|
HC CENTRL MOTR STDY UPPER & LOWER
|
Facility
|
OP
|
$2,508.00
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
900600322
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$501.60 |
| Max. Negotiated Rate |
$2,257.20 |
| Rate for Payer: Adventist Health Commercial |
$501.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,104.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,141.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,825.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,458.90
|
| Rate for Payer: Blue Shield of California Commercial |
$1,580.04
|
| Rate for Payer: Blue Shield of California EPN |
$995.68
|
| Rate for Payer: Cash Price |
$1,128.60
|
| Rate for Payer: Cash Price |
$1,128.60
|
| Rate for Payer: Cash Price |
$1,128.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,006.40
|
| Rate for Payer: Cigna of CA HMO |
$1,605.12
|
| Rate for Payer: Cigna of CA PPO |
$1,855.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,214.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,104.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,755.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,822.39
|
| Rate for Payer: EPIC Health Plan Senior |
$1,214.93
|
| Rate for Payer: Galaxy Health WC |
$2,131.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,504.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,257.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,811.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$714.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,104.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,592.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$789.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,546.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,480.00
|
| Rate for Payer: Multiplan Commercial |
$1,881.00
|
| Rate for Payer: Networks By Design Commercial |
$1,630.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,104.48
|
| Rate for Payer: Prime Health Services Commercial |
$2,131.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,170.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,214.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,504.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,504.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,104.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Vantage Medical Group Senior |
$1,104.48
|
|
|
HC CENTROMERE AB
|
Facility
|
OP
|
$186.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900913527
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$167.40 |
| Rate for Payer: Adventist Health Commercial |
$37.20
|
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.05
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$88.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$88.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.95
|
| Rate for Payer: Blue Shield of California Commercial |
$40.32
|
| Rate for Payer: Blue Shield of California Commercial |
$117.18
|
| Rate for Payer: Blue Shield of California EPN |
$25.41
|
| Rate for Payer: Blue Shield of California EPN |
$73.84
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Central Health Plan Commercial |
$148.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA HMO |
$119.04
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Cigna of CA PPO |
$137.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$130.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: EPIC Health Plan Senior |
$13.26
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Galaxy Health WC |
$158.10
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Global Benefits Group Commercial |
$111.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$167.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$118.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$139.50
|
| Rate for Payer: Networks By Design Commercial |
$120.90
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.05
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Prime Health Services Commercial |
$158.10
|
| Rate for Payer: Prime Health Services Medicare |
$12.77
|
| Rate for Payer: Prime Health Services Medicare |
$12.77
|
| Rate for Payer: Riverside University Health System MISP |
$13.26
|
| Rate for Payer: Riverside University Health System MISP |
$13.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.77
|
| Rate for Payer: United Healthcare All Other HMO |
$9.77
|
| Rate for Payer: United Healthcare All Other HMO |
$9.77
|
| Rate for Payer: United Healthcare HMO Rider |
$9.77
|
| Rate for Payer: United Healthcare HMO Rider |
$9.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.77
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.05
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC CENTROMERE AB
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900913527
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$167.40 |
| Rate for Payer: Adventist Health Commercial |
$37.20
|
| Rate for Payer: Cash Price |
$83.70
|
| Rate for Payer: Central Health Plan Commercial |
$148.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$130.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.40
|
| Rate for Payer: EPIC Health Plan Senior |
$74.40
|
| Rate for Payer: Galaxy Health WC |
$158.10
|
| Rate for Payer: Global Benefits Group Commercial |
$111.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$167.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$118.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$109.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.20
|
| Rate for Payer: Multiplan Commercial |
$139.50
|
| Rate for Payer: Networks By Design Commercial |
$120.90
|
| Rate for Payer: Prime Health Services Commercial |
$158.10
|
|
|
HC CEREBRAL BLOOD FLOW
|
Facility
|
IP
|
$2,830.00
|
|
|
Service Code
|
CPT 78610
|
| Hospital Charge Code |
909301412
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$566.00 |
| Max. Negotiated Rate |
$2,547.00 |
| Rate for Payer: Adventist Health Commercial |
$566.00
|
| Rate for Payer: Cash Price |
$1,273.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,264.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,981.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,132.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,132.00
|
| Rate for Payer: Galaxy Health WC |
$2,405.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,698.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,547.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,797.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,669.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$566.00
|
| Rate for Payer: Multiplan Commercial |
$2,122.50
|
| Rate for Payer: Networks By Design Commercial |
$1,839.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,405.50
|
|
|
HC CEREBRAL BLOOD FLOW
|
Facility
|
OP
|
$2,830.00
|
|
|
Service Code
|
CPT 78610
|
| Hospital Charge Code |
909301412
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$69.18 |
| Max. Negotiated Rate |
$2,547.00 |
| Rate for Payer: Adventist Health Commercial |
