|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
IP
|
$15,788.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
907201026
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$3,157.60 |
| Max. Negotiated Rate |
$14,209.20 |
| Rate for Payer: Cash Price |
$7,104.60
|
| Rate for Payer: Central Health Plan Commercial |
$12,630.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,315.20
|
| Rate for Payer: Galaxy Health WC |
$13,419.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,472.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,209.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,530.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,015.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,157.60
|
| Rate for Payer: Multiplan Commercial |
$11,841.00
|
| Rate for Payer: Networks By Design Commercial |
$10,262.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,419.80
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$11,400.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945000102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$542.38 |
| Max. Negotiated Rate |
$10,260.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$542.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$542.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,840.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$542.38
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,120.00
|
| Rate for Payer: Cigna of CA PPO |
$8,436.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.57
|
| Rate for Payer: Dignity Health Media |
$542.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$542.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$542.38
|
| Rate for Payer: Galaxy Health WC |
$9,690.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,260.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,550.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$889.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$894.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$542.38
|
| Rate for Payer: InnovAge PACE Commercial |
$813.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,603.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$726.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$726.79
|
| Rate for Payer: Multiplan Commercial |
$8,550.00
|
| Rate for Payer: Networks By Design Commercial |
$7,410.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,690.00
|
| Rate for Payer: Prime Health Services Medicare |
$574.92
|
| Rate for Payer: Riverside University Health System MISP |
$596.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,840.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Vantage Medical Group Senior |
$542.38
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
IP
|
$11,400.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945000102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,280.00 |
| Max. Negotiated Rate |
$10,260.00 |
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,560.00
|
| Rate for Payer: Galaxy Health WC |
$9,690.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,260.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,603.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,343.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Multiplan Commercial |
$8,550.00
|
| Rate for Payer: Networks By Design Commercial |
$7,410.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,690.00
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$11,400.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945000102
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$10,260.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$542.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$542.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,840.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,170.60
|
| Rate for Payer: Blue Shield of California EPN |
$5,574.60
|
| Rate for Payer: Caremore Medicare Advantage |
$542.38
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,120.00
|
| Rate for Payer: Cigna of CA HMO |
$7,296.00
|
| Rate for Payer: Cigna of CA PPO |
$8,436.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.57
|
| Rate for Payer: Dignity Health Media |
$542.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$542.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$542.38
|
| Rate for Payer: Galaxy Health WC |
$9,690.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,260.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,550.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$889.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$894.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$542.38
|
| Rate for Payer: InnovAge PACE Commercial |
$813.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,603.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$726.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$726.79
|
| Rate for Payer: Multiplan Commercial |
$8,550.00
|
| Rate for Payer: Networks By Design Commercial |
$7,410.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,690.00
|
| Rate for Payer: Prime Health Services Medicare |
$574.92
|
| Rate for Payer: Riverside University Health System MISP |
$596.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,840.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,840.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$762.00
|
| Rate for Payer: United Healthcare All Other HMO |
$515.00
|
| Rate for Payer: United Healthcare HMO Rider |
$312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$285.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Vantage Medical Group Senior |
$542.38
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$11,400.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945100102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$542.38 |
| Max. Negotiated Rate |
$10,260.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$542.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$542.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,840.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$542.38
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,120.00
|
| Rate for Payer: Cigna of CA PPO |
$8,436.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.57
|
| Rate for Payer: Dignity Health Media |
$542.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$542.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$542.38
|
| Rate for Payer: Galaxy Health WC |
$9,690.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,260.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,550.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$889.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$894.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$542.38
|
| Rate for Payer: InnovAge PACE Commercial |
$813.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,603.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$726.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$726.79
|
| Rate for Payer: Multiplan Commercial |
$8,550.00
|
| Rate for Payer: Networks By Design Commercial |
$7,410.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,690.00
|
| Rate for Payer: Prime Health Services Medicare |
$574.92
|
| Rate for Payer: Riverside University Health System MISP |
$596.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,840.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Vantage Medical Group Senior |
$542.38
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
IP
|
$11,400.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945100102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,280.00 |
| Max. Negotiated Rate |
$10,260.00 |
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,560.00
|
| Rate for Payer: Galaxy Health WC |
$9,690.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,260.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,603.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,343.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Multiplan Commercial |
$8,550.00
|
| Rate for Payer: Networks By Design Commercial |
$7,410.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,690.00
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
IP
|
$11,400.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945000102
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,280.00 |
| Max. Negotiated Rate |
$10,260.00 |
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,560.00
|
| Rate for Payer: Galaxy Health WC |
$9,690.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,260.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,603.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,343.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Multiplan Commercial |
$8,550.00
|
| Rate for Payer: Networks By Design Commercial |
$7,410.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,690.00
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
IP
|
$11,400.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
946100102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,280.00 |
| Max. Negotiated Rate |
$10,260.00 |
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,560.00
|
| Rate for Payer: Galaxy Health WC |
$9,690.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,260.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,603.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,343.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Multiplan Commercial |
$8,550.00
|
| Rate for Payer: Networks By Design Commercial |
$7,410.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,690.00
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$11,400.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
946100102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$542.38 |
| Max. Negotiated Rate |
$10,260.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$542.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$542.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,840.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$542.38
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Cash Price |
$5,130.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,120.00
|
| Rate for Payer: Cigna of CA PPO |
$8,436.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.57
|
| Rate for Payer: Dignity Health Media |
$542.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$542.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$542.38
|
| Rate for Payer: Galaxy Health WC |
