|
HC CHEMO INFUSION INITIAL
|
Facility
|
OP
|
$1,766.00
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
910100131
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$1,589.40 |
| Rate for Payer: Adventist Health Commercial |
$353.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$421.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,072.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$971.30
|
| Rate for Payer: Cash Price |
$971.30
|
| Rate for Payer: Cash Price |
$971.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,412.80
|
| Rate for Payer: Cigna of CA HMO |
$1,130.24
|
| Rate for Payer: Cigna of CA PPO |
$1,306.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.96
|
| Rate for Payer: EPIC Health Plan Senior |
$421.45
|
| Rate for Payer: Galaxy Health WC |
$1,501.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,059.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,589.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$691.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$174.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$518.38
|
| Rate for Payer: InnovAge PACE Commercial |
$632.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,177.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$421.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$564.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$564.74
|
| Rate for Payer: Multiplan Commercial |
$1,324.50
|
| Rate for Payer: Networks By Design Commercial |
$1,147.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$421.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,501.10
|
| Rate for Payer: Prime Health Services Medicare |
$446.74
|
| Rate for Payer: Riverside University Health System MISP |
$463.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,059.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,059.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$421.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC CHEMO INFUSION INITIAL
|
Facility
|
OP
|
$1,766.00
|
|
|
Service Code
|
CPT 96413
|
| Hospital Charge Code |
901200111
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$54.32 |
| Max. Negotiated Rate |
$1,589.40 |
| Rate for Payer: Adventist Health Commercial |
$353.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$421.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,072.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$971.30
|
| Rate for Payer: Cash Price |
$971.30
|
| Rate for Payer: Cash Price |
$971.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,412.80
|
| Rate for Payer: Cigna of CA HMO |
$1,130.24
|
| Rate for Payer: Cigna of CA PPO |
$1,306.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.96
|
| Rate for Payer: EPIC Health Plan Senior |
$421.45
|
| Rate for Payer: Galaxy Health WC |
$1,501.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,059.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,589.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$691.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$174.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$518.38
|
| Rate for Payer: InnovAge PACE Commercial |
$632.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,177.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$54.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$421.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$353.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$564.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$564.74
|
| Rate for Payer: Multiplan Commercial |
$1,324.50
|
| Rate for Payer: Networks By Design Commercial |
$1,147.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$421.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,501.10
|
| Rate for Payer: Prime Health Services Medicare |
$446.74
|
| Rate for Payer: Riverside University Health System MISP |
$463.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,059.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,059.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$421.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC CHEMO INJ SUB ARACH/VENT/SUBQ
|
Facility
|
IP
|
$538.00
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
911800817
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$484.20 |
| Rate for Payer: Adventist Health Commercial |
$107.60
|
| Rate for Payer: Cash Price |
$295.90
|
| Rate for Payer: Central Health Plan Commercial |
$430.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.20
|
| Rate for Payer: EPIC Health Plan Senior |
$215.20
|
| Rate for Payer: Galaxy Health WC |
$457.30
|
| Rate for Payer: Global Benefits Group Commercial |
$322.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$484.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$358.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$204.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$333.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.60
|
| Rate for Payer: Multiplan Commercial |
$403.50
|
| Rate for Payer: Networks By Design Commercial |
$349.70
|
| Rate for Payer: Prime Health Services Commercial |
$457.30
|
|
|
HC CHEMO INJ SUB ARACH/VENT/SUBQ
|
Facility
|
OP
|
$538.00
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
911800817
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$55.67 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$107.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$421.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$326.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Blue Shield of California Commercial |
