|
HC CARRY GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018307
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC CARRY GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018407
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC CARRY GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G8985
|
| Hospital Charge Code |
900018307
|
|
Hospital Revenue Code
|
440
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC CAR-T ADMIN AUTOLOGOUS
|
Facility
|
IP
|
$2,125.00
|
|
|
Service Code
|
CPT 38228
|
| Hospital Charge Code |
947000540
|
|
Hospital Revenue Code
|
874
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$1,912.50 |
| Rate for Payer: Adventist Health Commercial |
$425.00
|
| Rate for Payer: Cash Price |
$1,168.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.00
|
| Rate for Payer: EPIC Health Plan Senior |
$850.00
|
| Rate for Payer: Galaxy Health WC |
$1,806.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,912.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,417.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$809.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,315.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Multiplan Commercial |
$1,593.75
|
| Rate for Payer: Networks By Design Commercial |
$1,381.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,806.25
|
|
|
HC CAR-T ADMIN AUTOLOGOUS
|
Facility
|
OP
|
$2,125.00
|
|
|
Service Code
|
CPT 38228
|
| Hospital Charge Code |
947000540
|
|
Hospital Revenue Code
|
874
|
| Min. Negotiated Rate |
$421.45 |
| Max. Negotiated Rate |
$1,912.50 |
| Rate for Payer: Adventist Health Commercial |
$425.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$421.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,290.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,028.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,248.01
|
| Rate for Payer: Blue Shield of California Commercial |
$1,298.38
|
| Rate for Payer: Blue Shield of California EPN |
$847.88
|
| Rate for Payer: Cash Price |
$1,168.75
|
| Rate for Payer: Cash Price |
$1,168.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.00
|
| Rate for Payer: Cigna of CA HMO |
$1,360.00
|
| Rate for Payer: Cigna of CA PPO |
$1,572.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.96
|
| Rate for Payer: EPIC Health Plan Senior |
$421.45
|
| Rate for Payer: Galaxy Health WC |
$1,806.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,912.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$691.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$421.45
|
| Rate for Payer: InnovAge PACE Commercial |
$632.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,417.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$809.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$421.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$564.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$564.74
|
| Rate for Payer: Multiplan Commercial |
$1,593.75
|
| Rate for Payer: Networks By Design Commercial |
$1,381.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$421.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,806.25
|
| Rate for Payer: Prime Health Services Medicare |
$446.74
|
| Rate for Payer: Riverside University Health System MISP |
$463.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,275.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,062.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,062.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,062.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,062.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$421.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC CAR-T CRYOPRESERVATION STORAGE
|
Facility
|
OP
|
$3,315.00
|
|
|
Service Code
|
CPT 38226
|
| Hospital Charge Code |
947000538
|
|
Hospital Revenue Code
|
872
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$2,983.50 |
| Rate for Payer: Adventist Health Commercial |
$663.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,013.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,817.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,823.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,486.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,605.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,946.90
|
| Rate for Payer: Blue Shield of California Commercial |
$2,025.46
|
| Rate for Payer: Blue Shield of California EPN |
$1,322.68
|
| Rate for Payer: Cash Price |
$1,823.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,652.00
|
| Rate for Payer: Cigna of CA HMO |
$2,121.60
|
| Rate for Payer: Cigna of CA PPO |
$2,453.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,817.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,817.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,817.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.00
|
| Rate for Payer: Galaxy Health WC |
$2,817.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,983.50
|
| Rate for Payer: InnovAge PACE Commercial |
$1,657.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,051.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,320.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,320.50
|
| Rate for Payer: Multiplan Commercial |
$2,486.25
|
| Rate for Payer: Networks By Design Commercial |
$2,154.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,817.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,326.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,989.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,989.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,657.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,657.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,657.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,657.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,817.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,817.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,817.75
|
|
|
HC CAR-T CRYOPRESERVATION STORAGE
|
Facility
|
IP
|
$3,315.00
|
|
|
Service Code
|
CPT 38226
|
| Hospital Charge Code |
947000538
|
|
Hospital Revenue Code
|
872
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$2,983.50 |
| Rate for Payer: Adventist Health Commercial |
$663.00
|
| Rate for Payer: Cash Price |
$1,823.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,652.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.00
|
| Rate for Payer: Galaxy Health WC |
$2,817.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,983.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,051.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.00
|
| Rate for Payer: Multiplan Commercial |
$2,486.25
|
| Rate for Payer: Networks By Design Commercial |
$2,154.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,817.75
|
|
|
HC CAR-T HRVSTNG AUTOLOGOUS CELLS PER DAY
|
Facility
|
OP
|
$6,137.00
|
|
|
Service Code
|
CPT 38225
|
| Hospital Charge Code |
947000537
|
|
Hospital Revenue Code
|
871
|
| Min. Negotiated Rate |
$1,227.40 |
| Max. Negotiated Rate |
$5,523.30 |
| Rate for Payer: Adventist Health Commercial |
$1,227.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,727.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,216.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,375.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,602.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,971.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,604.26
