|
HC CROSSMATCH XM
|
Facility
|
IP
|
$761.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
900904551
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$152.20 |
| Max. Negotiated Rate |
$684.90 |
| Rate for Payer: Adventist Health Commercial |
$152.20
|
| Rate for Payer: Cash Price |
$342.45
|
| Rate for Payer: Central Health Plan Commercial |
$608.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$532.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$304.40
|
| Rate for Payer: EPIC Health Plan Senior |
$304.40
|
| Rate for Payer: Galaxy Health WC |
$646.85
|
| Rate for Payer: Global Benefits Group Commercial |
$456.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$684.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$483.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$448.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.20
|
| Rate for Payer: Multiplan Commercial |
$570.75
|
| Rate for Payer: Networks By Design Commercial |
$494.65
|
| Rate for Payer: Prime Health Services Commercial |
$646.85
|
|
|
HC CRPRA CVRNSA-CRPS SPNGSM SHNT, UNI OR BI
|
Facility
|
IP
|
$15,131.00
|
|
|
Service Code
|
CPT 54430
|
| Hospital Charge Code |
900504430
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,026.20 |
| Max. Negotiated Rate |
$13,617.90 |
| Rate for Payer: Adventist Health Commercial |
$3,026.20
|
| Rate for Payer: Cash Price |
$6,808.95
|
| Rate for Payer: Central Health Plan Commercial |
$12,104.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,591.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,052.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,052.40
|
| Rate for Payer: Galaxy Health WC |
$12,861.35
|
| Rate for Payer: Global Benefits Group Commercial |
$9,078.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,617.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,608.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,927.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,026.20
|
| Rate for Payer: Multiplan Commercial |
$11,348.25
|
| Rate for Payer: Networks By Design Commercial |
$9,835.15
|
| Rate for Payer: Prime Health Services Commercial |
$12,861.35
|
|
|
HC CRPRA CVRNSA-CRPS SPNGSM SHNT, UNI OR BI
|
Facility
|
OP
|
$15,131.00
|
|
|
Service Code
|
CPT 54430
|
| Hospital Charge Code |
900504430
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$13,617.90 |
| Rate for Payer: Adventist Health Commercial |
$3,026.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,861.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,322.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,348.25
|
| 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: Cash Price |
$6,808.95
|
| Rate for Payer: Cash Price |
$6,808.95
|
| Rate for Payer: Cash Price |
$6,808.95
|
| Rate for Payer: Cash Price |
$6,808.95
|
| Rate for Payer: Central Health Plan Commercial |
$12,104.80
|
| Rate for Payer: Cigna of CA HMO |
$9,683.84
|
| Rate for Payer: Cigna of CA PPO |
$11,196.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,861.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,861.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12,861.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,591.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,052.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,052.40
|
| Rate for Payer: Galaxy Health WC |
$12,861.35
|
| Rate for Payer: Global Benefits Group Commercial |
$9,078.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,617.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,608.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$929.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,927.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,026.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,591.70
|
| Rate for Payer: Multiplan Commercial |
$11,348.25
|
| Rate for Payer: Networks By Design Commercial |
$9,835.15
|
| Rate for Payer: Prime Health Services Commercial |
$12,861.35
|
| Rate for Payer: Riverside University Health System MISP |
$6,052.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,078.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,565.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,565.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,565.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,565.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,861.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,861.35
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.35
|
|
|
HC CRYABLATION BONE
|
Facility
|
OP
|
$24,364.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$21,927.60 |
| Rate for Payer: Adventist Health Commercial |
$4,872.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Central Health Plan Commercial |
$19,491.20
|
| Rate for Payer: Cigna of CA HMO |
$15,592.96
|
| Rate for Payer: Cigna of CA PPO |
$18,029.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,054.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$20,709.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14,618.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,927.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,471.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$341.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,872.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$18,273.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$15,836.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$20,709.40
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,618.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,182.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,182.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,182.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CRYABLATION BONE
|
Facility
|
IP
|
$24,364.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,872.80 |
| Max. Negotiated Rate |
$21,927.60 |
| Rate for Payer: Adventist Health Commercial |
$4,872.80
