|
HC COMPUTER/DYNAMIC POSTUROGRAPHY
|
Facility
|
OP
|
$475.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
905101073
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$95.00 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Adventist Health Commercial |
$95.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$171.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$499.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$230.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$276.31
|
| Rate for Payer: Blue Shield of California Commercial |
$299.25
|
| Rate for Payer: Blue Shield of California EPN |
$188.57
|
| Rate for Payer: Cash Price |
$213.75
|
| Rate for Payer: Cash Price |
$213.75
|
| Rate for Payer: Cash Price |
$213.75
|
| Rate for Payer: Central Health Plan Commercial |
$380.00
|
| Rate for Payer: Cigna of CA HMO |
$304.00
|
| Rate for Payer: Cigna of CA PPO |
$351.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$332.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$403.75
|
| Rate for Payer: Global Benefits Group Commercial |
$285.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$427.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$301.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$172.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$356.25
|
| Rate for Payer: Networks By Design Commercial |
$308.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Prime Health Services Commercial |
$403.75
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$285.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$285.00
|
| 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 |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY
|
Facility
|
IP
|
$475.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
905101073
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$95.00 |
| Max. Negotiated Rate |
$427.50 |
| Rate for Payer: Adventist Health Commercial |
$95.00
|
| Rate for Payer: Cash Price |
$213.75
|
| Rate for Payer: Central Health Plan Commercial |
$380.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$332.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.00
|
| Rate for Payer: EPIC Health Plan Senior |
$190.00
|
| Rate for Payer: Galaxy Health WC |
$403.75
|
| Rate for Payer: Global Benefits Group Commercial |
$285.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$427.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$301.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$280.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.00
|
| Rate for Payer: Multiplan Commercial |
$356.25
|
| Rate for Payer: Networks By Design Commercial |
$308.75
|
| Rate for Payer: Prime Health Services Commercial |
$403.75
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY COMM MCARE
|
Facility
|
IP
|
$475.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
900411039
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$95.00 |
| Max. Negotiated Rate |
$427.50 |
| Rate for Payer: Adventist Health Commercial |
$95.00
|
| Rate for Payer: Cash Price |
$213.75
|
| Rate for Payer: Central Health Plan Commercial |
$380.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$332.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.00
|
| Rate for Payer: EPIC Health Plan Senior |
$190.00
|
| Rate for Payer: Galaxy Health WC |
$403.75
|
| Rate for Payer: Global Benefits Group Commercial |
$285.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$427.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$301.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$280.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.00
|
| Rate for Payer: Multiplan Commercial |
$356.25
|
| Rate for Payer: Networks By Design Commercial |
$308.75
|
| Rate for Payer: Prime Health Services Commercial |
$403.75
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY COMM MCARE
|
Facility
|
OP
|
$475.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
900411039
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$95.00 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Adventist Health Commercial |
$95.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$171.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$499.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$230.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$276.31
|
| Rate for Payer: Blue Shield of California Commercial |
$299.25
|
| Rate for Payer: Blue Shield of California EPN |
$188.57
|
| Rate for Payer: Cash Price |
$213.75
|
| Rate for Payer: Cash Price |
$213.75
|
| Rate for Payer: Cash Price |
$213.75
|
| Rate for Payer: Central Health Plan Commercial |
$380.00
|
| Rate for Payer: Cigna of CA HMO |
$304.00
|
| Rate for Payer: Cigna of CA PPO |
$351.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$332.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$403.75
|
| Rate for Payer: Global Benefits Group Commercial |
$285.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$427.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$301.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$172.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$356.25
|
| Rate for Payer: Networks By Design Commercial |
$308.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Prime Health Services Commercial |
$403.75
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$285.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$285.00
|
| 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 |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC COMVAX ADMINISTRATION
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890226
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC COMVAX ADMINISTRATION
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890226
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.96
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906811595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,351.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906811595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,169.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| 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 |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,419.85
|
| Rate for Payer: Riverside University Health System MISP |
$4,586.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,840.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
|
HC CONG R & L HEART W SEPTAL
|
Facility
|
OP
|
$7,338.00
|
|
|
Service Code
|
CPT 93533
|
| Hospital Charge Code |
906811253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,467.60 |
| Max. Negotiated Rate |
$15,933.00 |
| Rate for Payer: Adventist Health Commercial |
$1,467.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,237.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,035.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,503.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| 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 |
$3,302.10
|
| Rate for Payer: Cash Price |
$3,302.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,870.40
|
| Rate for Payer: Cigna of CA HMO |
$4,769.70
|
| Rate for Payer: Cigna of CA PPO |
$5,430.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,237.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,237.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,237.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,136.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,935.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,935.20
|
| Rate for Payer: Galaxy Health WC |
$6,237.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,402.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,604.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,659.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,663.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,329.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,467.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,136.60