|
| Rate for Payer: Blue Shield of California Commercial |
$3,749.71
|
| Rate for Payer: Blue Shield of California EPN |
$2,448.66
|
| Rate for Payer: Cash Price |
$3,375.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,909.60
|
| Rate for Payer: Cigna of CA HMO |
$3,927.68
|
| Rate for Payer: Cigna of CA PPO |
$4,541.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,216.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,216.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,216.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,454.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,454.80
|
| Rate for Payer: Galaxy Health WC |
$5,216.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,682.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,523.30
|
| Rate for Payer: InnovAge PACE Commercial |
$3,068.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,093.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,338.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,798.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,227.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,295.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,295.90
|
| Rate for Payer: Multiplan Commercial |
$4,602.75
|
| Rate for Payer: Networks By Design Commercial |
$3,989.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,216.45
|
| Rate for Payer: Riverside University Health System MISP |
$2,454.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,682.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,682.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,068.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,068.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,068.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,068.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,216.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,216.45
|
| Rate for Payer: Vantage Medical Group Senior |
$5,216.45
|
|
|
HC CAR-T HRVSTNG AUTOLOGOUS CELLS PER DAY
|
Facility
|
IP
|
$6,137.00
|
|
|
Service Code
|
CPT 38225
|
| Hospital Charge Code |
947000537
|
|
Hospital Revenue Code
|
871
|
| Min. Negotiated Rate |
$1,227.40 |
| Max. Negotiated Rate |
$5,523.30 |
| Rate for Payer: Adventist Health Commercial |
$1,227.40
|
| Rate for Payer: Cash Price |
$3,375.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,909.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,454.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,454.80
|
| Rate for Payer: Galaxy Health WC |
$5,216.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,682.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,523.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,093.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,338.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,798.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,227.40
|
| Rate for Payer: Multiplan Commercial |
$4,602.75
|
| Rate for Payer: Networks By Design Commercial |
$3,989.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,216.45
|
|
|
HC CAR-T RECEIPT PREP FOR ADMIN
|
Facility
|
IP
|
$2,550.00
|
|
|
Service Code
|
CPT 38227
|
| Hospital Charge Code |
947000539
|
|
Hospital Revenue Code
|
873
|
| Min. Negotiated Rate |
$510.00 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Adventist Health Commercial |
$510.00
|
| Rate for Payer: Cash Price |
$1,402.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,040.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,020.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,020.00
|
| Rate for Payer: Galaxy Health WC |
$2,167.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,530.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,295.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,700.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$971.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,578.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$510.00
|
| Rate for Payer: Multiplan Commercial |
$1,912.50
|
| Rate for Payer: Networks By Design Commercial |
$1,657.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,167.50
|
|
|
HC CAR-T RECEIPT PREP FOR ADMIN
|
Facility
|
OP
|
$2,550.00
|
|
|
Service Code
|
CPT 38227
|
| Hospital Charge Code |
947000539
|
|
Hospital Revenue Code
|
873
|
| Min. Negotiated Rate |
$510.00 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Adventist Health Commercial |
$510.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,548.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,167.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,402.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,912.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,234.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,497.62
|
| Rate for Payer: Blue Shield of California Commercial |
$1,558.05
|
| Rate for Payer: Blue Shield of California EPN |
$1,017.45
|
| Rate for Payer: Cash Price |
$1,402.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,040.00
|
| Rate for Payer: Cigna of CA HMO |
$1,632.00
|
| Rate for Payer: Cigna of CA PPO |
$1,887.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,167.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,167.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,167.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,020.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,020.00
|
| Rate for Payer: Galaxy Health WC |
$2,167.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,530.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,295.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,275.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,700.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$971.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,578.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$510.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,785.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,785.00
|
| Rate for Payer: Multiplan Commercial |
$1,912.50
|
| Rate for Payer: Networks By Design Commercial |
$1,657.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,167.50
|
| Rate for Payer: Riverside University Health System MISP |
$1,020.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,530.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,530.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,275.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,275.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,275.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,275.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,167.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,167.50
|
| Rate for Payer: Vantage Medical Group Senior |
$2,167.50
|
|
|
HC CASE CONF EA ADDL 15 MIN
|
Facility
|
OP
|
$106.00
|
|
| Hospital Charge Code |
905104307
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$40.39 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$43.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$90.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$79.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Central Health Plan Commercial |
$84.80
|
| Rate for Payer: Cigna of CA HMO |
$67.84
|
| Rate for Payer: Cigna of CA PPO |