$328.72
|
| Rate for Payer: Blue Shield of California EPN |
$214.66
|
| Rate for Payer: Cash Price |
$295.90
|
| Rate for Payer: Cash Price |
$295.90
|
| Rate for Payer: Cash Price |
$295.90
|
| Rate for Payer: Central Health Plan Commercial |
$430.40
|
| Rate for Payer: Cigna of CA HMO |
$344.32
|
| Rate for Payer: Cigna of CA PPO |
$398.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.96
|
| Rate for Payer: EPIC Health Plan Senior |
$421.45
|
| Rate for Payer: Galaxy Health WC |
$457.30
|
| Rate for Payer: Global Benefits Group Commercial |
$322.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$484.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$691.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$55.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$518.38
|
| Rate for Payer: InnovAge PACE Commercial |
$632.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$358.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$162.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$421.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$564.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$564.74
|
| Rate for Payer: Multiplan Commercial |
$403.50
|
| Rate for Payer: Networks By Design Commercial |
$349.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$421.45
|
| Rate for Payer: Prime Health Services Commercial |
$457.30
|
| Rate for Payer: Prime Health Services Medicare |
$446.74
|
| Rate for Payer: Riverside University Health System MISP |
$463.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$322.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$322.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$421.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC CHEMO INTRALESIONAL OVER 7
|
Facility
|
IP
|
$528.00
|
|
|
Service Code
|
CPT 96406
|
| Hospital Charge Code |
911896406
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$105.60 |
| Max. Negotiated Rate |
$475.20 |
| Rate for Payer: Adventist Health Commercial |
$105.60
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Central Health Plan Commercial |
$422.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.20
|
| Rate for Payer: EPIC Health Plan Senior |
$211.20
|
| Rate for Payer: Galaxy Health WC |
$448.80
|
| Rate for Payer: Global Benefits Group Commercial |
$316.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$475.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$352.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$326.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.60
|
| Rate for Payer: Multiplan Commercial |
$396.00
|
| Rate for Payer: Networks By Design Commercial |
$343.20
|
| Rate for Payer: Prime Health Services Commercial |
$448.80
|
|
|
HC CHEMO INTRALESIONAL OVER 7
|
Facility
|
OP
|
$528.00
|
|
|
Service Code
|
CPT 96406
|
| Hospital Charge Code |
911896406
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$59.89 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$105.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$267.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$320.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Blue Shield of California Commercial |
$322.61
|
| Rate for Payer: Blue Shield of California EPN |
$210.67
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Cash Price |
$290.40
|
| Rate for Payer: Central Health Plan Commercial |
$422.40
|
| Rate for Payer: Cigna of CA HMO |
$337.92
|
| Rate for Payer: Cigna of CA PPO |
$390.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$267.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.39
|
| Rate for Payer: EPIC Health Plan Senior |
$267.70
|
| Rate for Payer: Galaxy Health WC |
$448.80
|
| Rate for Payer: Global Benefits Group Commercial |
$316.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$475.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$329.27
|
| Rate for Payer: InnovAge PACE Commercial |
$401.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$352.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.72
|
| Rate for Payer: Multiplan Commercial |
$396.00
|
| Rate for Payer: Networks By Design Commercial |
$343.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$267.70
|
| Rate for Payer: Prime Health Services Commercial |
$448.80
|
| Rate for Payer: Prime Health Services Medicare |
$283.76
|
| Rate for Payer: Riverside University Health System MISP |
$294.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$316.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$267.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.47
|
| Rate for Payer: Vantage Medical Group Senior |
$267.70
|
|
|
HC CHEMO INTRALESIONAL UP TO 7
|
Facility
|
OP
|
$169.00
|
|
|
Service Code
|
CPT 96405
|
| Hospital Charge Code |
911896405
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$90.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$102.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Blue Shield of California Commercial |
$103.26
|
| Rate for Payer: Blue Shield of California EPN |
$67.43
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Central Health Plan Commercial |
$135.20
|
| Rate for Payer: Cigna of CA HMO |
$108.16
|
| Rate for Payer: Cigna of CA PPO |
$125.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$135.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$90.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.08
|
| Rate for Payer: EPIC Health Plan Senior |
$90.43
|
| Rate for Payer: Galaxy Health WC |
