|
HC CAVILON BARRIER WAND 1ML
|
Facility
|
OP
|
$5.90
|
|
|
Service Code
|
CPT A6250
|
| Hospital Charge Code |
901698609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$5.31 |
| Rate for Payer: Adventist Health Commercial |
$1.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.43
|
| Rate for Payer: Blue Shield of California Commercial |
$3.74
|
| Rate for Payer: Blue Shield of California EPN |
$2.35
|
| Rate for Payer: Cash Price |
$2.66
|
| Rate for Payer: Cash Price |
$2.66
|
| Rate for Payer: Central Health Plan Commercial |
$4.72
|
| Rate for Payer: Cigna of CA HMO |
$3.78
|
| Rate for Payer: Cigna of CA PPO |
$4.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.36
|
| Rate for Payer: EPIC Health Plan Senior |
$2.36
|
| Rate for Payer: Galaxy Health WC |
$5.01
|
| Rate for Payer: Global Benefits Group Commercial |
$3.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4.13
|
| Rate for Payer: Multiplan Commercial |
$4.42
|
| Rate for Payer: Networks By Design Commercial |
$3.83
|
| Rate for Payer: Prime Health Services Commercial |
$5.01
|
| Rate for Payer: Riverside University Health System MISP |
$2.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.95
|
| Rate for Payer: United Healthcare All Other HMO |
$2.95
|
| Rate for Payer: United Healthcare HMO Rider |
$2.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.01
|
| Rate for Payer: Vantage Medical Group Senior |
$5.01
|
|
|
HC CBC W DIFFERENTIAL
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900910093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Senior |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$55.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.80
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
|
|
HC CBC W DIFFERENTIAL
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900910093
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$65.43 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.43
|
| Rate for Payer: Blue Shield of California Commercial |
$59.22
|
| Rate for Payer: Blue Shield of California Commercial |
$32.76
|
| Rate for Payer: Blue Shield of California EPN |
$37.32
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: Cigna of CA HMO |
$60.16
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$69.56
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC CBC WITHOUT DIFFERENTIAL
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900912020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Adventist Health Commercial |
$20.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Central Health Plan Commercial |
$83.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.60
|
| Rate for Payer: EPIC Health Plan Senior |
$41.60
|
| Rate for Payer: Galaxy Health WC |
$88.40
|
| Rate for Payer: Global Benefits Group Commercial |
$62.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$93.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$61.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.80
|
| Rate for Payer: Multiplan Commercial |
$78.00
|
| Rate for Payer: Networks By Design Commercial |
$67.60
|
| Rate for Payer: Prime Health Services Commercial |
$88.40
|
|
|
HC CBC WITHOUT DIFFERENTIAL
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900912020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Adventist Health Commercial |
$20.80
|
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.43
|
| Rate for Payer: Blue Shield of California Commercial |
$32.76
|
| Rate for Payer: Blue Shield of California Commercial |
$65.52
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$41.29
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Central Health Plan Commercial |
$83.20
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA HMO |
$66.56
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Cigna of CA PPO |
$76.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Galaxy Health WC |
$88.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Global Benefits Group Commercial |
$62.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$93.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Multiplan Commercial |
$78.00
|
| Rate for Payer: Networks By Design Commercial |
$67.60
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC CBC WO DIFFERENTIAL
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900910086
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Adventist Health Commercial |
$20.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Central Health Plan Commercial |
$83.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.60
|
| Rate for Payer: EPIC Health Plan Senior |
$41.60
|
| Rate for Payer: Galaxy Health WC |
$88.40
|
| Rate for Payer: Global Benefits Group Commercial |
$62.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$93.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$61.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.80
|
| Rate for Payer: Multiplan Commercial |
$78.00
|
| Rate for Payer: Networks By Design Commercial |
$67.60
|
| Rate for Payer: Prime Health Services Commercial |
$88.40
|
|
|
HC CBC WO DIFFERENTIAL
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900910086
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Adventist Health Commercial |
$20.80
|
| Rate for Payer: Adventist Health Commercial |
$7.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.43
|
| Rate for Payer: Blue Shield of California Commercial |
$23.31
|
| Rate for Payer: Blue Shield of California Commercial |
$65.52
|
| Rate for Payer: Blue Shield of California EPN |
$14.69
|
| Rate for Payer: Blue Shield of California EPN |
$41.29
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Cash Price |
$46.80
|
| Rate for Payer: Central Health Plan Commercial |
$83.20
|
| Rate for Payer: Central Health Plan Commercial |
$29.60
|
| Rate for Payer: Cigna of CA HMO |
$23.68
|
| Rate for Payer: Cigna of CA HMO |
$66.56
|
| Rate for Payer: Cigna of CA PPO |
$27.38
|
| Rate for Payer: Cigna of CA PPO |
$76.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$72.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: Galaxy Health WC |
$31.45
|
| Rate for Payer: Galaxy Health WC |
$88.40
|
| Rate for Payer: Global Benefits Group Commercial |
$22.20
|
| Rate for Payer: Global Benefits Group Commercial |
$62.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$93.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$27.75
|
| Rate for Payer: Multiplan Commercial |
$78.00
|