$78.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$90.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.40
|
| Rate for Payer: EPIC Health Plan Senior |
$42.40
|
| Rate for Payer: Galaxy Health WC |
$90.10
|
| Rate for Payer: Global Benefits Group Commercial |
$63.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.40
|
| Rate for Payer: InnovAge PACE Commercial |
$53.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$74.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74.20
|
| Rate for Payer: Multiplan Commercial |
$79.50
|
| Rate for Payer: Networks By Design Commercial |
$68.90
|
| Rate for Payer: Prime Health Services Commercial |
$90.10
|
| Rate for Payer: Riverside University Health System MISP |
$42.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$90.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.10
|
| Rate for Payer: Vantage Medical Group Senior |
$90.10
|
|
|
HC CASE CONF EA ADDL 15 MIN
|
Facility
|
IP
|
$106.00
|
|
| Hospital Charge Code |
905104307
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Adventist Health Commercial |
$21.20
|
| Rate for Payer: Cash Price |
$58.30
|
| Rate for Payer: Central Health Plan Commercial |
$84.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.40
|
| Rate for Payer: EPIC Health Plan Senior |
$42.40
|
| Rate for Payer: Galaxy Health WC |
$90.10
|
| Rate for Payer: Global Benefits Group Commercial |
$63.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.20
|
| Rate for Payer: Multiplan Commercial |
$79.50
|
| Rate for Payer: Networks By Design Commercial |
$68.90
|
| Rate for Payer: Prime Health Services Commercial |
$90.10
|
|
|
HC CASE CONF EA ADDL 15 MIN
|
Facility
|
IP
|
$77.00
|
|
| Hospital Charge Code |
900409041
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.40 |
| Max. Negotiated Rate |
$69.30 |
| Rate for Payer: Adventist Health Commercial |
$15.40
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Central Health Plan Commercial |
$61.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30.80
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.40
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
|
|
HC CASE CONF EA ADDL 15 MIN
|
Facility
|
OP
|
$77.00
|
|
| Hospital Charge Code |
900409041
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$29.34 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$31.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$46.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$65.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Central Health Plan Commercial |
$61.60
|
| Rate for Payer: Cigna of CA HMO |
$49.28
|
| Rate for Payer: Cigna of CA PPO |
$56.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$65.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$65.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$65.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.80
|
| Rate for Payer: EPIC Health Plan Senior |
$30.80
|
| Rate for Payer: Galaxy Health WC |
$65.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.30
|
| Rate for Payer: InnovAge PACE Commercial |
$38.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$51.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.90
|
| Rate for Payer: Multiplan Commercial |
$57.75
|
| Rate for Payer: Networks By Design Commercial |
$50.05
|
| Rate for Payer: Prime Health Services Commercial |
$65.45
|
| Rate for Payer: Riverside University Health System MISP |
$30.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$65.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.45
|
| Rate for Payer: Vantage Medical Group Senior |
$65.45
|
|
|
HC CASE CONFERENCE GT 3 STAFF W/PT
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
900409056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$877.50 |
| Rate for Payer: Adventist Health Commercial |
$195.00
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Central Health Plan Commercial |
$780.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.00
|
| Rate for Payer: EPIC Health Plan Senior |
$390.00
|
| Rate for Payer: Galaxy Health WC |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$877.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$650.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$603.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.00
|
| Rate for Payer: Multiplan Commercial |
$731.25
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
|
|
HC CASE CONFERENCE GT 3 STAFF W/PT
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
907001902
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$877.50 |
| Rate for Payer: Adventist Health Commercial |
$195.00
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Central Health Plan Commercial |
$780.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.00
|
| Rate for Payer: EPIC Health Plan Senior |
$390.00
|
| Rate for Payer: Galaxy Health WC |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$877.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$650.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$603.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.00
|
| Rate for Payer: Multiplan Commercial |
$731.25
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
|
|
HC CASE CONFERENCE GT 3 STAFF W/PT
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
901309993
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$877.50 |
| Rate for Payer: Adventist Health Commercial |
$195.00
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Central Health Plan Commercial |
$780.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.00
|
| Rate for Payer: EPIC Health Plan Senior |
$390.00
|
| Rate for Payer: Galaxy Health WC |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$877.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$650.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$603.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.00
|
| Rate for Payer: Multiplan Commercial |
$731.25
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
|
|
HC CASE CONFERENCE GT 3 STAFF W/PT
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
907001902
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$887.32 |
| Rate for Payer: Adventist Health Commercial |
$399.75
|
| Rate for Payer: Adventist Health Medi-Cal |
$541.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$592.12
|
| 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 |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Central Health Plan Commercial |
$780.00
|
| Rate for Payer: Cigna of CA HMO |
$624.00
|
| Rate for Payer: Cigna of CA PPO |
$721.50
|
| 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 |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$877.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$887.32
|
| 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 |
$650.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.75
|
| 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 |
$731.25
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$541.05
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
| 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 |
$585.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$649.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: 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 CASE CONFERENCE GT 3 STAFF W/PT
