|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
IP
|
$1,006.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
909081320
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.20 |
| Max. Negotiated Rate |
$905.40 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$704.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$402.40
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$638.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$593.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
|
|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
OP
|
$1,006.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
909081320
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$75.56 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$201.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$855.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$553.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$754.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Cash Price |
$452.70
|
| Rate for Payer: Central Health Plan Commercial |
$804.80
|
| Rate for Payer: Cigna of CA HMO |
$643.84
|
| Rate for Payer: Cigna of CA PPO |
$744.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$855.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$855.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$855.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$704.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$402.40
|
| Rate for Payer: Galaxy Health WC |
$855.10
|
| Rate for Payer: Global Benefits Group Commercial |
$603.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$905.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$75.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$638.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$83.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$593.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$201.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$704.20
|
| Rate for Payer: Multiplan Commercial |
$754.50
|
| Rate for Payer: Networks By Design Commercial |
$653.90
|
| Rate for Payer: Prime Health Services Commercial |
$855.10
|
| Rate for Payer: Riverside University Health System MISP |
$402.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$603.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$503.00
|
| 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 |
$855.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$855.10
|
| Rate for Payer: Vantage Medical Group Senior |
$855.10
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
IP
|
$1,081.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
909081321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.20 |
| Max. Negotiated Rate |
$972.90 |
| Rate for Payer: Adventist Health Commercial |
$216.20
|
| Rate for Payer: Cash Price |
$486.45
|
| Rate for Payer: Central Health Plan Commercial |
$864.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$756.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$432.40
|
| Rate for Payer: EPIC Health Plan Senior |
$432.40
|
| Rate for Payer: Galaxy Health WC |
$918.85
|
| Rate for Payer: Global Benefits Group Commercial |
$648.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$972.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$686.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$637.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.20
|
| Rate for Payer: Multiplan Commercial |
$810.75
|
| Rate for Payer: Networks By Design Commercial |
$702.65
|
| Rate for Payer: Prime Health Services Commercial |
$918.85
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
OP
|
$1,081.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
909081321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$216.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$216.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$918.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$594.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$810.75
|
| 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 |
$486.45
|
| Rate for Payer: Cash Price |
$486.45
|
| Rate for Payer: Cash Price |
$486.45
|
| Rate for Payer: Central Health Plan Commercial |
$864.80
|
| Rate for Payer: Cigna of CA HMO |
$691.84
|
| Rate for Payer: Cigna of CA PPO |
$799.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$918.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$918.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$918.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$756.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$432.40
|
| Rate for Payer: EPIC Health Plan Senior |
$432.40
|
| Rate for Payer: Galaxy Health WC |
$918.85
|
| Rate for Payer: Global Benefits Group Commercial |
$648.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$972.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$452.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$686.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$499.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$637.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$756.70
|
| Rate for Payer: Multiplan Commercial |
$810.75
|
| Rate for Payer: Networks By Design Commercial |
$702.65
|
| Rate for Payer: Prime Health Services Commercial |
$918.85
|
| Rate for Payer: Riverside University Health System MISP |
$432.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$648.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$540.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$918.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$918.85
|
| Rate for Payer: Vantage Medical Group Senior |
$918.85
|
|
|
HC ARTERIAL CATHETERIZATION KIT
|
Facility
|
OP
|
$458.95
|
|
| Hospital Charge Code |
901698288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.79 |
| Max. Negotiated Rate |
$413.06 |
| Rate for Payer: Adventist Health Commercial |
$91.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$278.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$344.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$222.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.97
|
| Rate for Payer: Blue Shield of California Commercial |
$290.97
|
| Rate for Payer: Blue Shield of California EPN |
$183.12
|
| Rate for Payer: Cash Price |
$206.53
|
| Rate for Payer: Central Health Plan Commercial |
$367.16
|
| Rate for Payer: Cigna of CA HMO |
$293.73
|
| Rate for Payer: Cigna of CA PPO |
$339.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$390.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$390.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$321.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.58
|
| Rate for Payer: EPIC Health Plan Senior |
$183.58
|
| Rate for Payer: Galaxy Health WC |
$390.11
|
| Rate for Payer: Global Benefits Group Commercial |
$275.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$413.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$291.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$166.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$270.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$321.26