$566.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$698.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,030.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$768.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$698.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$286.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,646.21
|
| Rate for Payer: Blue Shield of California Commercial |
$1,782.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,123.51
|
| Rate for Payer: Cash Price |
$1,273.50
|
| Rate for Payer: Cash Price |
$1,273.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,264.00
|
| Rate for Payer: Cigna of CA HMO |
$1,811.20
|
| Rate for Payer: Cigna of CA PPO |
$2,094.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$768.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$698.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,981.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.28
|
| Rate for Payer: EPIC Health Plan Senior |
$768.18
|
| Rate for Payer: Galaxy Health WC |
$2,405.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,698.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,547.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,145.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$69.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$698.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,797.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$76.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$977.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$566.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$935.79
|
| Rate for Payer: Multiplan Commercial |
$2,122.50
|
| Rate for Payer: Networks By Design Commercial |
$1,839.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$698.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,405.50
|
| Rate for Payer: Prime Health Services Medicare |
$740.25
|
| Rate for Payer: Riverside University Health System MISP |
$768.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,698.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,698.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$616.06
|
| Rate for Payer: United Healthcare All Other HMO |
$616.06
|
| Rate for Payer: United Healthcare HMO Rider |
$616.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$616.06
|
| Rate for Payer: Upland Medical Group Pediatric |
$698.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,047.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$768.18
|
| Rate for Payer: Vantage Medical Group Senior |
$698.35
|
|
|
HC CERULOPLASMIN
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900910839
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC CERULOPLASMIN
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900910839
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.70 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$10.74
|
| Rate for Payer: Adventist Health Medi-Cal |
$10.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.60
|
| Rate for Payer: Blue Shield of California Commercial |
$51.66
|
| Rate for Payer: Blue Shield of California Commercial |
$96.39
|
| Rate for Payer: Blue Shield of California EPN |
$32.55
|
| Rate for Payer: Blue Shield of California EPN |
$60.74
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA HMO |
$97.92
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Cigna of CA PPO |
$113.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.72
|
| Rate for Payer: EPIC Health Plan Senior |
$11.81
|
| Rate for Payer: EPIC Health Plan Senior |
$11.81
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10.74
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10.74
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
| Rate for Payer: Prime Health Services Medicare |
$11.38
|
| Rate for Payer: Prime Health Services Medicare |
$11.38
|
| Rate for Payer: Riverside University Health System MISP |
$11.81
|
| Rate for Payer: Riverside University Health System MISP |
$11.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.70
|
| Rate for Payer: United Healthcare All Other HMO |
$8.70
|
| Rate for Payer: United Healthcare All Other HMO |
$8.70
|
| Rate for Payer: United Healthcare HMO Rider |
$8.70
|
| Rate for Payer: United Healthcare HMO Rider |
$8.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.74
|
| Rate for Payer: Upland Medical Group Pediatric |
$10.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC CERVICAL CAP REMOVAL
|
Facility
|
IP
|
$616.00
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
910400031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.20 |
| Max. Negotiated Rate |
$554.40 |
| Rate for Payer: Adventist Health Commercial |
$123.20
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Central Health Plan Commercial |
$492.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Senior |
$246.40
|
| Rate for Payer: Galaxy Health WC |
$523.60
|
| Rate for Payer: Global Benefits Group Commercial |
$369.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$391.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$363.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.20
|
| Rate for Payer: Multiplan Commercial |
$462.00
|
| Rate for Payer: Networks By Design Commercial |
$400.40
|
| Rate for Payer: Prime Health Services Commercial |
$523.60
|
|
|
HC CERVICAL CAP REMOVAL
|
Facility
|
OP
|
$616.00
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
910400031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$123.20 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$123.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$407.27
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Central Health Plan Commercial |
$492.80
|
| Rate for Payer: Cigna of CA HMO |
$394.24
|
| Rate for Payer: Cigna of CA PPO |
$455.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$431.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.05
|
| Rate for Payer: EPIC Health Plan Senior |
$286.03
|
| Rate for Payer: Galaxy Health WC |
$523.60
|
| Rate for Payer: Global Benefits Group Commercial |
$369.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$554.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$426.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$391.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$462.00
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$400.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$260.03
|
| Rate for Payer: Preferred Health Network WC |
$415.58
|
| Rate for Payer: Prime Health Services Commercial |
$523.60
|
| Rate for Payer: Prime Health Services Medicare |
$275.63
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Riverside University Health System MISP |
$286.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$369.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$308.00
|
| Rate for Payer: United Healthcare All Other HMO |
$308.00
|
| Rate for Payer: United Healthcare HMO Rider |
$308.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$260.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC CERVICAL DILATOR INSERTION
|
Facility
|
OP
|
$2,167.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
902400113