| Rate for Payer: Networks By Design Commercial |
$67.60
|
| Rate for Payer: Networks By Design Commercial |
$24.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: Prime Health Services Commercial |
$31.45
|
| Rate for Payer: Prime Health Services Commercial |
$88.40
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC CBC W WBC AUTO DIFF
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
900910092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.29 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.77
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.64
|
| Rate for Payer: Blue Shield of California Commercial |
$32.76
|
| Rate for Payer: Blue Shield of California Commercial |
$94.50
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$59.55
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA HMO |
$96.00
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Cigna of CA PPO |
$111.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$105.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$8.55
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$95.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.41
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.77
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.77
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: Prime Health Services Medicare |
$8.24
|
| Rate for Payer: Prime Health Services Medicare |
$8.24
|
| Rate for Payer: Riverside University Health System MISP |
$8.55
|
| Rate for Payer: Riverside University Health System MISP |
$8.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.29
|
| Rate for Payer: United Healthcare All Other HMO |
$6.29
|
| Rate for Payer: United Healthcare All Other HMO |
$6.29
|
| Rate for Payer: United Healthcare HMO Rider |
$6.29
|
| Rate for Payer: United Healthcare HMO Rider |
$6.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.77
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7.77
|
| Rate for Payer: Vantage Medical Group Senior |
$7.77
|
|
|
HC CBC W WBC AUTO DIFF
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
900910092
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Cash Price |
$67.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$105.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$95.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$88.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
|
|
HC CBC W WBC AUTO DIFFERENTIAL INDIV
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
900912018
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.29 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Adventist Health Commercial |
$29.00
|
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.77
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$78.64
|
| Rate for Payer: Blue Shield of California Commercial |
$32.76
|
| Rate for Payer: Blue Shield of California Commercial |
$91.35
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$57.56
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$65.25
|
| Rate for Payer: Cash Price |
$65.25
|
| Rate for Payer: Central Health Plan Commercial |
$116.00
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA HMO |
$92.80
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Cigna of CA PPO |
$107.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$101.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$8.55
|
| Rate for Payer: EPIC Health Plan Senior |
$8.55
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Galaxy Health WC |
$123.25
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Global Benefits Group Commercial |
$87.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$130.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$92.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.41
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Multiplan Commercial |
$108.75
|
| Rate for Payer: Networks By Design Commercial |
$94.25
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.77
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.77
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$123.25
|
| Rate for Payer: Prime Health Services Medicare |
$8.24
|
| Rate for Payer: Prime Health Services Medicare |
$8.24
|
| Rate for Payer: Riverside University Health System MISP |
$8.55
|
| Rate for Payer: Riverside University Health System MISP |
$8.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$87.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$87.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.29
|
| Rate for Payer: United Healthcare All Other HMO |
$6.29
|
| Rate for Payer: United Healthcare All Other HMO |
$6.29
|
| Rate for Payer: United Healthcare HMO Rider |
$6.29
|
| Rate for Payer: United Healthcare HMO Rider |
$6.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.29
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.77
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7.77
|
| Rate for Payer: Vantage Medical Group Senior |
$7.77
|
|
|
HC CBC W WBC AUTO DIFFERENTIAL INDIV
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
900912018
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.00 |
| Max. Negotiated Rate |
$130.50 |
| Rate for Payer: Adventist Health Commercial |
$29.00
|
| Rate for Payer: Cash Price |
$65.25
|
| Rate for Payer: Central Health Plan Commercial |
$116.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$101.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.00
|
| Rate for Payer: EPIC Health Plan Senior |
$58.00
|
| Rate for Payer: Galaxy Health WC |
$123.25
|
| Rate for Payer: Global Benefits Group Commercial |
$87.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$130.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$92.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$85.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.00
|
| Rate for Payer: Multiplan Commercial |
$108.75
|
| Rate for Payer: Networks By Design Commercial |
$94.25
|
| Rate for Payer: Prime Health Services Commercial |
$123.25
|
|
|
HC CBC W WO DIFFERENTIAL INDIVIDUAL
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900912019
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$65.43 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$47.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.43
|
| Rate for Payer: Blue Shield of California Commercial |
$59.22
|
| Rate for Payer: Blue Shield of California Commercial |
$32.76
|
| Rate for Payer: Blue Shield of California EPN |
