|
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 |
$479.60
|
| Rate for Payer: Central Health Plan Commercial |
$697.60
|
| 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 Permanente of CA Commercial/Self Funded |
$581.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$539.77
|
| 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
|
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 |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,964.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,723.01
|
| Rate for Payer: Cash Price |
$4,186.05
|
| Rate for Payer: Cash Price |
$4,186.05
|
| Rate for Payer: Cash Price |
$4,186.05
|
| Rate for Payer: Cash Price |
$4,186.05
|
| 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 |
$4,446.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,260.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,964.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,001.75
|
| Rate for Payer: EPIC Health Plan Senior |
$2,964.26
|
| 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 |
$4,861.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,964.26
|
| Rate for Payer: InnovAge PACE Commercial |
$4,446.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,076.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,964.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,522.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,972.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,972.11
|
| 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 |
$2,964.26
|
| 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 |
$3,142.12
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Riverside University Health System MISP |
$3,260.69
|
| 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 |
$2,964.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,964.26
|
|
|
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 |
$4,186.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,088.80
|
| 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 Permanente of CA Commercial/Self Funded |
$5,076.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,899.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,711.21
|
| 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 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 |
$189.70
|
| Rate for Payer: Blue Shield of California Commercial |
$249.68
|
| Rate for Payer: Blue Shield of California EPN |
$162.79
|
| Rate for Payer: Cash Price |
$177.65
|
| Rate for Payer: Cash Price |
$177.65
|
| 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: 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: InnovAge PACE Commercial |
$161.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$215.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$166.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$226.10
|
| Rate for Payer: Molina Healthcare of CA 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 |
$249.68
|
| Rate for Payer: Blue Shield of California EPN |
$162.79
|
| Rate for Payer: Cash Price |
$177.65
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$215.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$123.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.94
|
| 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 |
$249.68
|
| Rate for Payer: Blue Shield of California EPN |
$162.79
|
| Rate for Payer: Cash Price |
$177.65
|
| 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: 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 Permanente of CA Commercial/Self Funded |
$215.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$123.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.94
|
| 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 |
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 |
$189.70
|
| Rate for Payer: Blue Shield of California Commercial |
$249.68
|
| Rate for Payer: Blue Shield of California EPN |
$162.79
|
| Rate for Payer: Cash Price |
$177.65
|
| Rate for Payer: Cash Price |
$177.65
|
| 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: 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: InnovAge PACE Commercial |
$161.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$215.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$166.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$226.10
|
| Rate for Payer: Molina Healthcare of CA 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
|
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 |
$541.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$991.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$811.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$595.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$541.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$959.06
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| 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 |
$811.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$595.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$541.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.42
|
| Rate for Payer: EPIC Health Plan Senior |
$541.05
|
| 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 |
$887.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$541.05
|
| Rate for Payer: InnovAge PACE Commercial |
$811.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,089.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$725.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$725.01
|
| 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 |
$541.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
| Rate for Payer: Prime Health Services Medicare |
$573.51
|
| Rate for Payer: Riverside University Health System MISP |
$595.15
|
| 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 |
$541.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$811.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$595.15
|
| Rate for Payer: Vantage Medical Group Senior |
$541.05
|
|
|
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 |
$898.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| 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 Permanente of CA Commercial/Self Funded |
$1,089.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$622.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,010.83
|
| 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: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$541.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$991.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$811.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$595.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$541.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$959.06
|
| Rate for Payer: Blue Shield of California Commercial |
$997.76
|
| Rate for Payer: Blue Shield of California EPN |
$651.57
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| 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 |
$811.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$595.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$541.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.42
|
| Rate for Payer: EPIC Health Plan Senior |
$541.05
|
| 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 |
$887.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$541.05
|
| Rate for Payer: InnovAge PACE Commercial |
$811.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,089.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$725.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$725.01
|
| 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 |
$541.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
| Rate for Payer: Prime Health Services Medicare |
$573.51
|
| Rate for Payer: Riverside University Health System MISP |
$595.15
|
| 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 |
$541.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$811.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$595.15
|
| Rate for Payer: Vantage Medical Group Senior |
$541.05
|
|
|
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 |
$898.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| 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 Permanente of CA Commercial/Self Funded |
$1,089.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$622.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,010.83
|
| 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 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 |
$1,532.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| 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 Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,061.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| 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 |
$1,692.55
|
| 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 |
$1,636.81
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| 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: 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: InnovAge PACE Commercial |
$1,393.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,950.90
|
| Rate for Payer: Molina Healthcare of CA 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
|
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 |
$1,532.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| 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 Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,061.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| 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 |
$1,692.55
|
| 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 |
$1,636.81
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| 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: 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: InnovAge PACE Commercial |
$1,393.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,950.90
|
| Rate for Payer: Molina Healthcare of CA 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 |
$1,532.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| 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 Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,061.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| 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
|
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 |
$1,692.55
|
| 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 |
$1,636.81
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| 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: 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: InnovAge PACE Commercial |
$1,393.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,950.90
|
| Rate for Payer: Molina Healthcare of CA 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
|
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 |
$1,692.55
|
| 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 |
$1,636.81
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| Rate for Payer: Cash Price |
$1,532.85
|
| 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: 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: InnovAge PACE Commercial |
$1,393.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,950.90
|
| Rate for Payer: Molina Healthcare of CA 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
|
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 |
$1,532.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| 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 Permanente of CA Commercial/Self Funded |
$1,858.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,061.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.15
|
| 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 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 |
$262.08
|
| Rate for Payer: Blue Shield of California Commercial |
$272.66
|
| Rate for Payer: Blue Shield of California EPN |
$178.05
|
| Rate for Payer: Cash Price |
$245.44
|
| 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: 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: InnovAge PACE Commercial |
$223.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$297.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$276.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$312.38
|
| Rate for Payer: Molina Healthcare of CA 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 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 |
$245.44
|
| Rate for Payer: Central Health Plan Commercial |
$357.00
|
| 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 Permanente of CA Commercial/Self Funded |
$297.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$276.23
|
| 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
|
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 |
$245.44
|
| Rate for Payer: Central Health Plan Commercial |
$357.00
|
| 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 Permanente of CA Commercial/Self Funded |
$297.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$276.23
|
| 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 |
$262.08
|
| Rate for Payer: Blue Shield of California Commercial |
$272.66
|
| Rate for Payer: Blue Shield of California EPN |
$178.05
|
| Rate for Payer: Cash Price |
$245.44
|
| 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: 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: InnovAge PACE Commercial |
$223.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$297.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$276.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$312.38
|
| Rate for Payer: Molina Healthcare of CA 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 32-37CM
|
Facility
|
IP
|
$446.25
|
|
| Hospital Charge Code |
901698213
|
|
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 |
$245.44
|
| Rate for Payer: Central Health Plan Commercial |
$357.00
|
| 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 Permanente of CA Commercial/Self Funded |
$297.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$276.23
|
| 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 32-37CM
|
Facility
|
OP
|
$446.25
|
|
| Hospital Charge Code |
901698213
|
|
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 |
$262.08
|
| Rate for Payer: Blue Shield of California Commercial |
$272.66
|
| Rate for Payer: Blue Shield of California EPN |
$178.05
|
| Rate for Payer: Cash Price |
$245.44
|
| 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: 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: InnovAge PACE Commercial |
$223.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$297.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$170.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$276.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$312.38
|
| Rate for Payer: Molina Healthcare of CA 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
|
|