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Central Health Plan Commercial |
$19,491.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,054.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,745.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,745.60
|
| Rate for Payer: Galaxy Health WC |
$20,709.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14,618.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,927.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,471.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,374.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,872.80
|
| Rate for Payer: Multiplan Commercial |
$18,273.00
|
| Rate for Payer: Networks By Design Commercial |
$15,836.60
|
| Rate for Payer: Prime Health Services Commercial |
$20,709.40
|
|
|
HC CRYABLATION BONE
|
Facility
|
IP
|
$24,364.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,872.80 |
| Max. Negotiated Rate |
$21,927.60 |
| Rate for Payer: Adventist Health Commercial |
$4,872.80
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Central Health Plan Commercial |
$19,491.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,054.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,745.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,745.60
|
| Rate for Payer: Galaxy Health WC |
$20,709.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14,618.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,927.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,471.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,374.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,872.80
|
| Rate for Payer: Multiplan Commercial |
$18,273.00
|
| Rate for Payer: Networks By Design Commercial |
$15,836.60
|
| Rate for Payer: Prime Health Services Commercial |
$20,709.40
|
|
|
HC CRYABLATION BONE
|
Facility
|
OP
|
$24,364.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$317.26 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$4,872.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$317.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,797.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,172.54
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$485.64
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Cash Price |
$10,963.80
|
| Rate for Payer: Central Health Plan Commercial |
$19,491.20
|
| Rate for Payer: Cigna of CA HMO |
$15,592.96
|
| Rate for Payer: Cigna of CA PPO |
$18,029.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$475.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$348.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,054.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$523.48
|
| Rate for Payer: EPIC Health Plan Senior |
$348.99
|
| Rate for Payer: Galaxy Health WC |
$20,709.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14,618.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,927.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$520.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,471.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,872.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$425.13
|
| Rate for Payer: Multiplan Commercial |
$18,273.00
|
| Rate for Payer: Multiplan WC |
$485.64
|
| Rate for Payer: Networks By Design Commercial |
$15,836.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$317.26
|
| Rate for Payer: Preferred Health Network WC |
$495.55
|
| Rate for Payer: Prime Health Services Commercial |
$20,709.40
|
| Rate for Payer: Prime Health Services Medicare |
$336.30
|
| Rate for Payer: Prime Health Services WC |
$480.68
|
| Rate for Payer: Riverside University Health System MISP |
$348.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,618.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,182.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$317.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$475.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$348.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.26
|
|
|
HC CRYO ABLATE BONE TUMOR(S) PERQ
|
Facility
|
IP
|
$22,916.00
|
|
|
Service Code
|
CPT 20983
|
| Hospital Charge Code |
909020983
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,583.20 |
| Max. Negotiated Rate |
$20,624.40 |
| Rate for Payer: Adventist Health Commercial |
$4,583.20
|
| Rate for Payer: Cash Price |
$10,312.20
|
| Rate for Payer: Central Health Plan Commercial |
$18,332.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,041.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,166.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,166.40
|
| Rate for Payer: Galaxy Health WC |
$19,478.60
|
| Rate for Payer: Global Benefits Group Commercial |
$13,749.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,624.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,551.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,520.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,583.20
|
| Rate for Payer: Multiplan Commercial |
$17,187.00
|
| Rate for Payer: Networks By Design Commercial |
$14,895.40
|
| Rate for Payer: Prime Health Services Commercial |
$19,478.60
|
|
|
HC CRYO ABLATE BONE TUMOR(S) PERQ
|
Facility
|
OP
|
$22,916.00
|
|
|
Service Code
|
CPT 20983
|
| Hospital Charge Code |
909020983
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$589.77 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,583.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$9,332.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$14,462.30
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$10,312.20
|
| Rate for Payer: Cash Price |
$10,312.20
|
| Rate for Payer: Cash Price |
$10,312.20
|
| Rate for Payer: Central Health Plan Commercial |
$18,332.80
|
| Rate for Payer: Cigna of CA HMO |
$14,666.24
|
| Rate for Payer: Cigna of CA PPO |
$16,957.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,041.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,398.95
|
| Rate for Payer: EPIC Health Plan Senior |
$10,265.97
|
| Rate for Payer: Galaxy Health WC |
