|
HC CANN TRACH SHILEY SIZE 8
|
Facility
|
IP
|
$32.88
|
|
|
Service Code
|
CPT A4623
|
| Hospital Charge Code |
901600967
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$29.59 |
| Rate for Payer: Adventist Health Commercial |
$6.58
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Central Health Plan Commercial |
$26.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.15
|
| Rate for Payer: EPIC Health Plan Senior |
$13.15
|
| Rate for Payer: Galaxy Health WC |
$27.95
|
| Rate for Payer: Global Benefits Group Commercial |
$19.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$24.66
|
| Rate for Payer: Networks By Design Commercial |
$21.37
|
| Rate for Payer: Prime Health Services Commercial |
$27.95
|
|
|
HC CANNULATION, THORACIC DUCT
|
Facility
|
OP
|
$872.00
|
|
|
Service Code
|
CPT 38794
|
| Hospital Charge Code |
909008794
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.40 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$174.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$741.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$479.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$654.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$392.40
|
| Rate for Payer: Cash Price |
$392.40
|
| Rate for Payer: Cash Price |
$392.40
|
| Rate for Payer: Central Health Plan Commercial |
$697.60
|
| Rate for Payer: Cigna of CA HMO |
$558.08
|
| Rate for Payer: Cigna of CA PPO |
$645.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$741.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$741.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$741.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$610.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.80
|
| Rate for Payer: EPIC Health Plan Senior |
$348.80
|
| Rate for Payer: Galaxy Health WC |
$741.20
|
| Rate for Payer: Global Benefits Group Commercial |
$523.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$784.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$290.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$553.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$514.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$610.40
|
| Rate for Payer: Multiplan Commercial |
$654.00
|
| Rate for Payer: Networks By Design Commercial |
$566.80
|
| Rate for Payer: Prime Health Services Commercial |
$741.20
|
| Rate for Payer: Riverside University Health System MISP |
$348.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$523.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$436.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$741.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$741.20
|
| Rate for Payer: Vantage Medical Group Senior |
$741.20
|
|
|
HC CANNULATION, THORACIC DUCT
|
Facility
|
IP
|
$872.00
|
|
|
Service Code
|
CPT 38794
|
| Hospital Charge Code |
909008794
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.40 |
| Max. Negotiated Rate |
$784.80 |
| Rate for Payer: Adventist Health Commercial |
$174.40
|
| Rate for Payer: Cash Price |
$392.40
|
| Rate for Payer: Central Health Plan Commercial |
$697.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$610.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.80
|
| Rate for Payer: EPIC Health Plan Senior |
$348.80
|
| Rate for Payer: Galaxy Health WC |
$741.20
|
| Rate for Payer: Global Benefits Group Commercial |
$523.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$784.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$553.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$514.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.40
|
| Rate for Payer: Multiplan Commercial |
$654.00
|
| Rate for Payer: Networks By Design Commercial |
$566.80
|
| Rate for Payer: Prime Health Services Commercial |
$741.20
|
|
|
HC CANTHOTOMY
|
Facility
|
IP
|
$7,611.00
|
|
|
Service Code
|
CPT 67715
|
| Hospital Charge Code |
900501183
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,522.20 |
| Max. Negotiated Rate |
$6,849.90 |
| Rate for Payer: Adventist Health Commercial |
$1,522.20
|
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,088.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,327.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,044.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,044.40
|
| Rate for Payer: Galaxy Health WC |
$6,469.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,566.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,849.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,832.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,490.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.20
|
| Rate for Payer: Multiplan Commercial |
$5,708.25
|
| Rate for Payer: Networks By Design Commercial |
$4,947.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,469.35
|
|
|
HC CANTHOTOMY
|
Facility
|
OP
|
$7,611.00
|
|
|
Service Code
|
CPT 67715
|
| Hospital Charge Code |
900501183
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.13 |
| Max. Negotiated Rate |
$6,849.90 |
| Rate for Payer: Adventist Health Commercial |
$1,522.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,057.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,723.01
|
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,088.80
|
| Rate for Payer: Cigna of CA HMO |
$4,871.04
|
| Rate for Payer: Cigna of CA PPO |
$5,632.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,363.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,057.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,327.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,045.44
|
| Rate for Payer: EPIC Health Plan Senior |
$3,363.62
|
| Rate for Payer: Galaxy Health WC |
$6,469.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,566.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,849.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,014.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,832.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,287.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,097.51
|
| Rate for Payer: Multiplan Commercial |