$143.65
|
| Rate for Payer: Global Benefits Group Commercial |
$101.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$152.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$148.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.23
|
| Rate for Payer: InnovAge PACE Commercial |
$135.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$74.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$121.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$121.18
|
| Rate for Payer: Multiplan Commercial |
$126.75
|
| Rate for Payer: Networks By Design Commercial |
$109.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$90.43
|
| Rate for Payer: Prime Health Services Commercial |
$143.65
|
| Rate for Payer: Prime Health Services Medicare |
$95.86
|
| Rate for Payer: Riverside University Health System MISP |
$99.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$101.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$101.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$90.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Vantage Medical Group Senior |
$90.43
|
|
|
HC CHEMO INTRALESIONAL UP TO 7
|
Facility
|
IP
|
$169.00
|
|
|
Service Code
|
CPT 96405
|
| Hospital Charge Code |
911896405
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Cash Price |
$92.95
|
| Rate for Payer: Central Health Plan Commercial |
$135.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.60
|
| Rate for Payer: EPIC Health Plan Senior |
$67.60
|
| Rate for Payer: Galaxy Health WC |
$143.65
|
| Rate for Payer: Global Benefits Group Commercial |
$101.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$152.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$104.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.80
|
| Rate for Payer: Multiplan Commercial |
$126.75
|
| Rate for Payer: Networks By Design Commercial |
$109.85
|
| Rate for Payer: Prime Health Services Commercial |
$143.65
|
|
|
HC CHEMO PROLONGED INFUSION 8HR OR MORE
|
Facility
|
OP
|
$1,063.00
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
911800808
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$212.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$421.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$645.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$584.65
|
| Rate for Payer: Cash Price |
$584.65
|
| Rate for Payer: Cash Price |
$584.65
|
| Rate for Payer: Central Health Plan Commercial |
$850.40
|
| Rate for Payer: Cigna of CA HMO |
$680.32
|
| Rate for Payer: Cigna of CA PPO |
$786.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.96
|
| Rate for Payer: EPIC Health Plan Senior |
$421.45
|
| Rate for Payer: Galaxy Health WC |
$903.55
|
| Rate for Payer: Global Benefits Group Commercial |
$637.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$956.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$691.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$172.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$518.38
|
| Rate for Payer: InnovAge PACE Commercial |
$632.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$709.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$421.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$564.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$564.74
|
| Rate for Payer: Multiplan Commercial |
$797.25
|
| Rate for Payer: Networks By Design Commercial |
$690.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$421.45
|
| Rate for Payer: Prime Health Services Commercial |
$903.55
|
| Rate for Payer: Prime Health Services Medicare |
$446.74
|
| Rate for Payer: Riverside University Health System MISP |
$463.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$637.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$637.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$421.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC CHEMO PROLONGED INFUSION 8HR OR MORE
|
Facility
|
IP
|
$1,063.00
|
|
|
Service Code
|
CPT 96416
|
| Hospital Charge Code |
911800808
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$212.60 |
| Max. Negotiated Rate |
$956.70 |
| Rate for Payer: Adventist Health Commercial |
$212.60
|
| Rate for Payer: Cash Price |
$584.65
|
| Rate for Payer: Central Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.20
|
| Rate for Payer: EPIC Health Plan Senior |
$425.20
|
| Rate for Payer: Galaxy Health WC |
$903.55
|
| Rate for Payer: Global Benefits Group Commercial |
$637.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$956.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$709.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$405.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$658.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$212.60
|
| Rate for Payer: Multiplan Commercial |
$797.25
|
| Rate for Payer: Networks By Design Commercial |
$690.95
|
| Rate for Payer: Prime Health Services Commercial |
$903.55
|
|
|
HC CHEMO PUSH EA ADD PUSH
|
Facility
|
OP
|
$902.00
|
|
|
Service Code
|
CPT 96411
|
| Hospital Charge Code |
910100136
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$34.12 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$180.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$90.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$547.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$496.10
|
| Rate for Payer: Cash Price |
$496.10
|
| Rate for Payer: Cash Price |
$496.10
|
| Rate for Payer: Central Health Plan Commercial |
$721.60
|
| Rate for Payer: Cigna of CA HMO |
$577.28
|