|
| Rate for Payer: Multiplan Commercial |
$344.21
|
| Rate for Payer: Networks By Design Commercial |
$298.32
|
| Rate for Payer: Prime Health Services Commercial |
$390.11
|
| Rate for Payer: Riverside University Health System MISP |
$183.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$275.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$275.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$229.47
|
| Rate for Payer: United Healthcare All Other HMO |
$229.47
|
| Rate for Payer: United Healthcare HMO Rider |
$229.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$229.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$390.11
|
| Rate for Payer: Vantage Medical Group Senior |
$390.11
|
|
|
HC ARTERIAL CATHETERIZATION KIT
|
Facility
|
IP
|
$458.95
|
|
| Hospital Charge Code |
901698288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.79 |
| Max. Negotiated Rate |
$413.06 |
| Rate for Payer: Adventist Health Commercial |
$91.79
|
| Rate for Payer: Cash Price |
$206.53
|
| Rate for Payer: Central Health Plan Commercial |
$367.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$321.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.58
|
| Rate for Payer: EPIC Health Plan Senior |
$183.58
|
| Rate for Payer: Galaxy Health WC |
$390.11
|
| Rate for Payer: Global Benefits Group Commercial |
$275.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$413.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$291.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$270.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.79
|
| Rate for Payer: Multiplan Commercial |
$344.21
|
| Rate for Payer: Networks By Design Commercial |
$298.32
|
| Rate for Payer: Prime Health Services Commercial |
$390.11
|
|
|
HC ARTERIAL LINE INSERTION KIT
|
Facility
|
IP
|
$111.68
|
|
| Hospital Charge Code |
901698279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$100.51 |
| Rate for Payer: Adventist Health Commercial |
$22.34
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Central Health Plan Commercial |
$89.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.67
|
| Rate for Payer: EPIC Health Plan Senior |
$44.67
|
| Rate for Payer: Galaxy Health WC |
$94.93
|
| Rate for Payer: Global Benefits Group Commercial |
$67.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.34
|
| Rate for Payer: Multiplan Commercial |
$83.76
|
| Rate for Payer: Networks By Design Commercial |
$72.59
|
| Rate for Payer: Prime Health Services Commercial |
$94.93
|
|
|
HC ARTERIAL LINE INSERTION KIT
|
Facility
|
OP
|
$111.68
|
|
| Hospital Charge Code |
901698279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$100.51 |
| Rate for Payer: Adventist Health Commercial |
$22.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.96
|
| Rate for Payer: Blue Shield of California Commercial |
$70.81
|
| Rate for Payer: Blue Shield of California EPN |
$44.56
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Central Health Plan Commercial |
$89.34
|
| Rate for Payer: Cigna of CA HMO |
$71.48
|
| Rate for Payer: Cigna of CA PPO |
$82.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$94.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.67
|
| Rate for Payer: EPIC Health Plan Senior |
$44.67
|
| Rate for Payer: Galaxy Health WC |
$94.93
|
| Rate for Payer: Global Benefits Group Commercial |
$67.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$100.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$78.18
|
| Rate for Payer: Multiplan Commercial |
$83.76
|
| Rate for Payer: Networks By Design Commercial |
$72.59
|
| Rate for Payer: Prime Health Services Commercial |
$94.93
|
| Rate for Payer: Riverside University Health System MISP |
$44.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.84
|
| Rate for Payer: United Healthcare All Other HMO |
$55.84
|
| Rate for Payer: United Healthcare HMO Rider |
$55.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.93
|
| Rate for Payer: Vantage Medical Group Senior |
$94.93
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$873.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.60 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Central Health Plan Commercial |
$698.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$785.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.60
|
| Rate for Payer: Multiplan Commercial |
$654.75
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$873.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$174.60 |
| Max. Negotiated Rate |
$785.70 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Central Health Plan Commercial |
$698.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$785.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.60
|
| Rate for Payer: Multiplan Commercial |
$654.75
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$873.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.93 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$654.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Central Health Plan Commercial |
$698.40
|
| Rate for Payer: Cigna of CA HMO |
$558.72
|
| Rate for Payer: Cigna of CA PPO |
$646.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$785.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$611.10
|
| Rate for Payer: Multiplan Commercial |
$654.75
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
| Rate for Payer: Riverside University Health System MISP |
$349.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$523.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$436.50
|
| Rate for Payer: United Healthcare All Other HMO |
$436.50
|
| Rate for Payer: United Healthcare HMO Rider |
$436.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$436.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.05
|
| Rate for Payer: Vantage Medical Group Senior |
$742.05
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$873.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.36 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$654.75
|
| 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 |
$392.85
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Central Health Plan Commercial |
$698.40
|
| Rate for Payer: Cigna of CA HMO |
$558.72
|
| Rate for Payer: Cigna of CA PPO |
$646.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$785.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$611.10
|
| Rate for Payer: Multiplan Commercial |
$654.75
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
| Rate for Payer: Riverside University Health System MISP |
$349.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$523.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$436.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.05
|
| Rate for Payer: Vantage Medical Group Senior |
$742.05
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
OP
|
$11,579.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
909081625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$222.48 |
| Max. Negotiated Rate |