$19,478.60
|
| Rate for Payer: Global Benefits Group Commercial |
$13,749.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,624.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,305.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$589.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,551.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$651.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,065.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,583.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,505.82
|
| Rate for Payer: Multiplan Commercial |
$17,187.00
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Networks By Design Commercial |
$14,895.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Preferred Health Network WC |
$14,757.45
|
| Rate for Payer: Prime Health Services Commercial |
$19,478.60
|
| Rate for Payer: Prime Health Services Medicare |
$9,892.66
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: Riverside University Health System MISP |
$10,265.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,749.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,458.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,332.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
HC CRYOABLATION-LUNG
|
Facility
|
IP
|
$16,169.00
|
|
|
Service Code
|
CPT 32994
|
| Hospital Charge Code |
909020150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,233.80 |
| Max. Negotiated Rate |
$14,552.10 |
| Rate for Payer: Adventist Health Commercial |
$3,233.80
|
| Rate for Payer: Cash Price |
$7,276.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,935.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,318.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,467.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,467.60
|
| Rate for Payer: Galaxy Health WC |
$13,743.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,701.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,552.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,267.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,539.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,233.80
|
| Rate for Payer: Multiplan Commercial |
$12,126.75
|
| Rate for Payer: Networks By Design Commercial |
$10,509.85
|
| Rate for Payer: Prime Health Services Commercial |
$13,743.65
|
|
|
HC CRYOABLATION-LUNG
|
Facility
|
OP
|
$16,169.00
|
|
|
Service Code
|
CPT 32994
|
| Hospital Charge Code |
909020150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,165.61 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,233.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,671.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,671.74
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$21,077.25
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$7,276.05
|
| Rate for Payer: Cash Price |
$7,276.05
|
| Rate for Payer: Cash Price |
$7,276.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,935.20
|
| Rate for Payer: Cigna of CA HMO |
$10,348.16
|
| Rate for Payer: Cigna of CA PPO |
$11,965.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,038.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,671.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,318.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,558.37
|
| Rate for Payer: EPIC Health Plan Senior |
$15,038.91
|
| Rate for Payer: Galaxy Health WC |
$13,743.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,701.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,552.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,421.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,904.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,267.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,940.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19,140.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,233.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,320.13
|
| Rate for Payer: Multiplan Commercial |
$12,126.75
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: Networks By Design Commercial |
$10,509.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Preferred Health Network WC |
$21,507.40
|
| Rate for Payer: Prime Health Services Commercial |
$13,743.65
|
| Rate for Payer: Prime Health Services Medicare |
$14,492.04
|
| Rate for Payer: Prime Health Services WC |
$20,862.18
|
| Rate for Payer: Riverside University Health System MISP |
$15,038.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,701.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,084.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,671.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13,671.74
|
|
|
HC CRYOABLATION PROBE
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C2618
|
| Hospital Charge Code |
909020059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$4,526.43 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,526.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,268.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2,472.60
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,415.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CRYOABLATION PROBE
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C2618
|
| Hospital Charge Code |
909020059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CRYO ABLAT LIVER TUMOR
|
Facility
|
IP
|
$15,698.00
|
|
|
Service Code
|
CPT 47381
|
| Hospital Charge Code |
909000269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,139.60 |
| Max. Negotiated Rate |
$14,128.20 |
| Rate for Payer: Adventist Health Commercial |
$3,139.60
|
| Rate for Payer: Cash Price |
$7,064.10
|
| Rate for Payer: Central Health Plan Commercial |
$12,558.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,988.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,279.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,279.20
|
| Rate for Payer: Galaxy Health WC |
$13,343.30
|
| Rate for Payer: Global Benefits Group Commercial |