| Rate for Payer: Cigna of CA PPO |
$667.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$135.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$90.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.08
|
| Rate for Payer: EPIC Health Plan Senior |
$90.43
|
| Rate for Payer: Galaxy Health WC |
$766.70
|
| Rate for Payer: Global Benefits Group Commercial |
$541.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$811.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$148.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$73.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.23
|
| Rate for Payer: InnovAge PACE Commercial |
$135.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$601.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$121.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$121.18
|
| Rate for Payer: Multiplan Commercial |
$676.50
|
| Rate for Payer: Networks By Design Commercial |
$586.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$90.43
|
| Rate for Payer: Prime Health Services Commercial |
$766.70
|
| Rate for Payer: Prime Health Services Medicare |
$95.86
|
| Rate for Payer: Riverside University Health System MISP |
$99.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$541.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$541.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$90.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Vantage Medical Group Senior |
$90.43
|
|
|
HC CHEMO PUSH EA ADD PUSH
|
Facility
|
IP
|
$902.00
|
|
|
Service Code
|
CPT 96411
|
| Hospital Charge Code |
911800805
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$180.40 |
| Max. Negotiated Rate |
$811.80 |
| Rate for Payer: Adventist Health Commercial |
$180.40
|
| Rate for Payer: Cash Price |
$496.10
|
| Rate for Payer: Central Health Plan Commercial |
$721.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.80
|
| Rate for Payer: EPIC Health Plan Senior |
$360.80
|
| Rate for Payer: Galaxy Health WC |
$766.70
|
| Rate for Payer: Global Benefits Group Commercial |
$541.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$811.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$601.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$343.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$558.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.40
|
| Rate for Payer: Multiplan Commercial |
$676.50
|
| Rate for Payer: Networks By Design Commercial |
$586.30
|
| Rate for Payer: Prime Health Services Commercial |
$766.70
|
|
|
HC CHEMO PUSH EA ADD PUSH
|
Facility
|
OP
|
$902.00
|
|
|
Service Code
|
CPT 96411
|
| Hospital Charge Code |
911800805
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$34.12 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$180.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$90.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$547.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Blue Shield of California Commercial |
$551.12
|
| Rate for Payer: Blue Shield of California EPN |
$359.90
|
| Rate for Payer: Cash Price |
$496.10
|
| Rate for Payer: Cash Price |
$496.10
|
| Rate for Payer: Cash Price |
$496.10
|
| Rate for Payer: Central Health Plan Commercial |
$721.60
|
| Rate for Payer: Cigna of CA HMO |
$577.28
|
| Rate for Payer: Cigna of CA PPO |
$667.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$135.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$90.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.08
|
| Rate for Payer: EPIC Health Plan Senior |
$90.43
|
| Rate for Payer: Galaxy Health WC |
$766.70
|
| Rate for Payer: Global Benefits Group Commercial |
$541.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$811.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$148.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$73.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.23
|
| Rate for Payer: InnovAge PACE Commercial |
$135.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$601.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$90.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$121.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$121.18
|
| Rate for Payer: Multiplan Commercial |
$676.50
|
| Rate for Payer: Networks By Design Commercial |
$586.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$90.43
|
| Rate for Payer: Prime Health Services Commercial |
$766.70
|
| Rate for Payer: Prime Health Services Medicare |
$95.86
|
| Rate for Payer: Riverside University Health System MISP |
$99.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$541.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$541.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$90.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$135.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.47
|
| Rate for Payer: Vantage Medical Group Senior |
$90.43
|
|
|
HC CHEMO PUSH EA ADD PUSH
|
Facility
|
IP
|
$902.00
|
|
|
Service Code
|
CPT 96411
|
| Hospital Charge Code |
910100136
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$180.40 |
| Max. Negotiated Rate |
$811.80 |
| Rate for Payer: Adventist Health Commercial |
$180.40
|
| Rate for Payer: Cash Price |
$496.10
|
| Rate for Payer: Central Health Plan Commercial |
$721.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.80
|
| Rate for Payer: EPIC Health Plan Senior |
$360.80
|
| Rate for Payer: Galaxy Health WC |
$766.70
|
| Rate for Payer: Global Benefits Group Commercial |