$5,708.25
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: Networks By Design Commercial |
$4,947.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,057.84
|
| Rate for Payer: Preferred Health Network WC |
$4,819.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,469.35
|
| Rate for Payer: Prime Health Services Medicare |
$3,241.31
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Riverside University Health System MISP |
$3,363.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,566.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,805.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,805.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,805.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,805.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,057.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,586.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,363.62
|
| Rate for Payer: Vantage Medical Group Senior |
$3,057.84
|
|
|
HC CANVAS VEST SO
|
Facility
|
OP
|
$323.00
|
|
|
Service Code
|
CPT L3675
|
| Hospital Charge Code |
905353675
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$105.78 |
| Max. Negotiated Rate |
$290.70 |
| Rate for Payer: Adventist Health Commercial |
$132.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$274.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$177.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$242.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$187.89
|
| Rate for Payer: Blue Shield of California Commercial |
$259.05
|
| Rate for Payer: Blue Shield of California EPN |
$162.79
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Central Health Plan Commercial |
$258.40
|
| Rate for Payer: Cigna of CA HMO |
$226.10
|
| Rate for Payer: Cigna of CA PPO |
$226.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$274.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$274.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$274.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$226.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$274.55
|
| Rate for Payer: Global Benefits Group Commercial |
$193.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$290.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$151.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$166.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$226.10
|
| Rate for Payer: Multiplan Commercial |
$242.25
|
| Rate for Payer: Networks By Design Commercial |
$161.50
|
| Rate for Payer: Prime Health Services Commercial |
$274.55
|
| Rate for Payer: Riverside University Health System MISP |
$129.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$193.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$193.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.22
|
| Rate for Payer: United Healthcare All Other HMO |
$117.99
|
| Rate for Payer: United Healthcare HMO Rider |
$115.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$105.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$274.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$274.55
|
| Rate for Payer: Vantage Medical Group Senior |
$274.55
|
|
|
HC CANVAS VEST SO
|
Facility
|
IP
|
$323.00
|
|
|
Service Code
|
CPT L3675
|
| Hospital Charge Code |
905353675
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$64.60 |
| Max. Negotiated Rate |
$290.70 |
| Rate for Payer: Adventist Health Commercial |
$64.60
|
| Rate for Payer: Blue Shield of California Commercial |
$259.05
|
| Rate for Payer: Blue Shield of California EPN |
$162.79
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Central Health Plan Commercial |
$258.40
|
| Rate for Payer: Cigna of CA HMO |
$226.10
|
| Rate for Payer: Cigna of CA PPO |
$226.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$226.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$274.55
|
| Rate for Payer: Global Benefits Group Commercial |
$193.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$290.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.60
|
| Rate for Payer: Multiplan Commercial |
$242.25
|
| Rate for Payer: Networks By Design Commercial |
$209.95
|
| Rate for Payer: Prime Health Services Commercial |
$274.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.22
|
| Rate for Payer: United Healthcare All Other HMO |
$117.99
|
| Rate for Payer: United Healthcare HMO Rider |
$115.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$105.78
|
|
|
HC CANVAS VEST SO
|
Facility
|
IP
|
$323.00
|
|
|
Service Code
|
CPT L3675
|
| Hospital Charge Code |
915353675
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$64.60 |
| Max. Negotiated Rate |
$290.70 |
| Rate for Payer: Adventist Health Commercial |
$64.60
|
| Rate for Payer: Blue Shield of California Commercial |
$259.05
|
| Rate for Payer: Blue Shield of California EPN |
$162.79
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Central Health Plan Commercial |
$258.40
|
| Rate for Payer: Cigna of CA HMO |
$226.10
|
| Rate for Payer: Cigna of CA PPO |
$226.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$226.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$274.55
|
| Rate for Payer: Global Benefits Group Commercial |
$193.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$290.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.60
|
| Rate for Payer: Multiplan Commercial |
$242.25
|
| Rate for Payer: Networks By Design Commercial |
$209.95
|
| Rate for Payer: Prime Health Services Commercial |
$274.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.22
|
| Rate for Payer: United Healthcare All Other HMO |
$117.99
|
| Rate for Payer: United Healthcare HMO Rider |
$115.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$105.78
|
|
|
HC CANVAS VEST SO
|
Facility
|
OP
|
$323.00
|
|
|
Service Code
|
CPT L3675
|
| Hospital Charge Code |
915353675
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$105.78 |
| Max. Negotiated Rate |
$290.70 |
| Rate for Payer: Adventist Health Commercial |