$9,418.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,128.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,968.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,261.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,139.60
|
| Rate for Payer: Multiplan Commercial |
$11,773.50
|
| Rate for Payer: Networks By Design Commercial |
$10,203.70
|
| Rate for Payer: Prime Health Services Commercial |
$13,343.30
|
|
|
HC CRYO ABLAT LIVER TUMOR
|
Facility
|
OP
|
$15,698.00
|
|
|
Service Code
|
CPT 47381
|
| Hospital Charge Code |
909000269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$316.98 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$3,139.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,343.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,633.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,773.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$7,064.10
|
| Rate for Payer: Cash Price |
$7,064.10
|
| Rate for Payer: Cash Price |
$7,064.10
|
| Rate for Payer: Central Health Plan Commercial |
$12,558.40
|
| Rate for Payer: Cigna of CA HMO |
$10,046.72
|
| Rate for Payer: Cigna of CA PPO |
$11,616.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,343.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,343.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,343.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,988.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,279.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,279.20
|
| Rate for Payer: Galaxy Health WC |
$13,343.30
|
| Rate for Payer: Global Benefits Group Commercial |
$9,418.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,128.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$316.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,968.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$350.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,261.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,139.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,988.60
|
| Rate for Payer: Multiplan Commercial |
$11,773.50
|
| Rate for Payer: Networks By Design Commercial |
$10,203.70
|
| Rate for Payer: Prime Health Services Commercial |
$13,343.30
|
| Rate for Payer: Riverside University Health System MISP |
$6,279.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,418.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,849.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,343.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,343.30
|
| Rate for Payer: Vantage Medical Group Senior |
$13,343.30
|
|
|
HC CRYO ABLAT RENAL TUMOR
|
Facility
|
IP
|
$19,100.00
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
909000268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,820.00 |
| Max. Negotiated Rate |
$17,190.00 |
| Rate for Payer: Adventist Health Commercial |
$3,820.00
|
| Rate for Payer: Cash Price |
$8,595.00
|
| Rate for Payer: Central Health Plan Commercial |
$15,280.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,370.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,640.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,640.00
|
| Rate for Payer: Galaxy Health WC |
$16,235.00
|
| Rate for Payer: Global Benefits Group Commercial |
$11,460.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,190.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,128.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,269.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,820.00
|
| Rate for Payer: Multiplan Commercial |
$14,325.00
|
| Rate for Payer: Networks By Design Commercial |
$12,415.00
|
| Rate for Payer: Prime Health Services Commercial |
$16,235.00
|
|
|
HC CRYO ABLAT RENAL TUMOR
|
Facility
|
OP
|
$19,100.00
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
909000268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,165.61 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,820.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,671.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,671.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,077.25
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$8,595.00
|
| Rate for Payer: Cash Price |
$8,595.00
|
| Rate for Payer: Cash Price |
$8,595.00
|
| Rate for Payer: Central Health Plan Commercial |
$15,280.00
|
| Rate for Payer: Cigna of CA HMO |
$12,224.00
|
| Rate for Payer: Cigna of CA PPO |
$14,134.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,038.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,671.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,370.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,558.37
|
| Rate for Payer: EPIC Health Plan Senior |
$15,038.91
|
| Rate for Payer: Galaxy Health WC |
$16,235.00
|
| Rate for Payer: Global Benefits Group Commercial |
$11,460.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,190.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,421.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,700.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,128.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,401.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19,140.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,820.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,320.13
|
| Rate for Payer: Multiplan Commercial |
$14,325.00
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: Networks By Design Commercial |
$12,415.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,671.74
|
| Rate for Payer: Preferred Health Network WC |
$21,507.40
|
| Rate for Payer: Prime Health Services Commercial |
$16,235.00
|
| Rate for Payer: Prime Health Services Medicare |
$14,492.04
|
| Rate for Payer: Prime Health Services WC |
$20,862.18
|
| Rate for Payer: Riverside University Health System MISP |
$15,038.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,460.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,550.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$13,671.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,507.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,038.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13,671.74