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$271.75 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$433.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$271.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,373.88
|
| Rate for Payer: Blue Shield of California EPN |
$864.63
|
| Rate for Payer: Cash Price |
$975.15
|
| Rate for Payer: Cash Price |
$975.15
|
| Rate for Payer: Cash Price |
$975.15
|
| Rate for Payer: Cash Price |
$975.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,733.60
|
| Rate for Payer: Cigna of CA HMO |
$1,386.88
|
| Rate for Payer: Cigna of CA PPO |
$1,603.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,516.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,841.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,300.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,950.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,376.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$786.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$433.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$1,625.25
|
| Rate for Payer: Networks By Design Commercial |
$1,408.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Prime Health Services Commercial |
$1,841.95
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,300.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,300.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC CERVICAL DILATOR INSERTION
|
Facility
|
IP
|
$2,167.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
902400113
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$433.40 |
| Max. Negotiated Rate |
$1,950.30 |
| Rate for Payer: Adventist Health Commercial |
$433.40
|
| Rate for Payer: Cash Price |
$975.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,733.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,516.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$866.80
|
| Rate for Payer: EPIC Health Plan Senior |
$866.80
|
| Rate for Payer: Galaxy Health WC |
$1,841.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,300.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,950.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,376.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,278.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$433.40
|
| Rate for Payer: Multiplan Commercial |
$1,625.25
|
| Rate for Payer: Networks By Design Commercial |
$1,408.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,841.95
|
|
|
HC CERVICAL DISCOGRAPHY, 1 LEV
|
Facility
|
IP
|
$610.00
|
|
|
Service Code
|
CPT 62291
|
| Hospital Charge Code |
909000184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$122.00 |
| Max. Negotiated Rate |
$549.00 |
| Rate for Payer: Adventist Health Commercial |
$122.00
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Central Health Plan Commercial |
$488.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$427.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$244.00
|
| Rate for Payer: EPIC Health Plan Senior |
$244.00
|
| Rate for Payer: Galaxy Health WC |
$518.50
|
| Rate for Payer: Global Benefits Group Commercial |
$366.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$549.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$387.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$359.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.00
|
| Rate for Payer: Multiplan Commercial |
$457.50
|
| Rate for Payer: Networks By Design Commercial |
$396.50
|
| Rate for Payer: Prime Health Services Commercial |
$518.50
|
|
|
HC CERVICAL DISCOGRAPHY, 1 LEV
|
Facility
|
OP
|
$610.00
|
|
|
Service Code
|
CPT 62291
|
| Hospital Charge Code |
909000184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$122.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$122.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$518.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$457.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Central Health Plan Commercial |
$488.00
|
| Rate for Payer: Cigna of CA HMO |
$390.40
|
| Rate for Payer: Cigna of CA PPO |
$451.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$518.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$518.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$518.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$427.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$244.00
|
| Rate for Payer: EPIC Health Plan Senior |
$244.00
|
| Rate for Payer: Galaxy Health WC |
$518.50
|
| Rate for Payer: Global Benefits Group Commercial |
$366.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$549.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$387.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$359.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$427.00
|
| Rate for Payer: Multiplan Commercial |
$457.50
|
| Rate for Payer: Networks By Design Commercial |
$396.50
|
| Rate for Payer: Prime Health Services Commercial |
$518.50
|
| Rate for Payer: Riverside University Health System MISP |
$244.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$366.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$305.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$518.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$518.50
|
| Rate for Payer: Vantage Medical Group Senior |
$518.50
|
|
|
HC CERVICAL PUNCTURE (FLUORO)
|
Facility
|
OP
|
$9,099.00
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
909000197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.63 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,819.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,094.55
|
| Rate for Payer: Cash Price |
$4,094.55
|
| Rate for Payer: Cash Price |
$4,094.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,279.20
|
| Rate for Payer: Cigna of CA HMO |
$5,823.36
|
| Rate for Payer: Cigna of CA PPO |
$6,733.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,369.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$7,734.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,459.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,189.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$130.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,777.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$144.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,819.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$6,824.25
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$5,914.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$7,734.15
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,459.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,549.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC CERVICAL PUNCTURE (FLUORO)
|
Facility
|
IP
|
$9,099.00
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
909000197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,819.80 |
| Max. Negotiated Rate |
$8,189.10 |
| Rate for Payer: Adventist Health Commercial |
$1,819.80
|
| Rate for Payer: Cash Price |
$4,094.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,279.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,369.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,639.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,639.60
|
| Rate for Payer: Galaxy Health WC |
