|
HC APHERESIS RBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
946100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,082.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,082.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,291.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,082.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,811.87
|
| Rate for Payer: EPIC Health Plan Senior |
$2,082.87
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,415.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,082.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,124.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,082.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,791.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,791.05
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,082.87
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,207.84
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,291.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,082.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Vantage Medical Group Senior |
$2,082.87
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
946100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,894.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,951.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,894.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,951.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,082.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,082.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,848.91
|
| Rate for Payer: Blue Shield of California EPN |
$5,125.55
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,291.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,082.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,811.87
|
| Rate for Payer: EPIC Health Plan Senior |
$2,082.87
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,415.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,082.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,124.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,082.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,791.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,791.05
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,082.87
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,207.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,291.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,082.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Vantage Medical Group Senior |
$2,082.87
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,894.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,951.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,082.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,082.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,291.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,082.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,811.87
|
| Rate for Payer: EPIC Health Plan Senior |
$2,082.87
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,415.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,082.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,124.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,082.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,791.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,791.05
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,082.87
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,207.84
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,291.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,082.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Vantage Medical Group Senior |
$2,082.87
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,082.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,082.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,291.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,082.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,811.87
|
| Rate for Payer: EPIC Health Plan Senior |
$2,082.87
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,415.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,082.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,124.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,082.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,791.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,791.05
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,082.87
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,207.84
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,291.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,082.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Vantage Medical Group Senior |
$2,082.87
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,082.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,082.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,848.91
|
| Rate for Payer: Blue Shield of California EPN |
$5,125.55
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,291.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,082.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,811.87
|
| Rate for Payer: EPIC Health Plan Senior |
$2,082.87
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,415.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,082.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,124.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,082.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,791.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,791.05
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,082.87
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,207.84
|
| Rate for Payer: Riverside University Health System MISP |
$2,291.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,082.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Vantage Medical Group Senior |
$2,082.87
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,894.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,951.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,894.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,951.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,894.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,951.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
946100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,569.20 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,138.40
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,894.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,951.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$12,846.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
946100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,680.94 |
| Max. Negotiated Rate |
$11,561.40 |
| Rate for Payer: Adventist Health Commercial |
$2,569.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,082.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,082.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,318.68
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Cash Price |
$7,065.30
|
| Rate for Payer: Central Health Plan Commercial |
$10,276.80
|
| Rate for Payer: Cigna of CA HMO |
$8,221.44
|
| Rate for Payer: Cigna of CA PPO |
$9,506.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,291.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,082.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,811.87
|
| Rate for Payer: EPIC Health Plan Senior |
$2,082.87
|
| Rate for Payer: Galaxy Health WC |