$541.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$811.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$601.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$343.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$558.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.40
|
| Rate for Payer: Multiplan Commercial |
$676.50
|
| Rate for Payer: Networks By Design Commercial |
$586.30
|
| Rate for Payer: Prime Health Services Commercial |
$766.70
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
OP
|
$952.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
901200110
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$34.12 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$190.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$421.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$578.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Central Health Plan Commercial |
$761.60
|
| Rate for Payer: Cigna of CA HMO |
$609.28
|
| Rate for Payer: Cigna of CA PPO |
$704.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.96
|
| Rate for Payer: EPIC Health Plan Senior |
$421.45
|
| Rate for Payer: Galaxy Health WC |
$809.20
|
| Rate for Payer: Global Benefits Group Commercial |
$571.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$856.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$691.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$135.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$518.38
|
| Rate for Payer: InnovAge PACE Commercial |
$632.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$634.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$421.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$564.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$564.74
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: Networks By Design Commercial |
$618.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$421.45
|
| Rate for Payer: Prime Health Services Commercial |
$809.20
|
| Rate for Payer: Prime Health Services Medicare |
$446.74
|
| Rate for Payer: Riverside University Health System MISP |
$463.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$571.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$571.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$421.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
IP
|
$952.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
910100130
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$190.40 |
| Max. Negotiated Rate |
$856.80 |
| Rate for Payer: Adventist Health Commercial |
$190.40
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Central Health Plan Commercial |
$761.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.80
|
| Rate for Payer: EPIC Health Plan Senior |
$380.80
|
| Rate for Payer: Galaxy Health WC |
$809.20
|
| Rate for Payer: Global Benefits Group Commercial |
$571.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$856.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$634.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$589.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.40
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: Networks By Design Commercial |
$618.80
|
| Rate for Payer: Prime Health Services Commercial |
$809.20
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
OP
|
$952.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
911800804
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$34.12 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$190.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$421.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$578.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Blue Shield of California Commercial |
$581.67
|
| Rate for Payer: Blue Shield of California EPN |
$379.85
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Central Health Plan Commercial |
$761.60
|
| Rate for Payer: Cigna of CA HMO |
$609.28
|
| Rate for Payer: Cigna of CA PPO |
$704.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.96
|
| Rate for Payer: EPIC Health Plan Senior |
$421.45
|
| Rate for Payer: Galaxy Health WC |
$809.20
|
| Rate for Payer: Global Benefits Group Commercial |
$571.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$856.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$691.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$135.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$518.38
|
| Rate for Payer: InnovAge PACE Commercial |
$632.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$634.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$421.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$564.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$564.74
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: Networks By Design Commercial |
$618.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$421.45
|
| Rate for Payer: Prime Health Services Commercial |
$809.20
|
| Rate for Payer: Prime Health Services Medicare |
$446.74
|
| Rate for Payer: Riverside University Health System MISP |
$463.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$571.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$571.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$421.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
IP
|
$952.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
901200110
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$190.40 |
| Max. Negotiated Rate |
$856.80 |
| Rate for Payer: Adventist Health Commercial |
$190.40
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Central Health Plan Commercial |
