|
HC BE MOLD SKT MUENSTER SUSPENSN
|
Facility
|
OP
|
$4,675.00
|
|
|
Service Code
|
CPT L6110
|
| Hospital Charge Code |
905356110
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,467.40 |
| Max. Negotiated Rate |
$4,207.50 |
| Rate for Payer: Adventist Health Commercial |
$1,916.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,571.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,506.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,719.45
|
| Rate for Payer: Blue Shield of California Commercial |
$3,749.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,356.20
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Cash Price |
$2,103.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,740.00
|
| Rate for Payer: Cigna of CA HMO |
$3,272.50
|
| Rate for Payer: Cigna of CA PPO |
$3,272.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,973.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,973.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,272.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,870.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,870.00
|
| Rate for Payer: Galaxy Health WC |
$3,973.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,805.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,207.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,467.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,968.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,620.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,758.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,916.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,272.50
|
| Rate for Payer: Multiplan Commercial |
$3,506.25
|
| Rate for Payer: Networks By Design Commercial |
$2,337.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,973.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,870.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,805.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,805.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,754.53
|
| Rate for Payer: United Healthcare All Other HMO |
$1,707.78
|
| Rate for Payer: United Healthcare HMO Rider |
$1,670.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,531.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,973.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,973.75
|
| Rate for Payer: Vantage Medical Group Senior |
$3,973.75
|
|
|
HC BENZODIAZPINES CONF
|
Facility
|
IP
|
$312.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900910515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$280.80 |
| Rate for Payer: Adventist Health Commercial |
$62.40
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Central Health Plan Commercial |
$249.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$218.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.80
|
| Rate for Payer: EPIC Health Plan Senior |
$124.80
|
| Rate for Payer: Galaxy Health WC |
$265.20
|
| Rate for Payer: Global Benefits Group Commercial |
$187.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$280.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.40
|
| Rate for Payer: Multiplan Commercial |
$234.00
|
| Rate for Payer: Networks By Design Commercial |
$202.80
|
| Rate for Payer: Prime Health Services Commercial |
$265.20
|
|
|
HC BENZODIAZPINES CONF
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
900910515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Adventist Health Commercial |
$62.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$265.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$171.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$194.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$234.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$129.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$129.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$179.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$179.42
|
| Rate for Payer: Blue Shield of California Commercial |
$163.17
|
| Rate for Payer: Blue Shield of California Commercial |
$196.56
|
| Rate for Payer: Blue Shield of California EPN |
$102.82
|
| Rate for Payer: Blue Shield of California EPN |
$123.86
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$140.40
|
| Rate for Payer: Central Health Plan Commercial |
$207.20
|
| Rate for Payer: Central Health Plan Commercial |
$249.60
|
| Rate for Payer: Cigna of CA HMO |
$199.68
|
| Rate for Payer: Cigna of CA HMO |
$165.76
|
| Rate for Payer: Cigna of CA PPO |
$191.66
|
| Rate for Payer: Cigna of CA PPO |
$230.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$220.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$265.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$265.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$220.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$265.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$218.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$181.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.80
|
| Rate for Payer: EPIC Health Plan Senior |
$124.80
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: Galaxy Health WC |
$265.20
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$187.20
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$280.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$164.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$113.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$94.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$152.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$181.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$218.40
|
| Rate for Payer: Multiplan Commercial |
$234.00
|
| Rate for Payer: Multiplan Commercial |
$194.25
|
| Rate for Payer: Networks By Design Commercial |
$202.80
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: Prime Health Services Commercial |
$265.20
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: Riverside University Health System MISP |
$103.60
|
| Rate for Payer: Riverside University Health System MISP |
$124.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$187.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$129.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$156.00
|
| Rate for Payer: United Healthcare All Other HMO |
$129.50
|