$132.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$274.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$177.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$242.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$187.89
|
| Rate for Payer: Blue Shield of California Commercial |
$259.05
|
| Rate for Payer: Blue Shield of California EPN |
$162.79
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Cash Price |
$145.35
|
| Rate for Payer: Central Health Plan Commercial |
$258.40
|
| Rate for Payer: Cigna of CA HMO |
$226.10
|
| Rate for Payer: Cigna of CA PPO |
$226.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$274.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$274.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$274.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$226.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$129.20
|
| Rate for Payer: Galaxy Health WC |
$274.55
|
| Rate for Payer: Global Benefits Group Commercial |
$193.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$290.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$151.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$166.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$190.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$226.10
|
| Rate for Payer: Multiplan Commercial |
$242.25
|
| Rate for Payer: Networks By Design Commercial |
$161.50
|
| Rate for Payer: Prime Health Services Commercial |
$274.55
|
| Rate for Payer: Riverside University Health System MISP |
$129.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$193.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$193.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.22
|
| Rate for Payer: United Healthcare All Other HMO |
$117.99
|
| Rate for Payer: United Healthcare HMO Rider |
$115.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$105.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$274.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$274.55
|
| Rate for Payer: Vantage Medical Group Senior |
$274.55
|
|
|
HC CAPD DAILY TREATMENT
|
Facility
|
IP
|
$1,633.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
905400105
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$326.60 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,143.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$653.20
|
| Rate for Payer: EPIC Health Plan Senior |
$653.20
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,036.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$963.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
|
|
HC CAPD DAILY TREATMENT
|
Facility
|
OP
|
$1,633.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
905400105
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$124.12 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$536.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$479.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$949.92
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Cigna of CA HMO |
$1,045.12
|
| Rate for Payer: Cigna of CA PPO |
$1,208.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$805.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$590.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$536.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,143.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$885.51
|
| Rate for Payer: EPIC Health Plan Senior |
$590.34
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$880.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$536.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,036.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$751.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$719.14
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$536.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
| Rate for Payer: Prime Health Services Medicare |
$568.87
|
| Rate for Payer: Riverside University Health System MISP |
$590.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$979.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$979.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$536.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Vantage Medical Group Senior |
$536.67
|
|
|
HC CAPD DAILY TREATMENT
|
Facility
|
IP
|
$1,633.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
944000101
|
|
Hospital Revenue Code
|
803
|
| Min. Negotiated Rate |
$326.60 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,143.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$653.20
|
| Rate for Payer: EPIC Health Plan Senior |
$653.20
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,036.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$963.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
|
|
HC CAPD DAILY TREATMENT
|
Facility
|
OP
|
$1,633.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
944000101
|
|
Hospital Revenue Code
|
803
|
| Min. Negotiated Rate |
$124.12 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$479.26
|
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$536.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$949.92
|
| Rate for Payer: Blue Shield of California Commercial |
$1,035.32
|
| Rate for Payer: Blue Shield of California EPN |
$651.57
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Cigna of CA HMO |
$1,045.12
|
| Rate for Payer: Cigna of CA PPO |
$1,208.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$805.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$590.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$536.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,143.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$885.51
|
| Rate for Payer: EPIC Health Plan Senior |
$590.34
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$880.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$536.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,036.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$751.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$719.14
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$536.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
| Rate for Payer: Prime Health Services Medicare |
$568.87
|