|
| Rate for Payer: Multiplan Commercial |
$5,503.50
|
| Rate for Payer: Networks By Design Commercial |
$4,769.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,237.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,935.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,402.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,402.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,669.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,669.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,669.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,669.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,237.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,237.30
|
| Rate for Payer: Vantage Medical Group Senior |
$6,237.30
|
|
|
HC CONG R & L HEART W SEPTAL
|
Facility
|
IP
|
$7,338.00
|
|
|
Service Code
|
CPT 93533
|
| Hospital Charge Code |
906811253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,467.60 |
| Max. Negotiated Rate |
$6,604.20 |
| Rate for Payer: Adventist Health Commercial |
$1,467.60
|
| Rate for Payer: Cash Price |
$3,302.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,870.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,136.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,935.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,935.20
|
| Rate for Payer: Galaxy Health WC |
$6,237.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,402.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,604.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,659.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,329.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,467.60
|
| Rate for Payer: Multiplan Commercial |
$5,503.50
|
| Rate for Payer: Networks By Design Commercial |
$4,769.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,237.30
|
|
|
HC CONG R & L HEART W TRANSEPTAL
|
Facility
|
OP
|
$6,638.00
|
|
|
Service Code
|
CPT 93532
|
| Hospital Charge Code |
906811252
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,327.60 |
| Max. Negotiated Rate |
$15,933.00 |
| Rate for Payer: Adventist Health Commercial |
$1,327.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,642.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,650.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,978.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| 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 |
$2,987.10
|
| Rate for Payer: Cash Price |
$2,987.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,310.40
|
| Rate for Payer: Cigna of CA HMO |
$4,314.70
|
| Rate for Payer: Cigna of CA PPO |
$4,912.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,642.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,642.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,642.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,646.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,655.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,655.20
|
| Rate for Payer: Galaxy Health WC |
$5,642.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,982.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,974.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,215.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,409.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,916.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,327.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,646.60
|
| Rate for Payer: Multiplan Commercial |
$4,978.50
|
| Rate for Payer: Networks By Design Commercial |
$4,314.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,642.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,655.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,982.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,982.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,319.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,319.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,319.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,642.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,642.30
|
| Rate for Payer: Vantage Medical Group Senior |
$5,642.30
|
|
|
HC CONG R & L HEART W TRANSEPTAL
|
Facility
|
IP
|
$6,638.00
|
|
|
Service Code
|
CPT 93532
|
| Hospital Charge Code |
906811252
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,327.60 |
| Max. Negotiated Rate |
$5,974.20 |
| Rate for Payer: Adventist Health Commercial |
$1,327.60
|
| Rate for Payer: Cash Price |
$2,987.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,310.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,646.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,655.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,655.20
|
| Rate for Payer: Galaxy Health WC |
$5,642.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,982.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,974.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,215.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,916.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,327.60
|
| Rate for Payer: Multiplan Commercial |
$4,978.50
|
| Rate for Payer: Networks By Design Commercial |
$4,314.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,642.30
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,351.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,169.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| 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 |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,419.85
|
| Rate for Payer: Riverside University Health System MISP |
$4,586.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,840.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,351.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,169.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| 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 |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,419.85
|
| Rate for Payer: Riverside University Health System MISP |
$4,586.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,840.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
|
HC CONG RT HEART CATH ABNL NAT
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,169.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| 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 |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,419.85
|
| Rate for Payer: Riverside University Health System MISP |
$4,586.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,840.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
|
HC CONG RT HEART CATH ABNL NAT
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,351.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,169.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| 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 |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,419.85
|
| Rate for Payer: Riverside University Health System MISP |
$4,586.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,840.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$2,556.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,606.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,351.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONIZATION CERVIX LOOP ELECTRODE EXCISSION
|
Facility
|
OP
|
$12,504.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
900100035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$386.09 |
| Max. Negotiated Rate |
$11,253.60 |
| Rate for Payer: Adventist Health Commercial |
$2,500.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,163.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,518.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| 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 |
