|
HC BODY POS D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8983
|
| Hospital Charge Code |
900018305
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC BODY POS D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8983
|
| Hospital Charge Code |
900018405
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC BODY POS GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8982
|
| Hospital Charge Code |
900018304
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC BODY POS GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8982
|
| Hospital Charge Code |
900018404
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC BODY POS GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8982
|
| Hospital Charge Code |
900018304
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC BODY POS GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8982
|
| Hospital Charge Code |
900018404
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC BONE AGE
|
Facility
|
OP
|
$831.00
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
909001602
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.83 |
| Max. Negotiated Rate |
$747.90 |
| Rate for Payer: Adventist Health Commercial |
$166.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$89.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.02
|
| Rate for Payer: Blue Shield of California Commercial |
$523.53
|
| Rate for Payer: Blue Shield of California EPN |
$329.91
|
| Rate for Payer: Cash Price |
$373.95
|
| Rate for Payer: Cash Price |
$373.95
|
| Rate for Payer: Central Health Plan Commercial |
$664.80
|
| Rate for Payer: Cigna of CA HMO |
$531.84
|
| Rate for Payer: Cigna of CA PPO |
$614.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$581.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$498.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$747.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$527.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$623.25
|
| Rate for Payer: Networks By Design Commercial |
$540.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$706.35
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$498.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$498.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC BONE AGE
|
Facility
|
IP
|
$831.00
|
|
|
Service Code
|
CPT 77072
|
| Hospital Charge Code |
909001602
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$166.20 |
| Max. Negotiated Rate |
$747.90 |
| Rate for Payer: Adventist Health Commercial |
$166.20
|
| Rate for Payer: Cash Price |
$373.95
|
| Rate for Payer: Central Health Plan Commercial |
$664.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$581.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$332.40
|
| Rate for Payer: EPIC Health Plan Senior |
$332.40
|
| Rate for Payer: Galaxy Health WC |
$706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$498.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$747.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$527.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$490.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.20
|
| Rate for Payer: Multiplan Commercial |
$623.25
|
| Rate for Payer: Networks By Design Commercial |
$540.15
|
| Rate for Payer: Prime Health Services Commercial |
$706.35
|
|
|
HC BONE BIOPSY DEEP, PERCUTAN
|
Facility
|
IP
|
$7,881.00
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
909000107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,576.20 |
| Max. Negotiated Rate |
$7,092.90 |
| Rate for Payer: Adventist Health Commercial |
$1,576.20
|
| Rate for Payer: Cash Price |
$3,546.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,304.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,516.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,152.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,152.40
|
| Rate for Payer: Galaxy Health WC |
$6,698.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,728.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,092.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,004.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,649.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,576.20
|
| Rate for Payer: Multiplan Commercial |
$5,910.75
|
| Rate for Payer: Networks By Design Commercial |
$5,122.65
|
| Rate for Payer: Prime Health Services Commercial |
$6,698.85
|
|
|
HC BONE BIOPSY DEEP, PERCUTAN
|
Facility
|
OP
|
$7,881.00
|
|
|
Service Code
|
CPT 20225
|
| Hospital Charge Code |
909000107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.14 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,576.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,546.45
|
| Rate for Payer: Cash Price |
$3,546.45
|
| Rate for Payer: Cash Price |
$3,546.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,304.80
|
| Rate for Payer: Cigna of CA HMO |
$5,043.84
|
| Rate for Payer: Cigna of CA PPO |
$5,831.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,516.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$6,698.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,728.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,092.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$256.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,004.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$282.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,576.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$5,910.75
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$5,122.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,698.85
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,728.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,940.50
|
| 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 |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BONE BIOPSY SUPFCL, PERCUT
|
Facility
|
IP
|
$3,643.00
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
909000106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$728.60 |
| Max. Negotiated Rate |
$3,278.70 |
| Rate for Payer: Adventist Health Commercial |
$728.60
|
| Rate for Payer: Cash Price |
$1,639.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,914.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,550.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,457.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,457.20
|
| Rate for Payer: Galaxy Health WC |
$3,096.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,185.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,278.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,313.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,149.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$728.60
|
| Rate for Payer: Multiplan Commercial |
$2,732.25
|
| Rate for Payer: Networks By Design Commercial |
$2,367.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,096.55
|
|
|
HC BONE BIOPSY SUPFCL, PERCUT
|
Facility
|
OP
|
$3,643.00
|
|
|
Service Code
|
CPT 20220
|
| Hospital Charge Code |
909000106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.65 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$728.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,639.35
|
| Rate for Payer: Cash Price |
$1,639.35
|
| Rate for Payer: Cash Price |
$1,639.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,914.40
|
| Rate for Payer: Cigna of CA HMO |
$2,331.52
|
| Rate for Payer: Cigna of CA PPO |