$761.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.80
|
| Rate for Payer: EPIC Health Plan Senior |
$380.80
|
| Rate for Payer: Galaxy Health WC |
$809.20
|
| Rate for Payer: Global Benefits Group Commercial |
$571.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$856.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$634.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$589.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.40
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: Networks By Design Commercial |
$618.80
|
| Rate for Payer: Prime Health Services Commercial |
$809.20
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
IP
|
$952.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
911800804
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$190.40 |
| Max. Negotiated Rate |
$856.80 |
| Rate for Payer: Adventist Health Commercial |
$190.40
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Central Health Plan Commercial |
$761.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.80
|
| Rate for Payer: EPIC Health Plan Senior |
$380.80
|
| Rate for Payer: Galaxy Health WC |
$809.20
|
| Rate for Payer: Global Benefits Group Commercial |
$571.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$856.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$634.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$589.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.40
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: Networks By Design Commercial |
$618.80
|
| Rate for Payer: Prime Health Services Commercial |
$809.20
|
|
|
HC CHEMO PUSH INITIAL
|
Facility
|
OP
|
$952.00
|
|
|
Service Code
|
CPT 96409
|
| Hospital Charge Code |
910100130
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$34.12 |
| Max. Negotiated Rate |
$1,461.00 |
| Rate for Payer: Adventist Health Commercial |
$190.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$421.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$578.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$421.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$990.00
|
| Rate for Payer: Blue Shield of California Commercial |
$581.67
|
| Rate for Payer: Blue Shield of California EPN |
$379.85
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Cash Price |
$523.60
|
| Rate for Payer: Central Health Plan Commercial |
$761.60
|
| Rate for Payer: Cigna of CA HMO |
$609.28
|
| Rate for Payer: Cigna of CA PPO |
$704.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$463.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$421.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.96
|
| Rate for Payer: EPIC Health Plan Senior |
$421.45
|
| Rate for Payer: Galaxy Health WC |
$809.20
|
| Rate for Payer: Global Benefits Group Commercial |
$571.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$856.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$691.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$135.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$518.38
|
| Rate for Payer: InnovAge PACE Commercial |
$632.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$634.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$421.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$564.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$564.74
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: Networks By Design Commercial |
$618.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$421.45
|
| Rate for Payer: Prime Health Services Commercial |
$809.20
|
| Rate for Payer: Prime Health Services Medicare |
$446.74
|
| Rate for Payer: Riverside University Health System MISP |
$463.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$571.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$571.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,461.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$887.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$813.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$421.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$463.60
|
| Rate for Payer: Vantage Medical Group Senior |
$421.45
|
|
|
HC CHEST 2 VIEWS
|
Facility
|
OP
|
$833.00
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
909001407
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$34.44 |
| Max. Negotiated Rate |
$749.70 |
| Rate for Payer: Adventist Health Commercial |
$166.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$505.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.44
|
| Rate for Payer: Blue Shield of California Commercial |
$505.63
|
| Rate for Payer: Blue Shield of California EPN |
$330.70
|
| Rate for Payer: Cash Price |
$458.15
|
| Rate for Payer: Cash Price |
$458.15
|
| Rate for Payer: Central Health Plan Commercial |
$666.40
|
| Rate for Payer: Cigna of CA HMO |
$533.12
|
| Rate for Payer: Cigna of CA PPO |
$616.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.04
|
| Rate for Payer: EPIC Health Plan Senior |
$111.88
|
| Rate for Payer: Galaxy Health WC |
$708.05
|
| Rate for Payer: Global Benefits Group Commercial |
$499.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$749.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$47.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.88
|
| Rate for Payer: InnovAge PACE Commercial |
$167.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$555.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$149.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.92
|
| Rate for Payer: Multiplan Commercial |
$624.75
|