| Rate for Payer: Riverside University Health System MISP |
$590.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$979.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$979.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$816.50
|
| Rate for Payer: United Healthcare All Other HMO |
$816.50
|
| Rate for Payer: United Healthcare HMO Rider |
$816.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$816.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$536.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Vantage Medical Group Senior |
$536.67
|
|
|
HC CAPD RE-TRAINING
|
Facility
|
IP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000203
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$557.40 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
|
|
HC CAPD RE-TRAINING
|
Facility
|
OP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000203
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$47.92 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$478.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,532.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,090.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,349.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,621.20
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Cigna of CA HMO |
$1,783.68
|
| Rate for Payer: Cigna of CA PPO |
$2,062.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,368.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,368.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$47.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,950.90
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,114.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,672.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Senior |
$2,368.95
|
|
|
HC CAPD RE-TRAINING
|
Facility
|
IP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000203
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$557.40 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
|
|
HC CAPD RE-TRAINING
|
Facility
|
OP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000203
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$47.92 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$478.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,532.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,090.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,349.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,621.20
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Cigna of CA HMO |
$1,783.68
|
| Rate for Payer: Cigna of CA PPO |
$2,062.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,368.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,368.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$47.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,950.90
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,114.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,672.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Senior |
$2,368.95
|
|
|
HC CAPD TRAINING
|
Facility
|
OP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000201
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$47.92 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Dignity Health Medi-Cal |
$2,368.95
|
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$478.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,532.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,090.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,349.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,621.20
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Cigna of CA HMO |
$1,783.68
|
| Rate for Payer: Cigna of CA PPO |
$2,062.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,368.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$47.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,950.90
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,114.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,672.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Senior |
$2,368.95
|
|
|
HC CAPD TRAINING
|
Facility
|
IP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000201
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$557.40 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
|
|
HC CAPD TRAINING
|
Facility
|
IP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000201
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$557.40 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
|
|
HC CAPD TRAINING
|
Facility
|
OP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000201
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$47.92 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$478.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,532.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,090.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,349.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,621.20
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Cigna of CA HMO |
$1,783.68
|
| Rate for Payer: Cigna of CA PPO |
$2,062.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,368.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,368.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$47.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,950.90
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,114.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,672.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Senior |
$2,368.95
|
|
|
HC CAP HEAD POST TORTLE 24-27CM
|
Facility
|
IP
|
$446.25
|
|
| Hospital Charge Code |
901698211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$401.62 |
| Rate for Payer: Adventist Health Commercial |
$89.25
|
| Rate for Payer: Cash Price |
$200.81
|
| Rate for Payer: Central Health Plan Commercial |
$357.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$312.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.50
|
| Rate for Payer: EPIC Health Plan Senior |
$178.50
|
| Rate for Payer: Galaxy Health WC |
$379.31
|
| Rate for Payer: Global Benefits Group Commercial |