$7,927.54
|
| Rate for Payer: Blue Shield of California EPN |
$4,989.10
|
| Rate for Payer: Cash Price |
$5,626.80
|
| Rate for Payer: Cash Price |
$5,626.80
|
| Rate for Payer: Cash Price |
$5,626.80
|
| Rate for Payer: Central Health Plan Commercial |
$10,003.20
|
| Rate for Payer: Cigna of CA HMO |
$8,002.56
|
| Rate for Payer: Cigna of CA PPO |
$9,252.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,752.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Galaxy Health WC |
$10,628.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,502.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,253.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,940.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$426.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,828.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,500.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan Commercial |
$9,378.00
|
| Rate for Payer: Networks By Design Commercial |
$8,127.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Prime Health Services Commercial |
$10,628.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,502.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,502.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,252.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,252.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,252.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,252.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
HC CONIZATION CERVIX LOOP ELECTRODE EXCISSION
|
Facility
|
IP
|
$12,504.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
900100035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,500.80 |
| Max. Negotiated Rate |
$11,253.60 |
| Rate for Payer: Adventist Health Commercial |
$2,500.80
|
| Rate for Payer: Cash Price |
$5,626.80
|
| Rate for Payer: Central Health Plan Commercial |
$10,003.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,752.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,001.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,001.60
|
| Rate for Payer: Galaxy Health WC |
$10,628.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,502.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,253.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,940.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,377.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,500.80
|
| Rate for Payer: Multiplan Commercial |
$9,378.00
|
| Rate for Payer: Networks By Design Commercial |
$8,127.60
|
| Rate for Payer: Prime Health Services Commercial |
$10,628.40
|
|
|
HC CONSULT WITH SLIDE PREP
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
903800034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$373.11 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Adventist Health Commercial |
$132.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$67.02
|
| Rate for Payer: Adventist Health Medi-Cal |
$67.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$373.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$373.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.29
|
| Rate for Payer: Blue Shield of California Commercial |
$416.43
|
| Rate for Payer: Blue Shield of California Commercial |
$120.96
|
| Rate for Payer: Blue Shield of California EPN |
$262.42
|
| Rate for Payer: Blue Shield of California EPN |
$76.22
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Central Health Plan Commercial |
$153.60
|
| Rate for Payer: Central Health Plan Commercial |
$528.80
|
| Rate for Payer: Cigna of CA HMO |
$423.04
|
| Rate for Payer: Cigna of CA HMO |
$122.88
|
| Rate for Payer: Cigna of CA PPO |
$489.14
|
| Rate for Payer: Cigna of CA PPO |
$142.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$134.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$462.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.58
|
| Rate for Payer: EPIC Health Plan Senior |
$73.72
|
| Rate for Payer: EPIC Health Plan Senior |
$73.72
|
| Rate for Payer: Galaxy Health WC |
$561.85
|
| Rate for Payer: Galaxy Health WC |
$163.20
|
| Rate for Payer: Global Benefits Group Commercial |
$396.60
|
| Rate for Payer: Global Benefits Group Commercial |
$115.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$594.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$172.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$109.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$109.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$152.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$152.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$121.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$419.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$167.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$167.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.81
|
| Rate for Payer: Multiplan Commercial |
$495.75
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$124.80
|
| Rate for Payer: Networks By Design Commercial |
$429.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$67.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$67.02
|
| Rate for Payer: Prime Health Services Commercial |
$561.85
|
| Rate for Payer: Prime Health Services Commercial |
$163.20
|
| Rate for Payer: Prime Health Services Medicare |
$71.04
|
| Rate for Payer: Prime Health Services Medicare |
$71.04
|
| Rate for Payer: Riverside University Health System MISP |
$73.72
|
| Rate for Payer: Riverside University Health System MISP |
$73.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$396.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$396.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$67.02
|
| Rate for Payer: Upland Medical Group Pediatric |
$67.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
|
|
HC CONSULT WITH SLIDE PREP
|
Facility
|
IP
|
$661.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
903800034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$132.20 |
| Max. Negotiated Rate |
$594.90 |
| Rate for Payer: Adventist Health Commercial |
$132.20
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Central Health Plan Commercial |
$528.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$462.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.40
|
| Rate for Payer: EPIC Health Plan Senior |
$264.40
|
| Rate for Payer: Galaxy Health WC |
$561.85
|
| Rate for Payer: Global Benefits Group Commercial |
$396.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$594.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$419.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$389.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.20
|
| Rate for Payer: Multiplan Commercial |
$495.75
|
| Rate for Payer: Networks By Design Commercial |
$429.65
|
| Rate for Payer: Prime Health Services Commercial |
$561.85
|
|
|
HC CONT GLUC MNTR PT PROV EQP
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
900095249
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$435.60 |
| Rate for Payer: Adventist Health Commercial |
$96.80
|
| Rate for Payer: Cash Price |
$217.80
|
| Rate for Payer: Central Health Plan Commercial |
$387.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$338.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$193.60
|
| Rate for Payer: EPIC Health Plan Senior |
$193.60
|
| Rate for Payer: Galaxy Health WC |
$411.40
|
| Rate for Payer: Global Benefits Group Commercial |
$290.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$435.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$307.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$285.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.80
|
| Rate for Payer: Multiplan Commercial |
$363.00
|
| Rate for Payer: Networks By Design Commercial |
$314.60
|
| Rate for Payer: Prime Health Services Commercial |
$411.40
|
|