| Rate for Payer: Networks By Design Commercial |
$541.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.88
|
| Rate for Payer: Prime Health Services Commercial |
$708.05
|
| Rate for Payer: Prime Health Services Medicare |
$118.59
|
| Rate for Payer: Riverside University Health System MISP |
$123.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$499.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$499.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.01
|
| Rate for Payer: United Healthcare All Other HMO |
$159.01
|
| Rate for Payer: United Healthcare HMO Rider |
$159.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.07
|
| Rate for Payer: Vantage Medical Group Senior |
$111.88
|
|
|
HC CHEST 2 VIEWS
|
Facility
|
IP
|
$833.00
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
909001407
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$166.60 |
| Max. Negotiated Rate |
$749.70 |
| Rate for Payer: Adventist Health Commercial |
$166.60
|
| Rate for Payer: Cash Price |
$458.15
|
| Rate for Payer: Central Health Plan Commercial |
$666.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$333.20
|
| Rate for Payer: EPIC Health Plan Senior |
$333.20
|
| Rate for Payer: Galaxy Health WC |
$708.05
|
| Rate for Payer: Global Benefits Group Commercial |
$499.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$749.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$555.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$317.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.60
|
| Rate for Payer: Multiplan Commercial |
$624.75
|
| Rate for Payer: Networks By Design Commercial |
$541.45
|
| Rate for Payer: Prime Health Services Commercial |
$708.05
|
|
|
HC CHEST COMP 4 VIEWS
|
Facility
|
IP
|
$1,002.00
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
909001402
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$200.40 |
| Max. Negotiated Rate |
$901.80 |
| Rate for Payer: Adventist Health Commercial |
$200.40
|
| Rate for Payer: Cash Price |
$551.10
|
| Rate for Payer: Central Health Plan Commercial |
$801.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$400.80
|
| Rate for Payer: EPIC Health Plan Senior |
$400.80
|
| Rate for Payer: Galaxy Health WC |
$851.70
|
| Rate for Payer: Global Benefits Group Commercial |
$601.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$901.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$668.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$381.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$620.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.40
|
| Rate for Payer: Multiplan Commercial |
$751.50
|
| Rate for Payer: Networks By Design Commercial |
$651.30
|
| Rate for Payer: Prime Health Services Commercial |
$851.70
|
|
|
HC CHEST COMP 4 VIEWS
|
Facility
|
OP
|
$1,002.00
|
|
|
Service Code
|
CPT 71048
|
| Hospital Charge Code |
909001402
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$45.17 |
| Max. Negotiated Rate |
$901.80 |
| Rate for Payer: Adventist Health Commercial |
$200.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$608.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$222.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.17
|
| Rate for Payer: Blue Shield of California Commercial |
$608.21
|
| Rate for Payer: Blue Shield of California EPN |
$397.79
|
| Rate for Payer: Cash Price |
$551.10
|
| Rate for Payer: Cash Price |
$551.10
|
| Rate for Payer: Central Health Plan Commercial |
$801.60
|
| Rate for Payer: Cigna of CA HMO |
$641.28
|
| Rate for Payer: Cigna of CA PPO |
$741.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$851.70
|
| Rate for Payer: Global Benefits Group Commercial |
$601.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$901.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$64.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$668.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$71.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$200.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$751.50
|
| Rate for Payer: Networks By Design Commercial |
$651.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$851.70
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$601.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$601.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$303.97
|
| Rate for Payer: United Healthcare All Other HMO |
$303.97
|
| Rate for Payer: United Healthcare HMO Rider |
$303.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$303.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC CHEST FLUORO/PACEMKR
|
Facility
|
IP
|
$872.00
|
|
| Hospital Charge Code |
909001469
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$174.40 |
| Max. Negotiated Rate |
$784.80 |
| Rate for Payer: Adventist Health Commercial |
$174.40
|
| Rate for Payer: Cash Price |
$479.60
|
| Rate for Payer: Central Health Plan Commercial |
$697.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$348.80
|
| Rate for Payer: EPIC Health Plan Senior |
$348.80
|
| Rate for Payer: Galaxy Health WC |
$741.20
|
| Rate for Payer: Global Benefits Group Commercial |
$523.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$784.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$581.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$539.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$174.40
|
| Rate for Payer: Multiplan Commercial |
$654.00
|
| Rate for Payer: Networks By Design Commercial |
$566.80
|
| Rate for Payer: Prime Health Services Commercial |
$741.20
|
|