| Rate for Payer: United Healthcare All Other HMO |
$156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$129.50
|
| Rate for Payer: United Healthcare HMO Rider |
$156.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$129.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$156.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$265.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$265.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.15
|
| Rate for Payer: Vantage Medical Group Senior |
$265.20
|
| Rate for Payer: Vantage Medical Group Senior |
$220.15
|
|
|
HC BER E 1 (BRAZIL NUT), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913741
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$11.65
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.34
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Cigna of CA HMO |
$11.83
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$13.68
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC BER E 1 (BRAZIL NUT), IGE
|
Facility
|
IP
|
$18.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913741
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.70
|
| Rate for Payer: Cash Price |
$8.32
|
| Rate for Payer: Central Health Plan Commercial |
$14.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7.40
|
| Rate for Payer: Galaxy Health WC |
$15.72
|
| Rate for Payer: Global Benefits Group Commercial |
$11.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.70
|
| Rate for Payer: Multiplan Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$12.02
|
| Rate for Payer: Prime Health Services Commercial |
$15.72
|
|
|
HC BE SPLIT SKT STEPUP HNG 1/2 CF
|
Facility
|
IP
|
$3,516.00
|
|
|
Service Code
|
CPT L6120
|
| Hospital Charge Code |
905356120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$703.20 |
| Max. Negotiated Rate |
$3,164.40 |
| Rate for Payer: Adventist Health Commercial |
$703.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,819.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,772.06
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,812.80
|
| Rate for Payer: Cigna of CA HMO |
$2,461.20
|
| Rate for Payer: Cigna of CA PPO |
$2,461.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,461.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,406.40
|
| Rate for Payer: Galaxy Health WC |
$2,988.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,109.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,164.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,232.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,074.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$703.20
|
| Rate for Payer: Multiplan Commercial |
$2,637.00
|
| Rate for Payer: Networks By Design Commercial |
$2,285.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,988.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,319.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,284.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,256.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,151.49
|
|
|
HC BE SPLIT SKT STEPUP HNG 1/2 CF
|
Facility
|
OP
|
$3,516.00
|
|
|
Service Code
|
CPT L6120
|
| Hospital Charge Code |
905356120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,151.49 |
| Max. Negotiated Rate |
$3,164.40 |
| Rate for Payer: Adventist Health Commercial |
$1,441.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,933.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,637.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,045.26
|
| Rate for Payer: Blue Shield of California Commercial |
$2,819.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,772.06
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,812.80
|
| Rate for Payer: Cigna of CA HMO |
$2,461.20
|
| Rate for Payer: Cigna of CA PPO |
$2,461.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,988.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,988.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,461.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,406.40
|
| Rate for Payer: Galaxy Health WC |
$2,988.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,109.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,164.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,697.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,232.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,875.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,074.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,441.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,461.20
|
| Rate for Payer: Multiplan Commercial |
$2,637.00
|
| Rate for Payer: Networks By Design Commercial |
$1,758.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,988.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,406.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,109.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,109.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,319.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,284.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,256.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,151.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,988.60
|
| Rate for Payer: Vantage Medical Group Senior |
$2,988.60
|
|
|
HC BE SPLIT SKT STEPUP HNG 1/2 CF
|
Facility
|
IP
|
$3,516.00
|
|
|
Service Code
|
CPT L6120
|
| Hospital Charge Code |
915356120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$703.20 |
| Max. Negotiated Rate |
$3,164.40 |
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,812.80
|
| Rate for Payer: Cigna of CA HMO |
$2,461.20
|
| Rate for Payer: Cigna of CA PPO |
$2,461.20
|
| Rate for Payer: Adventist Health Commercial |
$703.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,819.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,772.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,461.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,406.40
|
| Rate for Payer: Galaxy Health WC |
$2,988.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,109.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,164.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,232.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,074.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$703.20
|
| Rate for Payer: Multiplan Commercial |