$9,690.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,840.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,260.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,550.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$889.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$894.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$542.38
|
| Rate for Payer: InnovAge PACE Commercial |
$813.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,603.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,280.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$726.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$726.79
|
| Rate for Payer: Multiplan Commercial |
$8,550.00
|
| Rate for Payer: Networks By Design Commercial |
$7,410.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,690.00
|
| Rate for Payer: Prime Health Services Medicare |
$574.92
|
| Rate for Payer: Riverside University Health System MISP |
$596.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,840.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Vantage Medical Group Senior |
$542.38
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$11,758.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,351.60 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,703.20
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,479.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$11,758.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,856.85 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,054.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: Cigna of CA PPO |
$8,700.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Dignity Health Media |
$1,917.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,108.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,818.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,163.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,917.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Riverside University Health System MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,054.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$11,758.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
946100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,351.60 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,703.20
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,479.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$11,758.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,054.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,395.78
|
| Rate for Payer: Blue Shield of California EPN |
$5,749.66
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: Cigna of CA HMO |
$7,525.12
|
| Rate for Payer: Cigna of CA PPO |
$8,700.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Dignity Health Media |
$1,917.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,108.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,818.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,163.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,917.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Riverside University Health System MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,054.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,054.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$762.00
|
| Rate for Payer: United Healthcare All Other HMO |
$515.00
|
| Rate for Payer: United Healthcare HMO Rider |
$312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$285.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$11,758.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
946100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,856.85 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,054.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: Cigna of CA PPO |
$8,700.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Dignity Health Media |
$1,917.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,108.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,818.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,163.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,917.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Riverside University Health System MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,054.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC APHERESIS RBC
|
Facility
|
OP
|
$11,758.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,856.85 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,054.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: Cigna of CA PPO |
$8,700.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Dignity Health Media |
$1,917.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,108.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,818.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,163.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,917.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Riverside University Health System MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,054.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$11,758.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945100101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,351.60 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,703.20
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,479.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
|
|
HC APHERESIS RBC
|
Facility
|
IP
|
$11,758.00
|
|
|
Service Code
|
CPT 36512
|
| Hospital Charge Code |
945000101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,351.60 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,703.20
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,479.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$11,758.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
946100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,856.85 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,054.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: Cigna of CA PPO |
$8,700.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Dignity Health Media |
$1,917.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,108.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,818.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,163.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,917.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Riverside University Health System MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,054.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$11,758.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$285.00 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,054.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,395.78
|
| Rate for Payer: Blue Shield of California EPN |
$5,749.66
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: Cigna of CA HMO |
$7,525.12
|
| Rate for Payer: Cigna of CA PPO |
$8,700.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Dignity Health Media |
$1,917.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,108.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,818.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,163.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,917.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Riverside University Health System MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,054.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,054.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$762.00
|
| Rate for Payer: United Healthcare All Other HMO |
$515.00
|
| Rate for Payer: United Healthcare HMO Rider |
$312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$285.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$11,758.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,351.60 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,703.20
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,479.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$11,758.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,351.60 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,703.20
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,479.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$11,758.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,856.85 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,054.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: Cigna of CA PPO |
$8,700.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Dignity Health Media |
$1,917.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,108.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,818.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,163.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,917.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Riverside University Health System MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,054.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC APHERESIS WBC
|
Facility
|
OP
|
$11,758.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,856.85 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,054.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: Cigna of CA PPO |
$8,700.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Dignity Health Media |
$1,917.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,108.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,818.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,163.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,917.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Riverside University Health System MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,054.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$11,758.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
946100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,351.60 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,703.20
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,479.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
|
|
HC APHERESIS WBC
|
Facility
|
IP
|
$11,758.00
|
|
|
Service Code
|
CPT 36511
|
| Hospital Charge Code |
945000100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,351.60 |
| Max. Negotiated Rate |
$10,582.20 |
| Rate for Payer: Cash Price |
$5,291.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,703.20
|
| Rate for Payer: Galaxy Health WC |
$9,994.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,054.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,582.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,842.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,479.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,351.60
|
| Rate for Payer: Multiplan Commercial |
$8,818.50
|
| Rate for Payer: Networks By Design Commercial |
$7,642.70
|
| Rate for Payer: Prime Health Services Commercial |
$9,994.30
|
|