$11,808.82 |
| Rate for Payer: Adventist Health Commercial |
$2,315.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,156.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,110.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,646.15
|
| Rate for Payer: Blue Shield of California Commercial |
$7,294.77
|
| Rate for Payer: Blue Shield of California EPN |
$4,596.86
|
| Rate for Payer: Cash Price |
$5,210.55
|
| Rate for Payer: Cash Price |
$5,210.55
|
| Rate for Payer: Central Health Plan Commercial |
$9,263.20
|
| Rate for Payer: Cigna of CA HMO |
$7,410.56
|
| Rate for Payer: Cigna of CA PPO |
$8,568.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,105.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$9,842.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,947.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,421.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$222.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,352.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$245.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,315.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$8,684.25
|
| Rate for Payer: Networks By Design Commercial |
$7,526.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Prime Health Services Commercial |
$9,842.15
|
| Rate for Payer: Prime Health Services Medicare |
$7,586.27
|
| Rate for Payer: Riverside University Health System MISP |
$7,872.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,947.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,947.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
IP
|
$11,579.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
909081625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,315.80 |
| Max. Negotiated Rate |
$10,421.10 |
| Rate for Payer: Adventist Health Commercial |
$2,315.80
|
| Rate for Payer: Cash Price |
$5,210.55
|
| Rate for Payer: Central Health Plan Commercial |
$9,263.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,105.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,631.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,631.60
|
| Rate for Payer: Galaxy Health WC |
$9,842.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,947.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,421.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,352.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,831.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,315.80
|
| Rate for Payer: Multiplan Commercial |
$8,684.25
|
| Rate for Payer: Networks By Design Commercial |
$7,526.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,842.15
|
|
|
HC ARTERY CATHETRZATION KIT 20GA
|
Facility
|
IP
|
$379.32
|
|
| Hospital Charge Code |
901698947
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.86 |
| Max. Negotiated Rate |
$341.39 |
| Rate for Payer: Adventist Health Commercial |
$75.86
|
| Rate for Payer: Cash Price |
$170.69
|
| Rate for Payer: Central Health Plan Commercial |
$303.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$265.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.73
|
| Rate for Payer: EPIC Health Plan Senior |
$151.73
|
| Rate for Payer: Galaxy Health WC |
$322.42
|
| Rate for Payer: Global Benefits Group Commercial |
$227.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$341.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$240.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$223.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.86
|
| Rate for Payer: Multiplan Commercial |
$284.49
|
| Rate for Payer: Networks By Design Commercial |
$246.56
|
| Rate for Payer: Prime Health Services Commercial |
$322.42
|
|
|
HC ARTERY CATHETRZATION KIT 20GA
|
Facility
|
OP
|
$379.32
|
|
| Hospital Charge Code |
901698947
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.86 |
| Max. Negotiated Rate |
$341.39 |
| Rate for Payer: Adventist Health Commercial |
$75.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$230.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$322.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$208.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$284.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$183.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$220.65
|
| Rate for Payer: Blue Shield of California Commercial |
$240.49
|
| Rate for Payer: Blue Shield of California EPN |
$151.35
|
| Rate for Payer: Cash Price |
$170.69
|
| Rate for Payer: Central Health Plan Commercial |
$303.46
|
| Rate for Payer: Cigna of CA HMO |
$242.76
|
| Rate for Payer: Cigna of CA PPO |
$280.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$322.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$322.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$322.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$265.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.73
|
| Rate for Payer: EPIC Health Plan Senior |
$151.73
|
| Rate for Payer: Galaxy Health WC |
$322.42
|
| Rate for Payer: Global Benefits Group Commercial |
$227.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$341.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$240.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$223.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$265.52
|
| Rate for Payer: Multiplan Commercial |
$284.49
|
| Rate for Payer: Networks By Design Commercial |
$246.56
|
| Rate for Payer: Prime Health Services Commercial |
$322.42
|
| Rate for Payer: Riverside University Health System MISP |
$151.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$227.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$227.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$189.66
|
| Rate for Payer: United Healthcare All Other HMO |
$189.66
|
| Rate for Payer: United Healthcare HMO Rider |
$189.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$322.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$322.42
|
| Rate for Payer: Vantage Medical Group Senior |
$322.42
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
IP
|
$1,289.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$257.80 |
| Max. Negotiated Rate |
$1,160.10 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,031.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$902.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.60
|
| Rate for Payer: EPIC Health Plan Senior |
$515.60
|
| Rate for Payer: Galaxy Health WC |
$1,095.65
|
| Rate for Payer: Global Benefits Group Commercial |
$773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,160.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$818.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$760.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.80
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: Networks By Design Commercial |
$837.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,095.65
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
OP
|
$1,289.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$72.14 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,031.20
|