$2,637.00
|
| Rate for Payer: Networks By Design Commercial |
$2,285.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,988.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,319.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,284.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,256.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,151.49
|
|
|
HC BE SPLIT SKT STEPUP HNG 1/2 CF
|
Facility
|
OP
|
$3,516.00
|
|
|
Service Code
|
CPT L6120
|
| Hospital Charge Code |
915356120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,151.49 |
| Max. Negotiated Rate |
$3,164.40 |
| Rate for Payer: Adventist Health Commercial |
$1,441.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,933.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,637.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,045.26
|
| Rate for Payer: Blue Shield of California Commercial |
$2,819.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,772.06
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,812.80
|
| Rate for Payer: Cigna of CA HMO |
$2,461.20
|
| Rate for Payer: Cigna of CA PPO |
$2,461.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,988.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,988.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,461.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,406.40
|
| Rate for Payer: Galaxy Health WC |
$2,988.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,109.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,164.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,697.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,232.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,875.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,074.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,441.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,461.20
|
| Rate for Payer: Multiplan Commercial |
$2,637.00
|
| Rate for Payer: Networks By Design Commercial |
$1,758.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,988.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,406.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,109.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,109.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,319.55
|
| Rate for Payer: United Healthcare All Other HMO |
$1,284.39
|
| Rate for Payer: United Healthcare HMO Rider |
$1,256.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,151.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,988.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,988.60
|
| Rate for Payer: Vantage Medical Group Senior |
$2,988.60
|
|
|
HC BE SPLIT SKT STMP ACTIVAT LOCK
|
Facility
|
OP
|
$6,016.00
|
|
|
Service Code
|
CPT L6130
|
| Hospital Charge Code |
915356130
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,970.24 |
| Max. Negotiated Rate |
$5,414.40 |
| Rate for Payer: Adventist Health Commercial |
$2,466.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,113.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,308.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,512.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,499.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,824.83
|
| Rate for Payer: Blue Shield of California EPN |
$3,032.06
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,812.80
|
| Rate for Payer: Cigna of CA HMO |
$4,211.20
|
| Rate for Payer: Cigna of CA PPO |
$4,211.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,113.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,113.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,113.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,211.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,406.40
|
| Rate for Payer: Galaxy Health WC |
$5,113.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,609.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,414.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,126.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,820.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,348.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,549.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,466.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,211.20
|
| Rate for Payer: Multiplan Commercial |
$4,512.00
|
| Rate for Payer: Networks By Design Commercial |
$3,008.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,113.60
|
| Rate for Payer: Riverside University Health System MISP |
$2,406.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,609.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,609.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,257.80
|
| Rate for Payer: United Healthcare All Other HMO |
$2,197.64
|
| Rate for Payer: United Healthcare HMO Rider |
$2,150.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,970.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,113.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,113.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,113.60
|
|
|
HC BE SPLIT SKT STMP ACTIVAT LOCK
|
Facility
|
IP
|
$6,016.00
|
|
|
Service Code
|
CPT L6130
|
| Hospital Charge Code |
915356130
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,203.20 |
| Max. Negotiated Rate |
$5,414.40 |
| Rate for Payer: United Healthcare HMO Rider |
$2,150.12
|
| Rate for Payer: Adventist Health Commercial |
$1,203.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,824.83
|
| Rate for Payer: Blue Shield of California EPN |
$3,032.06
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,812.80
|
| Rate for Payer: Cigna of CA HMO |
$4,211.20
|
| Rate for Payer: Cigna of CA PPO |
$4,211.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,211.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,406.40
|
| Rate for Payer: Galaxy Health WC |
$5,113.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,609.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,414.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,820.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,549.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,203.20
|
| Rate for Payer: Multiplan Commercial |
$4,512.00
|
| Rate for Payer: Networks By Design Commercial |
$3,910.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,257.80
|
| Rate for Payer: United Healthcare All Other HMO |