$37.32
|
| Rate for Payer: Blue Shield of California EPN |
$20.64
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Central Health Plan Commercial |
$41.60
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: Cigna of CA HMO |
$60.16
|
| Rate for Payer: Cigna of CA HMO |
$33.28
|
| Rate for Payer: Cigna of CA PPO |
$69.56
|
| Rate for Payer: Cigna of CA PPO |
$38.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Galaxy Health WC |
$44.20
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Global Benefits Group Commercial |
$31.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: Networks By Design Commercial |
$33.80
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
| Rate for Payer: Prime Health Services Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC CBC W WO DIFFERENTIAL INDIVIDUAL
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
900912019
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$65.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Senior |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$59.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$55.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.80
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
|
|
HC CCPD DAILY TREATMENT
|
Facility
|
OP
|
$1,633.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
943000102
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$124.12 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$536.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$479.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$949.92
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Cigna of CA HMO |
$1,045.12
|
| Rate for Payer: Cigna of CA PPO |
$1,208.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$805.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$590.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$536.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,143.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$885.51
|
| Rate for Payer: EPIC Health Plan Senior |
$590.34
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$880.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$536.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,036.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$751.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$719.14
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$536.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
| Rate for Payer: Prime Health Services Medicare |
$568.87
|
| Rate for Payer: Riverside University Health System MISP |
$590.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$979.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$979.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$536.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Vantage Medical Group Senior |
$536.67
|
|
|
HC CCPD DAILY TREATMENT
|
Facility
|
IP
|
$1,633.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
905400102
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$326.60 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,143.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$653.20
|
| Rate for Payer: EPIC Health Plan Senior |
$653.20
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,036.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$963.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
|
|
HC CCPD DAILY TREATMENT
|
Facility
|
OP
|
$1,633.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
905400102
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$124.12 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$536.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$479.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$949.92
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Cigna of CA HMO |
$1,045.12
|
| Rate for Payer: Cigna of CA PPO |
$1,208.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$805.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$590.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$536.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,143.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$885.51
|
| Rate for Payer: EPIC Health Plan Senior |
$590.34
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$880.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$536.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,036.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$751.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$719.14
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$536.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
| Rate for Payer: Prime Health Services Medicare |
$568.87
|
| Rate for Payer: Riverside University Health System MISP |
$590.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$979.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$979.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$536.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$805.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$590.34
|
| Rate for Payer: Vantage Medical Group Senior |
$536.67
|
|
|
HC CCPD DAILY TREATMENT
|
Facility
|
IP
|
$1,633.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
943000102
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$326.60 |
| Max. Negotiated Rate |
$1,469.70 |
| Rate for Payer: Adventist Health Commercial |
$326.60
|
| Rate for Payer: Cash Price |
$734.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,306.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,143.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$653.20
|
| Rate for Payer: EPIC Health Plan Senior |
$653.20
|
| Rate for Payer: Galaxy Health WC |
$1,388.05
|
| Rate for Payer: Global Benefits Group Commercial |
$979.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,469.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,036.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$963.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$326.60
|
| Rate for Payer: Multiplan Commercial |
$1,224.75
|
| Rate for Payer: Networks By Design Commercial |
$1,061.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,388.05
|
|
|
HC CCPD RE-TRAINING
|
Facility
|
IP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
943000207
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$557.40 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
|
|
HC CCPD RE-TRAINING
|
Facility
|
OP
|
$2,787.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