$7,734.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,459.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,189.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,777.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,368.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,819.80
|
| Rate for Payer: Multiplan Commercial |
$6,824.25
|
| Rate for Payer: Networks By Design Commercial |
$5,914.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,734.15
|
|
|
HC CERVICAL PUNCTURE FOR MYELO
|
Facility
|
IP
|
$2,064.00
|
|
|
Service Code
|
CPT 61055
|
| Hospital Charge Code |
909000179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$412.80 |
| Max. Negotiated Rate |
$1,857.60 |
| Rate for Payer: Adventist Health Commercial |
$412.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,651.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,444.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$825.60
|
| Rate for Payer: EPIC Health Plan Senior |
$825.60
|
| Rate for Payer: Galaxy Health WC |
$1,754.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,238.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,857.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,310.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,217.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$412.80
|
| Rate for Payer: Multiplan Commercial |
$1,548.00
|
| Rate for Payer: Networks By Design Commercial |
$1,341.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,754.40
|
|
|
HC CERVICAL PUNCTURE FOR MYELO
|
Facility
|
OP
|
$2,064.00
|
|
|
Service Code
|
CPT 61055
|
| Hospital Charge Code |
909000179
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$243.33 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$412.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$394.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Cash Price |
$928.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,651.20
|
| Rate for Payer: Cigna of CA HMO |
$1,320.96
|
| Rate for Payer: Cigna of CA PPO |
$1,527.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,444.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,754.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,238.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,857.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$243.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,310.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$268.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$552.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$412.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,548.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,341.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,754.40
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,238.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,032.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC CERVICAL/VAGINAL CANCER SCREEN
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
902890216
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Adventist Health Commercial |
$56.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$146.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$136.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$164.04
|
| Rate for Payer: Blue Shield of California Commercial |
$178.79
|
| Rate for Payer: Blue Shield of California EPN |
$112.52
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Central Health Plan Commercial |
$225.60
|
| Rate for Payer: Cigna of CA HMO |
$180.48
|
| Rate for Payer: Cigna of CA PPO |
$208.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$197.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$239.70
|
| Rate for Payer: Global Benefits Group Commercial |
$169.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$253.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$179.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$211.50
|
| Rate for Payer: Networks By Design Commercial |
$183.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$239.70
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$169.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$169.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$141.00
|
| Rate for Payer: United Healthcare All Other HMO |
$141.00
|
| Rate for Payer: United Healthcare HMO Rider |
$141.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$141.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC CERVICAL/VAGINAL CANCER SCREEN
|
Facility
|
OP
|
$282.00
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
902890216
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Adventist Health Commercial |
$56.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$146.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$136.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$164.04
|
| Rate for Payer: Blue Shield of California Commercial |
$178.79
|
| Rate for Payer: Blue Shield of California EPN |
$112.52
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Central Health Plan Commercial |
$225.60
|
| Rate for Payer: Cigna of CA HMO |
$180.48
|
| Rate for Payer: Cigna of CA PPO |
$208.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$197.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$239.70
|
| Rate for Payer: Global Benefits Group Commercial |
$169.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$253.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$179.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$211.50
|
| Rate for Payer: Networks By Design Commercial |
$183.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$239.70
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$169.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$169.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$141.00
|
| Rate for Payer: United Healthcare All Other HMO |
$141.00
|
| Rate for Payer: United Healthcare HMO Rider |
$141.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$141.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC CERVICAL/VAGINAL CANCER SCREEN
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
902890216
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Adventist Health Commercial |
$56.40
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Central Health Plan Commercial |
$225.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$197.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.80
|
| Rate for Payer: EPIC Health Plan Senior |
$112.80
|
| Rate for Payer: Galaxy Health WC |
$239.70
|
| Rate for Payer: Global Benefits Group Commercial |
$169.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$253.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$179.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$166.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.40
|
| Rate for Payer: Multiplan Commercial |
$211.50
|
| Rate for Payer: Networks By Design Commercial |
$183.30
|
| Rate for Payer: Prime Health Services Commercial |
$239.70
|
|
|
HC CERVICAL/VAGINAL CANCER SCREEN
|
Facility
|
IP
|
$282.00
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
902890216
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$253.80 |
| Rate for Payer: Adventist Health Commercial |
$56.40
|
| Rate for Payer: Cash Price |