$2,197.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,970.24
|
|
|
HC BE SPLIT SKT STMP ACTIVAT LOCK
|
Facility
|
OP
|
$6,016.00
|
|
|
Service Code
|
CPT L6130
|
| Hospital Charge Code |
905356130
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,970.24 |
| Max. Negotiated Rate |
$5,414.40 |
| Rate for Payer: Adventist Health Commercial |
$2,466.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,113.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,308.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,512.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,499.51
|
| Rate for Payer: Blue Shield of California Commercial |
$4,824.83
|
| Rate for Payer: Blue Shield of California EPN |
$3,032.06
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,812.80
|
| Rate for Payer: Cigna of CA HMO |
$4,211.20
|
| Rate for Payer: Cigna of CA PPO |
$4,211.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,113.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,113.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,113.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,211.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,406.40
|
| Rate for Payer: Galaxy Health WC |
$5,113.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,609.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,414.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,126.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,820.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,348.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,549.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,466.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,211.20
|
| Rate for Payer: Multiplan Commercial |
$4,512.00
|
| Rate for Payer: Networks By Design Commercial |
$3,008.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,113.60
|
| Rate for Payer: Riverside University Health System MISP |
$2,406.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,609.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,609.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,257.80
|
| Rate for Payer: United Healthcare All Other HMO |
$2,197.64
|
| Rate for Payer: United Healthcare HMO Rider |
$2,150.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,970.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,113.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,113.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,113.60
|
|
|
HC BE SPLIT SKT STMP ACTIVAT LOCK
|
Facility
|
IP
|
$6,016.00
|
|
|
Service Code
|
CPT L6130
|
| Hospital Charge Code |
905356130
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,203.20 |
| Max. Negotiated Rate |
$5,414.40 |
| Rate for Payer: Adventist Health Commercial |
$1,203.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,824.83
|
| Rate for Payer: Blue Shield of California EPN |
$3,032.06
|
| Rate for Payer: Cash Price |
$2,707.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,812.80
|
| Rate for Payer: Cigna of CA HMO |
$4,211.20
|
| Rate for Payer: Cigna of CA PPO |
$4,211.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,211.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,406.40
|
| Rate for Payer: Galaxy Health WC |
$5,113.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,609.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,414.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,820.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,549.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,203.20
|
| Rate for Payer: Multiplan Commercial |
$4,512.00
|
| Rate for Payer: Networks By Design Commercial |
$3,910.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,257.80
|
| Rate for Payer: United Healthcare All Other HMO |
$2,197.64
|
| Rate for Payer: United Healthcare HMO Rider |
$2,150.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,970.24
|
|
|
HC BETA HCG POC
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
900912138
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Adventist Health Commercial |
$37.60
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Central Health Plan Commercial |
$150.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$131.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.20
|
| Rate for Payer: EPIC Health Plan Senior |
$75.20
|
| Rate for Payer: Galaxy Health WC |
$159.80
|
| Rate for Payer: Global Benefits Group Commercial |
$112.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$169.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$119.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$110.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.60
|
| Rate for Payer: Multiplan Commercial |
$141.00
|
| Rate for Payer: Networks By Design Commercial |
$122.20
|
| Rate for Payer: Prime Health Services Commercial |
$159.80
|
|
|
HC BETA HCG POC
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
900912138
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.09 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Adventist Health Commercial |
$37.60
|
| Rate for Payer: Adventist Health Commercial |
$10.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.52
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.99
|
| Rate for Payer: Blue Shield of California Commercial |
$34.02
|
| Rate for Payer: Blue Shield of California Commercial |
$118.44
|
| Rate for Payer: Blue Shield of California EPN |
$21.44
|
| Rate for Payer: Blue Shield of California EPN |
$74.64
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Central Health Plan Commercial |
$150.40
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA HMO |
$120.32
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Cigna of CA PPO |
$139.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$131.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.41
|
| Rate for Payer: EPIC Health Plan Senior |
$8.27
|
| Rate for Payer: EPIC Health Plan Senior |
$8.27
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Galaxy Health WC |
$159.80
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Global Benefits Group Commercial |
$112.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$169.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.33