$10,919.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,707.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,561.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,415.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,082.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,124.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,568.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,082.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,569.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,791.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,791.05
|
| Rate for Payer: Multiplan Commercial |
$9,634.50
|
| Rate for Payer: Multiplan WC |
$3,318.68
|
| Rate for Payer: Networks By Design Commercial |
$8,349.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,082.87
|
| Rate for Payer: Preferred Health Network WC |
$3,386.41
|
| Rate for Payer: Prime Health Services Commercial |
$10,919.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,207.84
|
| Rate for Payer: Prime Health Services WC |
$3,284.82
|
| Rate for Payer: Riverside University Health System MISP |
$2,291.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,707.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,082.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,124.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,291.16
|
| Rate for Payer: Vantage Medical Group Senior |
$2,082.87
|
|
|
HC APHERESIS W SEL ABS FILT REINF ADULT
|
Facility
|
IP
|
$14,213.00
|
|
|
Service Code
|
CPT 36516
|
| Hospital Charge Code |
945003651
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,842.60 |
| Max. Negotiated Rate |
$12,791.70 |
| Rate for Payer: Adventist Health Commercial |
$2,842.60
|
| Rate for Payer: Cash Price |
$7,817.15
|
| Rate for Payer: Central Health Plan Commercial |
$11,370.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,685.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,685.20
|
| Rate for Payer: Galaxy Health WC |
$12,081.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,527.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,791.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,480.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,415.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,797.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,842.60
|
| Rate for Payer: Multiplan Commercial |
$10,659.75
|
| Rate for Payer: Networks By Design Commercial |
$9,238.45
|
| Rate for Payer: Prime Health Services Commercial |
$12,081.05
|
|
|
HC APHERESIS W SEL ABS FILT REINF ADULT
|
Facility
|
OP
|
$14,213.00
|
|
|
Service Code
|
CPT 36516
|
| Hospital Charge Code |
945003651
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$12,791.70 |
| Rate for Payer: Adventist Health Commercial |
$2,842.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$5,952.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,929.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,548.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,952.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,684.14
|
| Rate for Payer: Blue Shield of California EPN |
$5,670.99
|
| Rate for Payer: Cash Price |
$7,817.15
|
| Rate for Payer: Cash Price |
$7,817.15
|
| Rate for Payer: Cash Price |
$7,817.15
|
| Rate for Payer: Central Health Plan Commercial |
$11,370.40
|
| Rate for Payer: Cigna of CA HMO |
$9,096.32
|
| Rate for Payer: Cigna of CA PPO |
$10,517.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,929.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,548.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,952.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,036.52
|
| Rate for Payer: EPIC Health Plan Senior |
$5,952.98
|
| Rate for Payer: Galaxy Health WC |
$12,081.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,527.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,791.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9,762.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,090.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,952.98
|
| Rate for Payer: InnovAge PACE Commercial |
$8,929.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,480.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,623.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,952.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,842.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,976.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,976.99
|
| Rate for Payer: Multiplan Commercial |
$10,659.75
|
| Rate for Payer: Networks By Design Commercial |
$9,238.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,952.98
|
| Rate for Payer: Prime Health Services Commercial |
$12,081.05
|
| Rate for Payer: Prime Health Services Medicare |
$6,310.16
|
| Rate for Payer: Riverside University Health System MISP |
$6,548.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,527.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,527.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,952.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,929.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,548.28
|
| Rate for Payer: Vantage Medical Group Senior |
$5,952.98
|
|
|
HC APHERESIS W SEL ABS FILT REINF PEDS
|
Facility
|
OP
|
$14,213.00
|
|
|
Service Code
|
CPT 36516
|
| Hospital Charge Code |
945036516
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$12,791.70 |
| Rate for Payer: Adventist Health Commercial |
$2,842.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$5,952.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,929.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,548.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,952.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,684.14
|
| Rate for Payer: Blue Shield of California EPN |
$5,670.99
|
| Rate for Payer: Cash Price |
$7,817.15
|
| Rate for Payer: Cash Price |
$7,817.15
|
| Rate for Payer: Cash Price |
$7,817.15
|
| Rate for Payer: Central Health Plan Commercial |
$11,370.40
|
| Rate for Payer: Cigna of CA HMO |
$9,096.32
|
| Rate for Payer: Cigna of CA PPO |
$10,517.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,929.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,548.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,952.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,036.52
|
| Rate for Payer: EPIC Health Plan Senior |
$5,952.98
|
| Rate for Payer: Galaxy Health WC |
$12,081.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,527.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,791.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9,762.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,090.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,952.98
|
| Rate for Payer: InnovAge PACE Commercial |
$8,929.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,480.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,623.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,952.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,842.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,976.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,976.99
|
| Rate for Payer: Multiplan Commercial |
$10,659.75
|
| Rate for Payer: Networks By Design Commercial |
$9,238.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,952.98
|
| Rate for Payer: Prime Health Services Commercial |
$12,081.05
|
| Rate for Payer: Prime Health Services Medicare |
$6,310.16
|
| Rate for Payer: Riverside University Health System MISP |
$6,548.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,527.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,527.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,952.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,929.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,548.28
|
| Rate for Payer: Vantage Medical Group Senior |
$5,952.98
|
|
|
HC APHERESIS W SEL ABS FILT REINF PEDS
|
Facility
|
IP
|
$14,213.00
|
|
|
Service Code
|
CPT 36516
|
| Hospital Charge Code |
945036516
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,842.60 |
| Max. Negotiated Rate |