| Rate for Payer: Cigna of CA HMO |
$824.96
|
| Rate for Payer: Cigna of CA PPO |
$953.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$902.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,095.65
|
| Rate for Payer: Global Benefits Group Commercial |
$773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,160.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$818.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$837.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,095.65
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$773.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.50
|
| Rate for Payer: United Healthcare All Other HMO |
$644.50
|
| Rate for Payer: United Healthcare HMO Rider |
$644.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$644.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
IP
|
$1,289.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$257.80 |
| Max. Negotiated Rate |
$1,160.10 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,031.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$902.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.60
|
| Rate for Payer: EPIC Health Plan Senior |
$515.60
|
| Rate for Payer: Galaxy Health WC |
$1,095.65
|
| Rate for Payer: Global Benefits Group Commercial |
$773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,160.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$818.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$760.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.80
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: Networks By Design Commercial |
$837.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,095.65
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
IP
|
$1,289.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.80 |
| Max. Negotiated Rate |
$1,160.10 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,031.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$902.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.60
|
| Rate for Payer: EPIC Health Plan Senior |
$515.60
|
| Rate for Payer: Galaxy Health WC |
$1,095.65
|
| Rate for Payer: Global Benefits Group Commercial |
$773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,160.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$818.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$760.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.80
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: Networks By Design Commercial |
$837.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,095.65
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
OP
|
$1,289.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.31 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,031.20
|
| Rate for Payer: Cigna of CA HMO |
$824.96
|
| Rate for Payer: Cigna of CA PPO |
$953.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$902.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,095.65
|
| Rate for Payer: Global Benefits Group Commercial |
$773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,160.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$818.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$837.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,095.65
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$773.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
OP
|
$1,289.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$65.31 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$257.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$230.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$817.23
|
| Rate for Payer: Blue Shield of California EPN |
$514.31
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Cash Price |
$580.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,031.20
|
| Rate for Payer: Cigna of CA HMO |
$824.96
|
| Rate for Payer: Cigna of CA PPO |
$953.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$902.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,095.65
|
| Rate for Payer: Global Benefits Group Commercial |
$773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,160.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$818.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$966.75
|
| Rate for Payer: Networks By Design Commercial |
$837.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Prime Health Services Commercial |
$1,095.65
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$773.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$773.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.50
|
| Rate for Payer: United Healthcare All Other HMO |
$644.50
|
| Rate for Payer: United Healthcare HMO Rider |
$644.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$644.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
IP
|
$1,771.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$354.20 |
| Max. Negotiated Rate |
$1,593.90 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$708.40
|
| Rate for Payer: EPIC Health Plan Senior |
$708.40
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,044.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
OP
|
$1,771.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$61.54 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$354.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Cigna of CA HMO |
$1,133.44
|
| Rate for Payer: Cigna of CA PPO |
$1,310.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$61.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,062.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$885.50
|
| Rate for Payer: United Healthcare All Other HMO |
$885.50
|
| Rate for Payer: United Healthcare HMO Rider |
$885.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$885.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ARTHO ASP &/OR INJ SM JOINT
|
Facility
|
OP
|
$1,771.00
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
909000109
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$61.54 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$726.11
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$219.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Cash Price |
$796.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,416.80
|
| Rate for Payer: Cigna of CA HMO |
$1,133.44
|
| Rate for Payer: Cigna of CA PPO |
$1,310.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,239.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,505.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,062.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,593.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,124.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$61.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$354.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,328.25
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,151.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,505.35
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,062.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,062.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