$2,695.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,550.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$3,096.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,185.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,278.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$146.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,313.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$161.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$728.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$2,732.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$2,367.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$3,096.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,185.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,821.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$805.00
|
|
| Hospital Charge Code |
909081735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$603.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$367.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$441.46
|
| Rate for Payer: Blue Shield of California Commercial |
$645.61
|
| Rate for Payer: Blue Shield of California EPN |
$405.72
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$684.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$511.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$292.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$474.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$563.50
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Riverside University Health System MISP |
$322.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$805.00
|
|
| Hospital Charge Code |
909081735
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Blue Shield of California Commercial |
$645.61
|
| Rate for Payer: Blue Shield of California EPN |
$405.72
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$511.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$474.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
|
|
HC BONE, FINE NEEDLE ASPIRATION
|
Facility
|
IP
|
$1,618.00
|
|
|
Service Code
|
CPT 20615
|
| Hospital Charge Code |
909020019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.60 |
| Max. Negotiated Rate |
$1,456.20 |
| Rate for Payer: Adventist Health Commercial |
$323.60
|
| Rate for Payer: Cash Price |
$728.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,294.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,132.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$647.20
|
| Rate for Payer: EPIC Health Plan Senior |
$647.20
|
| Rate for Payer: Galaxy Health WC |
$1,375.30
|
| Rate for Payer: Global Benefits Group Commercial |
$970.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,456.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,027.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$954.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.60
|
| Rate for Payer: Multiplan Commercial |
$1,213.50
|
| Rate for Payer: Networks By Design Commercial |
$1,051.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,375.30
|
|
|
HC BONE, FINE NEEDLE ASPIRATION
|
Facility
|
OP
|
$1,618.00
|
|
|
Service Code
|
CPT 20615
|
| Hospital Charge Code |
909020019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$290.08 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$323.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$910.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$728.10
|
| Rate for Payer: Cash Price |
$728.10
|
| Rate for Payer: Cash Price |
$728.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,294.40
|
| Rate for Payer: Cigna of CA HMO |
$1,035.52
|
| Rate for Payer: Cigna of CA PPO |
$1,197.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,132.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$1,375.30
|
| Rate for Payer: Global Benefits Group Commercial |
$970.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,456.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$290.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,027.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$1,213.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$1,051.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,375.30
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$970.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$809.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC BONE LENGTH
|
Facility
|
IP
|
$1,378.00
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
909001603
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$275.60 |
| Max. Negotiated Rate |
$1,240.20 |
| Rate for Payer: Adventist Health Commercial |
$275.60
|
| Rate for Payer: Cash Price |
$620.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,102.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$964.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$551.20
|
| Rate for Payer: EPIC Health Plan Senior |
$551.20
|
| Rate for Payer: Galaxy Health WC |
$1,171.30
|
| Rate for Payer: Global Benefits Group Commercial |
$826.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,240.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$875.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$813.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.60
|
| Rate for Payer: Multiplan Commercial |
$1,033.50
|
| Rate for Payer: Networks By Design Commercial |
$895.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,171.30
|
|
|
HC BONE LENGTH
|
Facility
|
OP
|
$1,378.00
|
|
|
Service Code
|
CPT 77073
|
| Hospital Charge Code |
909001603
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.13 |
| Max. Negotiated Rate |
$1,240.20 |
| Rate for Payer: Adventist Health Commercial |
$275.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$154.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$164.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$228.58
|
| Rate for Payer: Blue Shield of California Commercial |
$868.14
|
| Rate for Payer: Blue Shield of California EPN |
$547.07
|
| Rate for Payer: Cash Price |
$620.10
|
| Rate for Payer: Cash Price |
$620.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,102.40
|
| Rate for Payer: Cigna of CA HMO |
$881.92
|
| Rate for Payer: Cigna of CA PPO |
$1,019.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$964.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$1,171.30
|
| Rate for Payer: Global Benefits Group Commercial |
$826.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,240.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$55.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$875.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$275.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$1,033.50
|
| Rate for Payer: Networks By Design Commercial |
$895.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,171.30
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$826.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$826.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC BONE MARROW ASP/AT TIME OF BX
|
Facility
|
IP
|
$4,855.00
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
911800314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$971.00 |
| Max. Negotiated Rate |
$4,369.50 |
| Rate for Payer: Adventist Health Commercial |
$971.00
|
| Rate for Payer: Cash Price |
$2,184.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,884.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,398.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,942.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,942.00
|
| Rate for Payer: Galaxy Health WC |
$4,126.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,913.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,369.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,082.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,864.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.00