$12,791.70 |
| Rate for Payer: Adventist Health Commercial |
$2,842.60
|
| Rate for Payer: Cash Price |
$7,817.15
|
| Rate for Payer: Central Health Plan Commercial |
$11,370.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,685.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,685.20
|
| Rate for Payer: Galaxy Health WC |
$12,081.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,527.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,791.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,480.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,415.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,797.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,842.60
|
| Rate for Payer: Multiplan Commercial |
$10,659.75
|
| Rate for Payer: Networks By Design Commercial |
$9,238.45
|
| Rate for Payer: Prime Health Services Commercial |
$12,081.05
|
|
|
HC APLS IGA
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900913647
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$117.54 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$16.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.86
|
| Rate for Payer: Blue Shield of California Commercial |
$31.56
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.69
|
| Rate for Payer: EPIC Health Plan Senior |
$16.07
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: InnovAge PACE Commercial |
$24.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.53
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16.07
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Medicare |
$17.03
|
| Rate for Payer: Riverside University Health System MISP |
$17.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
|
|
HC APLS IGA
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900913647
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Senior |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
|
|
HC APLS IGG
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913648
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$105.06 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$25.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.32
|
| Rate for Payer: Blue Shield of California Commercial |
$59.49
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.36
|
| Rate for Payer: EPIC Health Plan Senior |
$25.45
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$41.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.45
|
| Rate for Payer: InnovAge PACE Commercial |
$38.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.10
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25.45
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Medicare |
$26.98
|
| Rate for Payer: Riverside University Health System MISP |
$28.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.00
|
| Rate for Payer: Vantage Medical Group Senior |
$25.45
|
|
|
HC APLS IGG
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
900913648
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC APLS IGM
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900913649
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$117.54 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$16.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.86
|
| Rate for Payer: Blue Shield of California Commercial |
$31.56
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.69
|
| Rate for Payer: EPIC Health Plan Senior |
$16.07
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.07
|
| Rate for Payer: InnovAge PACE Commercial |
$24.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.53
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16.07
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Medicare |
$17.03
|
| Rate for Payer: Riverside University Health System MISP |
$17.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.01
|
| Rate for Payer: United Healthcare All Other HMO |
$13.01
|
| Rate for Payer: United Healthcare HMO Rider |
$13.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.68
|
| Rate for Payer: Vantage Medical Group Senior |
$16.07
|
|
|
HC APLS IGM
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
900913649
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Cash Price |
$28.60
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Senior |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
|
|
HC APP HIP SPICA CASE-ONE LEG
|
Facility
|
IP
|
$1,381.00
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
900501680
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.20 |
| Max. Negotiated Rate |
$1,242.90 |
| Rate for Payer: Adventist Health Commercial |
$276.20
|
| Rate for Payer: Cash Price |
$759.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,104.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$552.40
|
| Rate for Payer: Galaxy Health WC |
$1,173.85
|
| Rate for Payer: Global Benefits Group Commercial |
$828.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,242.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$921.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$854.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.20
|
| Rate for Payer: Multiplan Commercial |
$1,035.75
|
| Rate for Payer: Networks By Design Commercial |
$897.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.85
|
|
|
HC APP HIP SPICA CASE-ONE LEG
|
Facility
|
OP
|
$1,381.00
|
|
|
Service Code
|
CPT 29305
|
| Hospital Charge Code |
900501680
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$276.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$537.66
|
| Rate for Payer: Cash Price |
$759.55
|
| Rate for Payer: Cash Price |
$759.55
|
| Rate for Payer: Cash Price |
$759.55
|
| Rate for Payer: Cash Price |
$759.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,104.80
|
| Rate for Payer: Cigna of CA HMO |
$883.84
|
| Rate for Payer: Cigna of CA PPO |
$1,021.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$506.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$371.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$337.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$455.56
|
| Rate for Payer: EPIC Health Plan Senior |
$337.45
|
| Rate for Payer: Galaxy Health WC |
$1,173.85
|
| Rate for Payer: Global Benefits Group Commercial |
$828.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,242.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$553.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$337.45
|
| Rate for Payer: InnovAge PACE Commercial |
$506.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$921.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$470.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$337.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$452.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$452.18
|
| Rate for Payer: Multiplan Commercial |
$1,035.75
|
| Rate for Payer: Multiplan WC |
$537.66
|
| Rate for Payer: Networks By Design Commercial |
$897.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$337.45
|
| Rate for Payer: Preferred Health Network WC |
$548.63
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.85
|
| Rate for Payer: Prime Health Services Medicare |
$357.70
|
| Rate for Payer: Prime Health Services WC |
$532.17
|
| Rate for Payer: Riverside University Health System MISP |
$371.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$828.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$690.50
|
| Rate for Payer: United Healthcare All Other HMO |
$690.50
|
| Rate for Payer: United Healthcare HMO Rider |
$690.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$690.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$337.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$506.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$371.19
|
| Rate for Payer: Vantage Medical Group Senior |
$337.45
|
|