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$119.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$34.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.08
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Multiplan Commercial |
$141.00
|
| Rate for Payer: Networks By Design Commercial |
$122.20
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.52
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.52
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Commercial |
$159.80
|
| Rate for Payer: Prime Health Services Medicare |
$7.97
|
| Rate for Payer: Prime Health Services Medicare |
$7.97
|
| Rate for Payer: Riverside University Health System MISP |
$8.27
|
| Rate for Payer: Riverside University Health System MISP |
$8.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$112.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$112.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.09
|
| Rate for Payer: United Healthcare All Other HMO |
$6.09
|
| Rate for Payer: United Healthcare All Other HMO |
$6.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.52
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.27
|
| Rate for Payer: Vantage Medical Group Senior |
$7.52
|
| Rate for Payer: Vantage Medical Group Senior |
$7.52
|
|
|
HC BETA HCG, QUAL
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
900910840
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.09 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Adventist Health Commercial |
$37.60
|
| Rate for Payer: Adventist Health Commercial |
$15.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.52
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$54.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.99
|
| Rate for Payer: Blue Shield of California Commercial |
$47.88
|
| Rate for Payer: Blue Shield of California Commercial |
$118.44
|
| Rate for Payer: Blue Shield of California EPN |
$30.17
|
| Rate for Payer: Blue Shield of California EPN |
$74.64
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Central Health Plan Commercial |
$150.40
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: Cigna of CA HMO |
$48.64
|
| Rate for Payer: Cigna of CA HMO |
$120.32
|
| Rate for Payer: Cigna of CA PPO |
$56.24
|
| Rate for Payer: Cigna of CA PPO |
$139.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$131.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.41
|
| Rate for Payer: EPIC Health Plan Senior |
$8.27
|
| Rate for Payer: EPIC Health Plan Senior |
$8.27
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Galaxy Health WC |
$159.80
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Global Benefits Group Commercial |
$112.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$169.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.33
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$119.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.08
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Multiplan Commercial |
$141.00
|
| Rate for Payer: Networks By Design Commercial |
$122.20
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.52
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.52
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
| Rate for Payer: Prime Health Services Commercial |
$159.80
|
| Rate for Payer: Prime Health Services Medicare |
$7.97
|
| Rate for Payer: Prime Health Services Medicare |
$7.97
|
| Rate for Payer: Riverside University Health System MISP |
$8.27
|
| Rate for Payer: Riverside University Health System MISP |
$8.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$112.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$112.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.09
|
| Rate for Payer: United Healthcare All Other HMO |
$6.09
|
| Rate for Payer: United Healthcare All Other HMO |
$6.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.52
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.27
|
| Rate for Payer: Vantage Medical Group Senior |
$7.52
|
| Rate for Payer: Vantage Medical Group Senior |
$7.52
|
|
|
HC BETA HCG, QUAL
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
CPT 84703
|
| Hospital Charge Code |
900910840
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$169.20 |
| Rate for Payer: Adventist Health Commercial |
$37.60
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Central Health Plan Commercial |
$150.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$131.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.20
|
| Rate for Payer: EPIC Health Plan Senior |
$75.20
|
| Rate for Payer: Galaxy Health WC |
$159.80
|
| Rate for Payer: Global Benefits Group Commercial |
$112.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$169.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$119.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$110.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.60
|
| Rate for Payer: Multiplan Commercial |
$141.00
|
| Rate for Payer: Networks By Design Commercial |
$122.20
|
| Rate for Payer: Prime Health Services Commercial |
$159.80
|
|
|
HC BETA HCG, QUANT
|
Facility
|
IP
|
$449.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
900910814
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$89.80 |
| Max. Negotiated Rate |
$404.10 |
| Rate for Payer: Adventist Health Commercial |
$89.80
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Central Health Plan Commercial |
$359.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$314.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$179.60
|
| Rate for Payer: EPIC Health Plan Senior |
$179.60
|
| Rate for Payer: Galaxy Health WC |
$381.65
|
| Rate for Payer: Global Benefits Group Commercial |
$269.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$404.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$285.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$264.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.80
|
| Rate for Payer: Multiplan Commercial |
$336.75
|
| Rate for Payer: Networks By Design Commercial |
$291.85
|
| Rate for Payer: Prime Health Services Commercial |
$381.65
|
|
|
HC BETA HCG, QUANT
|
Facility
|
OP
|
$126.00
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
900910814
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$145.71 |
| Rate for Payer: Adventist Health Commercial |
