of CA PPO |
$1,979.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,403.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,403.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,403.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,979.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,131.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,131.00
|
| Rate for Payer: Galaxy Health WC |
$2,403.38
|
| Rate for Payer: Global Benefits Group Commercial |
$1,696.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,544.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,795.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,026.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,668.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$565.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,979.25
|
| Rate for Payer: Multiplan Commercial |
$2,120.62
|
| Rate for Payer: Networks By Design Commercial |
$1,413.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,403.38
|
| Rate for Payer: Riverside University Health System MISP |
$1,131.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,696.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,696.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,061.16
|
| Rate for Payer: United Healthcare All Other HMO |
$1,032.89
|
| Rate for Payer: United Healthcare HMO Rider |
$1,010.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$926.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,403.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,403.38
|
| Rate for Payer: Vantage Medical Group Senior |
$2,403.38
|
|
|
HC ARGON, THROMBEC CATH
|
Facility
|
IP
|
$2,827.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$565.50 |
| Max. Negotiated Rate |
$2,544.75 |
| Rate for Payer: Adventist Health Commercial |
$565.50
|
| Rate for Payer: Blue Shield of California Commercial |
$2,267.66
|
| Rate for Payer: Blue Shield of California EPN |
$1,425.06
|
| Rate for Payer: Cash Price |
$1,272.38
|
| Rate for Payer: Central Health Plan Commercial |
$2,262.00
|
| Rate for Payer: Cigna of CA HMO |
$1,979.25
|
| Rate for Payer: Cigna of CA PPO |
$1,979.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,979.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,131.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,131.00
|
| Rate for Payer: Galaxy Health WC |
$2,403.38
|
| Rate for Payer: Global Benefits Group Commercial |
$1,696.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,544.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,795.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,668.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$565.50
|
| Rate for Payer: Multiplan Commercial |
$2,120.62
|
| Rate for Payer: Networks By Design Commercial |
$1,413.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,403.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,061.16
|
| Rate for Payer: United Healthcare All Other HMO |
$1,032.89
|
| Rate for Payer: United Healthcare HMO Rider |
$1,010.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$926.01
|
|
|
HC ARTER, EA ADDL, 2ND/3RD ORD
|
Facility
|
IP
|
$758.00
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
909081322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$151.60 |
| Max. Negotiated Rate |
$682.20 |
| Rate for Payer: Adventist Health Commercial |
$151.60
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Central Health Plan Commercial |
$606.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$530.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.20
|
| Rate for Payer: EPIC Health Plan Senior |
$303.20
|
| Rate for Payer: Galaxy Health WC |
$644.30
|
| Rate for Payer: Global Benefits Group Commercial |
$454.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$682.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$481.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$447.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.60
|
| Rate for Payer: Multiplan Commercial |
$568.50
|
| Rate for Payer: Networks By Design Commercial |
$492.70
|
| Rate for Payer: Prime Health Services Commercial |
$644.30
|
|
|
HC ARTER, EA ADDL, 2ND/3RD ORD
|
Facility
|
OP
|
$758.00
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
909081322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14.72 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$151.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$644.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$416.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$568.50
|
| 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 |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Cash Price |
$341.10
|
| Rate for Payer: Central Health Plan Commercial |
$606.40
|
| Rate for Payer: Cigna of CA HMO |
$485.12
|
| Rate for Payer: Cigna of CA PPO |
$560.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$644.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$644.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$644.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$530.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$303.20
|
| Rate for Payer: EPIC Health Plan Senior |
$303.20
|
| Rate for Payer: Galaxy Health WC |
$644.30
|
| Rate for Payer: Global Benefits Group Commercial |
$454.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$682.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$481.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$447.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$530.60
|
| Rate for Payer: Multiplan Commercial |
$568.50
|
| Rate for Payer: Networks By Design Commercial |
$492.70
|
| Rate for Payer: Prime Health Services Commercial |
$644.30
|
| Rate for Payer: Riverside University Health System MISP |
$303.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$454.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$379.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$644.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$644.30
|
| Rate for Payer: Vantage Medical Group Senior |
$644.30
|
|
|
HC ARTERIAL, 1ST ORDER CATH PL
|
Facility
|
OP
|
$1,984.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
909081319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$309.93 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$396.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,686.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,091.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,488.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$892.80
|
| Rate for Payer: Cash Price |
$892.80
|
| Rate for Payer: Cash Price |
$892.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,587.20
|
| Rate for Payer: Cigna of CA HMO |
$1,269.76
|
| Rate for Payer: Cigna of CA PPO |
$1,468.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,686.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,686.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,686.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,388.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$793.60
|
| Rate for Payer: EPIC Health Plan Senior |
$793.60
|
| Rate for Payer: Galaxy Health WC |
$1,686.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,190.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,785.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$309.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,259.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$342.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,170.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,388.80
|
| Rate for Payer: Multiplan Commercial |
$1,488.00
|
| Rate for Payer: Networks By Design Commercial |
$1,289.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,686.40
|
| Rate for Payer: Riverside University Health System MISP |
$793.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,190.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$992.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,686.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,686.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,686.40
|
|
|
HC ARTERIAL, 1ST ORDER CATH PL
|
Facility
|
IP
|
$1,984.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
909081319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.80 |
| Max. Negotiated Rate |
$1,785.60 |
| Rate for Payer: Adventist Health Commercial |
$396.80
|
| Rate for Payer: Cash Price |
$892.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,587.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,388.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$793.60
|
| Rate for Payer: EPIC Health Plan Senior |
$793.60
|
| Rate for Payer: Galaxy Health WC |
$1,686.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,190.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,785.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,259.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,170.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$396.80
|
| Rate for Payer: Multiplan Commercial |
$1,488.00
|
| Rate for Payer: Networks By Design Commercial |
$1,289.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,686.40
|
|