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
900409056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$887.32 |
| Rate for Payer: Adventist Health Commercial |
$399.75
|
| Rate for Payer: Adventist Health Medi-Cal |
$541.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$592.12
|
| 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 |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Central Health Plan Commercial |
$780.00
|
| Rate for Payer: Cigna of CA HMO |
$624.00
|
| Rate for Payer: Cigna of CA PPO |
$721.50
|
| 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 |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$877.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$887.32
|
| 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 |
$650.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.75
|
| 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 |
$731.25
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$541.05
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
| 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 |
$585.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$649.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: 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 CASE CONFERENCE GT 3 STAFF W/PT
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
901309993
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$887.32 |
| Rate for Payer: Adventist Health Commercial |
$399.75
|
| Rate for Payer: Adventist Health Medi-Cal |
$541.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$592.12
|
| 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 |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Central Health Plan Commercial |
$780.00
|
| Rate for Payer: Cigna of CA HMO |
$624.00
|
| Rate for Payer: Cigna of CA PPO |
$721.50
|
| 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 |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$877.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$887.32
|
| 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 |
$650.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.75
|
| 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 |
$731.25
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$541.05
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
| 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 |
$585.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$649.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: 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 CASE CONFERENCE GT 3 STAFF W/PT MCAL
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
907000005
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$195.00 |
| Max. Negotiated Rate |
$877.50 |
| Rate for Payer: Adventist Health Commercial |
$195.00
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Central Health Plan Commercial |
$780.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$390.00
|
| Rate for Payer: EPIC Health Plan Senior |
$390.00
|
| Rate for Payer: Galaxy Health WC |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$877.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$650.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$603.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$195.00
|
| Rate for Payer: Multiplan Commercial |
$731.25
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
|
|
HC CASE CONFERENCE GT 3 STAFF W/PT MCAL
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
CPT G0175
|
| Hospital Charge Code |
907000005
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$887.32 |
| Rate for Payer: Adventist Health Commercial |
$399.75
|
| Rate for Payer: Adventist Health Medi-Cal |
$541.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$592.12
|
| 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 |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Cash Price |
$536.25
|
| Rate for Payer: Central Health Plan Commercial |
$780.00
|
| Rate for Payer: Cigna of CA HMO |
$624.00
|
| Rate for Payer: Cigna of CA PPO |
$721.50
|
| 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 |
$828.75
|
| Rate for Payer: Global Benefits Group Commercial |
$585.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$877.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$887.32
|
| 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 |
$650.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.75
|
| 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 |
$731.25
|
| Rate for Payer: Networks By Design Commercial |
$633.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$541.05
|
| Rate for Payer: Prime Health Services Commercial |
$828.75
|
| 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 |
$585.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$649.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: 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 CASE CONF INITIAL 30 MIN
|
Facility
|
IP
|
$163.00
|
|
| Hospital Charge Code |
900409040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$32.60 |
| Max. Negotiated Rate |
$146.70 |
| Rate for Payer: Adventist Health Commercial |
$32.60
|
| Rate for Payer: Cash Price |
$89.65
|
| Rate for Payer: Central Health Plan Commercial |
$130.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$65.20
|
| Rate for Payer: EPIC Health Plan Senior |
$65.20
|
| Rate for Payer: Galaxy Health WC |
$138.55
|
| Rate for Payer: Global Benefits Group Commercial |
$97.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$146.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$62.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$100.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.60
|
| Rate for Payer: Multiplan Commercial |
$122.25
|
| Rate for Payer: Networks By Design Commercial |
$105.95
|
| Rate for Payer: Prime Health Services Commercial |
$138.55
|
|
|
HC CASE CONF INITIAL 30 MIN
|
Facility
|
OP
|
$179.00
|
|
| Hospital Charge Code |
905104306
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$68.20 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$73.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$152.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$98.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$98.45
|
| Rate for Payer: Cash Price |
$98.45
|
| Rate for Payer: Cash Price |
$98.45
|
| Rate for Payer: Central Health Plan Commercial |
$143.20
|
| Rate for Payer: Cigna of CA HMO |
$114.56
|
| Rate for Payer: Cigna of CA PPO |
$132.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$152.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$152.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$152.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.60
|
| Rate for Payer: EPIC Health Plan Senior |
$71.60
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.10
|
| Rate for Payer: InnovAge PACE Commercial |
$89.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$125.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$125.30
|
| Rate for Payer: Multiplan Commercial |
$134.25
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
| Rate for Payer: Riverside University Health System MISP |
$71.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$152.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$152.15
|
| Rate for Payer: Vantage Medical Group Senior |
$152.15
|
|