$126.90
|
| Rate for Payer: Central Health Plan Commercial |
$225.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$197.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.80
|
| Rate for Payer: EPIC Health Plan Senior |
$112.80
|
| Rate for Payer: Galaxy Health WC |
$239.70
|
| Rate for Payer: Global Benefits Group Commercial |
$169.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$253.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$179.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$166.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.40
|
| Rate for Payer: Multiplan Commercial |
$211.50
|
| Rate for Payer: Networks By Design Commercial |
$183.30
|
| Rate for Payer: Prime Health Services Commercial |
$239.70
|
|
|
HC CERV/THOR FACET INJ 3RD EA ADD
|
Facility
|
OP
|
$1,944.00
|
|
|
Service Code
|
CPT 64492
|
| Hospital Charge Code |
909020049
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.96 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$388.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,652.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,069.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,458.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$874.80
|
| Rate for Payer: Cash Price |
$874.80
|
| Rate for Payer: Cash Price |
$874.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,555.20
|
| Rate for Payer: Cigna of CA HMO |
$1,244.16
|
| Rate for Payer: Cigna of CA PPO |
$1,438.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,652.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,652.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,652.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,360.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$777.60
|
| Rate for Payer: EPIC Health Plan Senior |
$777.60
|
| Rate for Payer: Galaxy Health WC |
$1,652.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,166.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,749.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$138.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,234.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,146.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$388.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,360.80
|
| Rate for Payer: Multiplan Commercial |
$1,458.00
|
| Rate for Payer: Networks By Design Commercial |
$1,263.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,652.40
|
| Rate for Payer: Riverside University Health System MISP |
$777.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,166.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$972.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,652.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,652.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,652.40
|
|
|
HC CERV/THOR FACET INJ 3RD EA ADD
|
Facility
|
IP
|
$1,944.00
|
|
|
Service Code
|
CPT 64492
|
| Hospital Charge Code |
909020049
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$388.80 |
| Max. Negotiated Rate |
$1,749.60 |
| Rate for Payer: Adventist Health Commercial |
$388.80
|
| Rate for Payer: Cash Price |
$874.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,555.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,360.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$777.60
|
| Rate for Payer: EPIC Health Plan Senior |
$777.60
|
| Rate for Payer: Galaxy Health WC |
$1,652.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,166.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,749.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,234.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,146.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$388.80
|
| Rate for Payer: Multiplan Commercial |
$1,458.00
|
| Rate for Payer: Networks By Design Commercial |
$1,263.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,652.40
|
|
|
HC CESAREAN DELIVERY ONLY
|
Facility
|
OP
|
$7,016.00
|
|
|
Service Code
|
CPT 59514
|
| Hospital Charge Code |
900501514
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$581.00 |
| Max. Negotiated Rate |
$11,690.00 |
| Rate for Payer: Adventist Health Commercial |
$1,403.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,007.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,963.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,858.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,262.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,407.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,690.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,448.14
|
| Rate for Payer: Blue Shield of California EPN |
$2,799.38
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,612.80
|
| Rate for Payer: Cigna of CA HMO |
$4,490.24
|
| Rate for Payer: Cigna of CA PPO |
$5,191.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,963.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,963.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,963.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,911.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,806.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,806.40
|
| Rate for Payer: Galaxy Health WC |
$5,963.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,209.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,314.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,455.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,034.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,139.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,403.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,911.20
|
| Rate for Payer: Multiplan Commercial |
$5,262.00
|
| Rate for Payer: Networks By Design Commercial |
$4,560.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,963.60
|
| Rate for Payer: Riverside University Health System MISP |
$2,806.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,209.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,209.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,963.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,963.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,963.60
|
|
|
HC CESAREAN DELIVERY ONLY
|
Facility
|
IP
|
$7,016.00
|
|
|
Service Code
|
CPT 59514
|
| Hospital Charge Code |
900501514
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,403.20 |
| Max. Negotiated Rate |
$6,314.40 |
| Rate for Payer: Adventist Health Commercial |
$1,403.20
|
| Rate for Payer: Cash Price |
$3,157.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,612.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,911.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,806.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,806.40
|
| Rate for Payer: Galaxy Health WC |
$5,963.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,209.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,314.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,455.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,139.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,403.20
|
| Rate for Payer: Multiplan Commercial |
$5,262.00
|
| Rate for Payer: Networks By Design Commercial |
$4,560.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,963.60
|
|