$25.20
|
| Rate for Payer: Adventist Health Commercial |
$89.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.05
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.71
|
| Rate for Payer: Blue Shield of California Commercial |
$282.87
|
| Rate for Payer: Blue Shield of California Commercial |
$79.38
|
| Rate for Payer: Blue Shield of California EPN |
$178.25
|
| Rate for Payer: Blue Shield of California EPN |
$50.02
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Cash Price |
$202.05
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Central Health Plan Commercial |
$100.80
|
| Rate for Payer: Central Health Plan Commercial |
$359.20
|
| Rate for Payer: Cigna of CA HMO |
$287.36
|
| Rate for Payer: Cigna of CA HMO |
$80.64
|
| Rate for Payer: Cigna of CA PPO |
$332.26
|
| Rate for Payer: Cigna of CA PPO |
$93.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$314.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.83
|
| Rate for Payer: EPIC Health Plan Senior |
$16.55
|
| Rate for Payer: EPIC Health Plan Senior |
$16.55
|
| Rate for Payer: Galaxy Health WC |
$381.65
|
| Rate for Payer: Galaxy Health WC |
$107.10
|
| Rate for Payer: Global Benefits Group Commercial |
$269.40
|
| Rate for Payer: Global Benefits Group Commercial |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$404.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.68
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$80.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$285.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.17
|
| Rate for Payer: Multiplan Commercial |
$336.75
|
| Rate for Payer: Multiplan Commercial |
$94.50
|
| Rate for Payer: Networks By Design Commercial |
$81.90
|
| Rate for Payer: Networks By Design Commercial |
$291.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.05
|
| Rate for Payer: Prime Health Services Commercial |
$381.65
|
| Rate for Payer: Prime Health Services Commercial |
$107.10
|
| Rate for Payer: Prime Health Services Medicare |
$15.95
|
| Rate for Payer: Prime Health Services Medicare |
$15.95
|
| Rate for Payer: Riverside University Health System MISP |
$16.55
|
| Rate for Payer: Riverside University Health System MISP |
$16.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$269.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$269.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.20
|
| Rate for Payer: United Healthcare All Other HMO |
$12.20
|
| Rate for Payer: United Healthcare All Other HMO |
$12.20
|
| Rate for Payer: United Healthcare HMO Rider |
$12.20
|
| Rate for Payer: United Healthcare HMO Rider |
$12.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.05
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC BETA-HYDROXYBUTYRATE
|
Facility
|
IP
|
$260.00
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
900910356
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.00 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Adventist Health Commercial |
$52.00
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$208.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$182.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.00
|
| Rate for Payer: EPIC Health Plan Senior |
$104.00
|
| Rate for Payer: Galaxy Health WC |
$221.00
|
| Rate for Payer: Global Benefits Group Commercial |
$156.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$165.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$153.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.00
|
| Rate for Payer: Multiplan Commercial |
$195.00
|
| Rate for Payer: Networks By Design Commercial |
$169.00
|
| Rate for Payer: Prime Health Services Commercial |
$221.00
|
|
|
HC BETA-HYDROXYBUTYRATE
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
900910356
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Adventist Health Commercial |
$52.00
|
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.17
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$60.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.18
|
| Rate for Payer: Blue Shield of California Commercial |
$25.83
|
| Rate for Payer: Blue Shield of California Commercial |
$163.80
|
| Rate for Payer: Blue Shield of California EPN |
$16.28
|
| Rate for Payer: Blue Shield of California EPN |
$103.22
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$208.00
|
| Rate for Payer: Central Health Plan Commercial |
$32.80
|
| Rate for Payer: Cigna of CA HMO |
$26.24
|
| Rate for Payer: Cigna of CA HMO |
$166.40
|
| Rate for Payer: Cigna of CA PPO |
$30.34
|
| Rate for Payer: Cigna of CA PPO |
$192.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$182.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.48
|
| Rate for Payer: EPIC Health Plan Senior |
$8.99
|
| Rate for Payer: EPIC Health Plan Senior |
$8.99
|
| Rate for Payer: Galaxy Health WC |
$34.85
|
| Rate for Payer: Galaxy Health WC |
$221.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.60
|
| Rate for Payer: Global Benefits Group Commercial |
$156.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$13.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$165.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.95
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: Multiplan Commercial |
$195.00
|
| Rate for Payer: Networks By Design Commercial |
$169.00
|
| Rate for Payer: Networks By Design Commercial |
$26.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.17
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.17
|
| Rate for Payer: Prime Health Services Commercial |
$34.85
|
| Rate for Payer: Prime Health Services Commercial |
$221.00
|
| Rate for Payer: Prime Health Services Medicare |
$8.66
|
| Rate for Payer: Prime Health Services Medicare |
$8.66
|
| Rate for Payer: Riverside University Health System MISP |
$8.99
|
| Rate for Payer: Riverside University Health System MISP |
$8.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$156.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$156.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.62
|
| Rate for Payer: United Healthcare All Other HMO |
$6.62
|
| Rate for Payer: United Healthcare All Other HMO |
$6.62
|
| Rate for Payer: United Healthcare HMO Rider |
$6.62
|
| Rate for Payer: United Healthcare HMO Rider |