$267.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$401.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$283.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$263.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.25
|
| Rate for Payer: Multiplan Commercial |
$334.69
|
| Rate for Payer: Networks By Design Commercial |
$290.06
|
| Rate for Payer: Prime Health Services Commercial |
$379.31
|
|
|
HC CAP HEAD POST TORTLE 24-27CM
|
Facility
|
OP
|
$446.25
|
|
| Hospital Charge Code |
901698211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$401.62 |
| Rate for Payer: Adventist Health Commercial |
$89.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$271.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$379.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$245.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$334.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$216.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.58
|
| Rate for Payer: Blue Shield of California Commercial |
$282.92
|
| Rate for Payer: Blue Shield of California EPN |
$178.05
|
| Rate for Payer: Cash Price |
$200.81
|
| Rate for Payer: Central Health Plan Commercial |
$357.00
|
| Rate for Payer: Cigna of CA HMO |
$285.60
|
| Rate for Payer: Cigna of CA PPO |
$330.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$379.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$379.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$379.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$312.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.50
|
| Rate for Payer: EPIC Health Plan Senior |
$178.50
|
| Rate for Payer: Galaxy Health WC |
$379.31
|
| Rate for Payer: Global Benefits Group Commercial |
$267.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$401.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$283.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$161.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$263.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$312.38
|
| Rate for Payer: Multiplan Commercial |
$334.69
|
| Rate for Payer: Networks By Design Commercial |
$290.06
|
| Rate for Payer: Prime Health Services Commercial |
$379.31
|
| Rate for Payer: Riverside University Health System MISP |
$178.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$267.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$267.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$223.12
|
| Rate for Payer: United Healthcare All Other HMO |
$223.12
|
| Rate for Payer: United Healthcare HMO Rider |
$223.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$379.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$379.31
|
| Rate for Payer: Vantage Medical Group Senior |
$379.31
|
|
|
HC CAP HEAD POST TORTLE 27-31CM
|
Facility
|
IP
|
$446.25
|
|
| Hospital Charge Code |
901698212
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$401.62 |
| Rate for Payer: Adventist Health Commercial |
$89.25
|
| Rate for Payer: Cash Price |
$200.81
|
| Rate for Payer: Central Health Plan Commercial |
$357.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$312.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.50
|
| Rate for Payer: EPIC Health Plan Senior |
$178.50
|
| Rate for Payer: Galaxy Health WC |
$379.31
|
| Rate for Payer: Global Benefits Group Commercial |
$267.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$401.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$283.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$263.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.25
|
| Rate for Payer: Multiplan Commercial |
$334.69
|
| Rate for Payer: Networks By Design Commercial |
$290.06
|
| Rate for Payer: Prime Health Services Commercial |
$379.31
|
|
|
HC CAP HEAD POST TORTLE 27-31CM
|
Facility
|
OP
|
$446.25
|
|
| Hospital Charge Code |
901698212
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$401.62 |
| Rate for Payer: Adventist Health Commercial |
$89.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$271.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$379.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$245.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$334.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$216.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$259.58
|
| Rate for Payer: Blue Shield of California Commercial |
$282.92
|
| Rate for Payer: Blue Shield of California EPN |
$178.05
|
| Rate for Payer: Cash Price |
$200.81
|
| Rate for Payer: Central Health Plan Commercial |
$357.00
|
| Rate for Payer: Cigna of CA HMO |
$285.60
|
| Rate for Payer: Cigna of CA PPO |
$330.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$379.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$379.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$379.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$312.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$178.50
|
| Rate for Payer: EPIC Health Plan Senior |
$178.50
|
| Rate for Payer: Galaxy Health WC |
$379.31
|
| Rate for Payer: Global Benefits Group Commercial |
$267.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$401.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$283.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$161.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$263.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$312.38
|
| Rate for Payer: Multiplan Commercial |
$334.69
|
| Rate for Payer: Networks By Design Commercial |
$290.06
|
| Rate for Payer: Prime Health Services Commercial |
$379.31
|
| Rate for Payer: Riverside University Health System MISP |
$178.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$267.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$267.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$223.12
|
| Rate for Payer: United Healthcare All Other HMO |
$223.12
|
| Rate for Payer: United Healthcare HMO Rider |
$223.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$379.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$379.31
|
| Rate for Payer: Vantage Medical Group Senior |
$379.31
|
|