943000207
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$47.92 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$478.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,532.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,090.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,349.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,621.20
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Cigna of CA HMO |
$1,783.68
|
| Rate for Payer: Cigna of CA PPO |
$2,062.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,368.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,368.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$47.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,950.90
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,114.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,672.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Senior |
$2,368.95
|
|
|
HC CCPD TRAINING
|
Facility
|
IP
|
$2,787.00
|
|
|
Service Code
|
CPT 90989
|
| Hospital Charge Code |
943000202
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$557.40 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
|
|
HC CCPD TRAINING
|
Facility
|
OP
|
$2,787.00
|
|
|
Service Code
|
CPT 90989
|
| Hospital Charge Code |
943000202
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$504.00 |
| Max. Negotiated Rate |
$2,508.30 |
| Rate for Payer: Adventist Health Commercial |
$557.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,221.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,532.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,090.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,349.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,621.20
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Cash Price |
$1,254.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,229.60
|
| Rate for Payer: Cigna of CA HMO |
$1,783.68
|
| Rate for Payer: Cigna of CA PPO |
$2,062.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,368.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,368.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,950.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,114.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,114.80
|
| Rate for Payer: Galaxy Health WC |
$2,368.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,508.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,147.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,769.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,268.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,950.90
|
| Rate for Payer: Multiplan Commercial |
$2,090.25
|
| Rate for Payer: Networks By Design Commercial |
$1,811.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,368.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,114.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,672.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$735.00
|
| Rate for Payer: United Healthcare All Other HMO |
$726.00
|
| Rate for Payer: United Healthcare HMO Rider |
$550.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$504.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,368.95
|
| Rate for Payer: Vantage Medical Group Senior |
$2,368.95
|
|
|
HC CD3
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
903900102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$91.60 |
| Max. Negotiated Rate |
$412.20 |
| Rate for Payer: Adventist Health Commercial |
$91.60
|
| Rate for Payer: Cash Price |
$206.10
|
| Rate for Payer: Central Health Plan Commercial |
$366.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$320.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.20
|
| Rate for Payer: EPIC Health Plan Senior |
$183.20
|
| Rate for Payer: Galaxy Health WC |
$389.30
|
| Rate for Payer: Global Benefits Group Commercial |
$274.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$412.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$290.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$270.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.60
|
| Rate for Payer: Multiplan Commercial |
$343.50
|
| Rate for Payer: Networks By Design Commercial |
$297.70
|
| Rate for Payer: Prime Health Services Commercial |
$389.30
|
|
|
HC CD3
|
Facility
|
OP
|
$191.00
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
903900102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.56 |
| Max. Negotiated Rate |
$382.19 |
| Rate for Payer: Adventist Health Commercial |
$38.20
|
| Rate for Payer: Adventist Health Commercial |
$91.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$37.73
|
| Rate for Payer: Adventist Health Medi-Cal |
$37.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$276.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$276.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$274.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$274.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.19
|
| Rate for Payer: Blue Shield of California Commercial |
$288.54
|
| Rate for Payer: Blue Shield of California Commercial |
$120.33
|
| Rate for Payer: Blue Shield of California EPN |
$181.83
|
| Rate for Payer: Blue Shield of California EPN |
$75.83
|
| Rate for Payer: Cash Price |
$206.10
|
| Rate for Payer: Cash Price |
$206.10
|
| Rate for Payer: Cash Price |
$85.95
|
| Rate for Payer: Cash Price |
$85.95
|
| Rate for Payer: Central Health Plan Commercial |
$152.80
|
| Rate for Payer: Central Health Plan Commercial |
$366.40
|
| Rate for Payer: Cigna of CA HMO |
$293.12
|
| Rate for Payer: Cigna of CA HMO |
$122.24
|
| Rate for Payer: Cigna of CA PPO |
$338.92
|
| Rate for Payer: Cigna of CA PPO |
$141.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$133.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$320.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.25
|
| Rate for Payer: EPIC Health Plan Senior |
$41.50
|
| Rate for Payer: EPIC Health Plan Senior |
$41.50
|
| Rate for Payer: Galaxy Health WC |
$389.30
|
| Rate for Payer: Galaxy Health WC |
$162.35
|
| Rate for Payer: Global Benefits Group Commercial |
$274.80
|
| Rate for Payer: Global Benefits Group Commercial |
$114.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$412.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$171.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$121.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$290.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$50.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$50.56