|
| Rate for Payer: Multiplan Commercial |
$3,641.25
|
| Rate for Payer: Networks By Design Commercial |
$3,155.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,126.75
|
|
|
HC BONE MARROW ASP/AT TIME OF BX
|
Facility
|
OP
|
$4,855.00
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
911800314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$265.10 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$971.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,735.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$2,184.75
|
| Rate for Payer: Cash Price |
$2,184.75
|
| Rate for Payer: Cash Price |
$2,184.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,884.00
|
| Rate for Payer: Cigna of CA HMO |
$3,107.20
|
| Rate for Payer: Cigna of CA PPO |
$3,592.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,398.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$4,126.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,913.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,369.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$265.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,082.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$292.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$3,641.25
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$3,155.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$4,126.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,913.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,427.50
|
| 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 |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC BONE MARROW ASP ONLY
|
Facility
|
OP
|
$3,014.00
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
911800312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.69 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$602.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$1,356.30
|
| Rate for Payer: Cash Price |
$1,356.30
|
| Rate for Payer: Cash Price |
$1,356.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,411.20
|
| Rate for Payer: Cigna of CA HMO |
$1,928.96
|
| Rate for Payer: Cigna of CA PPO |
$2,230.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,109.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$2,561.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,808.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,712.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$315.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,913.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$348.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$602.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$2,260.50
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,959.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$2,561.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,808.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,507.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BONE MARROW ASP ONLY
|
Facility
|
IP
|
$3,014.00
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
911800312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$602.80 |
| Max. Negotiated Rate |
$2,712.60 |
| Rate for Payer: Adventist Health Commercial |
$602.80
|
| Rate for Payer: Cash Price |
$1,356.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,411.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,109.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,205.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,205.60
|
| Rate for Payer: Galaxy Health WC |
$2,561.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,808.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,712.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,913.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,778.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$602.80
|
| Rate for Payer: Multiplan Commercial |
$2,260.50
|
| Rate for Payer: Networks By Design Commercial |
$1,959.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,561.90
|
|
|
HC BONE MARROW BX ONLY
|
Facility
|
IP
|
$4,855.00
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
909020057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$971.00 |
| Max. Negotiated Rate |
$4,369.50 |
| Rate for Payer: Adventist Health Commercial |
$971.00
|
| Rate for Payer: Cash Price |
$2,184.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,884.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,398.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,942.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,942.00
|
| Rate for Payer: Galaxy Health WC |
$4,126.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,913.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,369.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,082.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,864.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.00
|
| Rate for Payer: Multiplan Commercial |
$3,641.25
|
| Rate for Payer: Networks By Design Commercial |
$3,155.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,126.75
|
|
|
HC BONE MARROW BX ONLY
|
Facility
|
OP
|
$4,855.00
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
909020057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$336.83 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$971.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$2,184.75
|
| Rate for Payer: Cash Price |
$2,184.75
|
| Rate for Payer: Cash Price |
$2,184.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,884.00
|
| Rate for Payer: Cigna of CA HMO |
$3,107.20
|
| Rate for Payer: Cigna of CA PPO |
$3,592.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,398.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$4,126.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,913.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,369.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$336.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,082.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$372.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$971.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$3,641.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,155.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,126.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,913.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,427.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC BONE MARROW IMAGING, LTD
|
Facility
|
IP
|
$1,297.00
|
|
|
Service Code
|
CPT 78102
|
| Hospital Charge Code |
909301330
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$259.40 |
| Max. Negotiated Rate |
$1,167.30 |
| Rate for Payer: Adventist Health Commercial |
$259.40
|
| Rate for Payer: Cash Price |
$583.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,037.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$907.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$518.80
|
| Rate for Payer: EPIC Health Plan Senior |
$518.80
|
| Rate for Payer: Galaxy Health WC |
$1,102.45
|
| Rate for Payer: Global Benefits Group Commercial |
$778.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,167.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$823.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$765.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$259.40
|
| Rate for Payer: Multiplan Commercial |
$972.75
|
| Rate for Payer: Networks By Design Commercial |
$843.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,102.45
|
|