$6.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.17
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Vantage Medical Group Senior |
$8.17
|
| Rate for Payer: Vantage Medical Group Senior |
$8.17
|
|
|
HC BETA STREP RAPID TEST
|
Facility
|
OP
|
$138.00
|
|
|
Service Code
|
CPT 87430
|
| Hospital Charge Code |
900911635
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.62 |
| Max. Negotiated Rate |
$124.20 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Adventist Health Commercial |
$9.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$16.81
|
| Rate for Payer: Adventist Health Medi-Cal |
$16.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$65.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.90
|
| Rate for Payer: Blue Shield of California Commercial |
$29.61
|
| Rate for Payer: Blue Shield of California Commercial |
$86.94
|
| Rate for Payer: Blue Shield of California EPN |
$18.66
|
| Rate for Payer: Blue Shield of California EPN |
$54.79
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cash Price |
$21.15
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Central Health Plan Commercial |
$110.40
|
| Rate for Payer: Central Health Plan Commercial |
$37.60
|
| Rate for Payer: Cigna of CA HMO |
$30.08
|
| Rate for Payer: Cigna of CA HMO |
$88.32
|
| Rate for Payer: Cigna of CA PPO |
$34.78
|
| Rate for Payer: Cigna of CA PPO |
$102.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.74
|
| Rate for Payer: EPIC Health Plan Senior |
$18.49
|
| Rate for Payer: EPIC Health Plan Senior |
$18.49
|
| Rate for Payer: Galaxy Health WC |
$39.95
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$28.20
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$42.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.53
|
| Rate for Payer: Multiplan Commercial |
$35.25
|
| Rate for Payer: Multiplan Commercial |
$103.50
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Networks By Design Commercial |
$30.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16.81
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16.81
|
| Rate for Payer: Prime Health Services Commercial |
$39.95
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
| Rate for Payer: Prime Health Services Medicare |
$17.82
|
| Rate for Payer: Prime Health Services Medicare |
$17.82
|
| Rate for Payer: Riverside University Health System MISP |
$18.49
|
| Rate for Payer: Riverside University Health System MISP |
$18.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.62
|
| Rate for Payer: United Healthcare All Other HMO |
$13.62
|
| Rate for Payer: United Healthcare All Other HMO |
$13.62
|
| Rate for Payer: United Healthcare HMO Rider |
$13.62
|
| Rate for Payer: United Healthcare HMO Rider |
$13.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.49
|
| Rate for Payer: Vantage Medical Group Senior |
$16.81
|
| Rate for Payer: Vantage Medical Group Senior |
$16.81
|
|
|
HC BETA STREP RAPID TEST
|
Facility
|
IP
|
$138.00
|
|
|
Service Code
|
CPT 87430
|
| Hospital Charge Code |
900911635
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$124.20 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Central Health Plan Commercial |
$110.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: EPIC Health Plan Senior |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: Multiplan Commercial |
$103.50
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
|
|
HC BET V 2 (SILVER BIRCH), IGE
|
Facility
|
OP
|
$15.41
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913750
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$167.30 |
| Rate for Payer: Adventist Health Commercial |
$3.08
|
| Rate for Payer: Adventist Health Commercial |
$3.91
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Adventist Health Medi-Cal |
$17.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$115.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$120.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.30
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$9.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.76
|
| Rate for Payer: Blue Shield of California EPN |
$6.12
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Cash Price |
$6.93
|
| Rate for Payer: Central Health Plan Commercial |
$12.33
|
| Rate for Payer: Central Health Plan Commercial |
$15.64
|
| Rate for Payer: Cigna of CA HMO |
$12.51
|
| Rate for Payer: Cigna of CA HMO |
$9.86
|
| Rate for Payer: Cigna of CA PPO |
$14.47
|
| Rate for Payer: Cigna of CA PPO |
$11.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: EPIC Health Plan Senior |
$19.72
|
| Rate for Payer: Galaxy Health WC |
$16.62
|
| Rate for Payer: Galaxy Health WC |
$13.10
|
| Rate for Payer: Global Benefits Group Commercial |
$11.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$14.66
|
| Rate for Payer: Multiplan Commercial |
$11.56
|
| Rate for Payer: Networks By Design Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$12.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$16.62
|
| Rate for Payer: Prime Health Services Commercial |
$13.10
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Prime Health Services Medicare |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Riverside University Health System MISP |
$19.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare All Other HMO |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare HMO Rider |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.53
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Upland Medical Group Pediatric |
$17.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC BET V 2 (SILVER BIRCH), IGE
|
Facility
|
IP
|
$19.55
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913750
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$17.59 |
| Rate for Payer: Adventist Health Commercial |
$3.91
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Central Health Plan Commercial |
$15.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7.82
|
| Rate for Payer: Galaxy Health WC |
$16.62
|
| Rate for Payer: Global Benefits Group Commercial |
$11.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.91
|
| Rate for Payer: Multiplan Commercial |
$14.66
|
| Rate for Payer: Networks By Design Commercial |
$12.71
|
| Rate for Payer: Prime Health Services Commercial |
$16.62
|
|