|
| Rate for Payer: Multiplan Commercial |
$343.50
|
| Rate for Payer: Multiplan Commercial |
$143.25
|
| Rate for Payer: Networks By Design Commercial |
$124.15
|
| Rate for Payer: Networks By Design Commercial |
$297.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$37.73
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$37.73
|
| Rate for Payer: Prime Health Services Commercial |
$389.30
|
| Rate for Payer: Prime Health Services Commercial |
$162.35
|
| Rate for Payer: Prime Health Services Medicare |
$39.99
|
| Rate for Payer: Prime Health Services Medicare |
$39.99
|
| Rate for Payer: Riverside University Health System MISP |
$41.50
|
| Rate for Payer: Riverside University Health System MISP |
$41.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$114.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$114.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.56
|
| Rate for Payer: United Healthcare All Other HMO |
$30.56
|
| Rate for Payer: United Healthcare All Other HMO |
$30.56
|
| Rate for Payer: United Healthcare HMO Rider |
$30.56
|
| Rate for Payer: United Healthcare HMO Rider |
$30.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$37.73
|
| Rate for Payer: Upland Medical Group Pediatric |
$37.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.50
|
| Rate for Payer: Vantage Medical Group Senior |
$37.73
|
| Rate for Payer: Vantage Medical Group Senior |
$37.73
|
|
|
HC CD45 LEUKEMIA/LYMPHOMA
|
Facility
|
OP
|
$417.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
903900100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.55 |
| Max. Negotiated Rate |
$760.68 |
| Rate for Payer: Adventist Health Commercial |
$83.40
|
| Rate for Payer: Adventist Health Commercial |
$154.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$461.02
|
| Rate for Payer: Adventist Health Medi-Cal |
$461.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$533.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$533.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$461.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$461.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$283.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$283.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$394.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$394.51
|
| Rate for Payer: Blue Shield of California Commercial |
$486.99
|
| Rate for Payer: Blue Shield of California Commercial |
$262.71
|
| Rate for Payer: Blue Shield of California EPN |
$306.88
|
| Rate for Payer: Blue Shield of California EPN |
$165.55
|
| Rate for Payer: Cash Price |
$347.85
|
| Rate for Payer: Cash Price |
$347.85
|
| Rate for Payer: Cash Price |
$187.65
|
| Rate for Payer: Cash Price |
$187.65
|
| Rate for Payer: Central Health Plan Commercial |
$333.60
|
| Rate for Payer: Central Health Plan Commercial |
$618.40
|
| Rate for Payer: Cigna of CA HMO |
$494.72
|
| Rate for Payer: Cigna of CA HMO |
$266.88
|
| Rate for Payer: Cigna of CA PPO |
$572.02
|
| Rate for Payer: Cigna of CA PPO |
$308.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$691.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$691.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$461.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$461.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$291.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$760.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$760.68
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Galaxy Health WC |
$354.45
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Global Benefits Group Commercial |
$250.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$695.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$375.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$756.07
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$756.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$461.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$461.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$264.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$490.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$80.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$645.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$645.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$617.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$617.77
|
| Rate for Payer: Multiplan Commercial |
$579.75
|
| Rate for Payer: Multiplan Commercial |
$312.75
|
| Rate for Payer: Networks By Design Commercial |
$271.05
|
| Rate for Payer: Networks By Design Commercial |
$502.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$461.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$461.02
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
| Rate for Payer: Prime Health Services Commercial |
$354.45
|
| Rate for Payer: Prime Health Services Medicare |
$488.68
|
| Rate for Payer: Prime Health Services Medicare |
$488.68
|
| Rate for Payer: Riverside University Health System MISP |
$507.12
|
| Rate for Payer: Riverside University Health System MISP |
$507.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$250.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$463.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$463.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$250.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$461.02
|
| Rate for Payer: Upland Medical Group Pediatric |
$461.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Vantage Medical Group Senior |
$461.02
|
| Rate for Payer: Vantage Medical Group Senior |
$461.02
|
|
|
HC CD45 LEUKEMIA/LYMPHOMA
|
Facility
|
IP
|
$773.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
903900100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$154.60 |
| Max. Negotiated Rate |
$695.70 |
| Rate for Payer: Adventist Health Commercial |
$154.60
|
| Rate for Payer: Cash Price |
$347.85
|
| Rate for Payer: Central Health Plan Commercial |
$618.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.20
|
| Rate for Payer: EPIC Health Plan Senior |
$309.20
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$695.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$490.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.60
|
| Rate for Payer: Multiplan Commercial |
$579.75
|
| Rate for Payer: Networks By Design Commercial |
$502.45
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
|