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
IP
|
$1,504.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$300.80 |
| Max. Negotiated Rate |
$1,353.60 |
| Rate for Payer: Adventist Health Commercial |
$300.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,203.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,052.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$601.60
|
| Rate for Payer: EPIC Health Plan Senior |
$601.60
|
| Rate for Payer: Galaxy Health WC |
$1,278.40
|
| Rate for Payer: Global Benefits Group Commercial |
$902.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,353.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$955.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$887.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.80
|
| Rate for Payer: Multiplan Commercial |
$1,128.00
|
| Rate for Payer: Networks By Design Commercial |
$977.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,278.40
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
OP
|
$1,504.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$300.80 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$300.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,203.20
|
| Rate for Payer: Cigna of CA HMO |
$962.56
|
| Rate for Payer: Cigna of CA PPO |
$1,112.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,052.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,278.40
|
| Rate for Payer: Global Benefits Group Commercial |
$902.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,353.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$955.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$351.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$1,128.00
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$977.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,278.40
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$902.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$752.00
|
| Rate for Payer: United Healthcare All Other HMO |
$752.00
|
| Rate for Payer: United Healthcare HMO Rider |
$752.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$752.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
IP
|
$1,504.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$300.80 |
| Max. Negotiated Rate |
$1,353.60 |
| Rate for Payer: Adventist Health Commercial |
$300.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,203.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,052.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$601.60
|
| Rate for Payer: EPIC Health Plan Senior |
$601.60
|
| Rate for Payer: Galaxy Health WC |
$1,278.40
|
| Rate for Payer: Global Benefits Group Commercial |
$902.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,353.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$955.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$887.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.80
|
| Rate for Payer: Multiplan Commercial |
$1,128.00
|
| Rate for Payer: Networks By Design Commercial |
$977.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,278.40
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
OP
|
$1,504.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$300.80 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$300.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$826.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$953.54
|
| Rate for Payer: Blue Shield of California EPN |
$600.10
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,203.20
|
| Rate for Payer: Cigna of CA HMO |
$962.56
|
| Rate for Payer: Cigna of CA PPO |
$1,112.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,052.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,278.40
|
| Rate for Payer: Global Benefits Group Commercial |
$902.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,353.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$318.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$955.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$351.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$1,128.00
|
| Rate for Payer: Networks By Design Commercial |
$977.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Prime Health Services Commercial |
$1,278.40
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$902.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$902.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$752.00
|
| Rate for Payer: United Healthcare All Other HMO |
$752.00
|
| Rate for Payer: United Healthcare HMO Rider |
$752.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$752.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC CRYOGLOBULINS QUAL
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
900910978
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Adventist Health Commercial |
$12.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.73
|
| Rate for Payer: Blue Shield of California Commercial |
$39.06
|
| Rate for Payer: Blue Shield of California Commercial |
$96.39
|
| Rate for Payer: Blue Shield of California EPN |
$24.61
|
| Rate for Payer: Blue Shield of California EPN |
$60.74
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: Central Health Plan Commercial |
$49.60
|
| Rate for Payer: Cigna of CA HMO |
$39.68
|
| Rate for Payer: Cigna of CA HMO |
$97.92
|
| Rate for Payer: Cigna of CA PPO |
$45.88
|
| Rate for Payer: Cigna of CA PPO |
$113.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$43.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.68
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: EPIC Health Plan Senior |
$7.12
|
| Rate for Payer: Galaxy Health WC |
$52.70
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$37.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$46.50
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Networks By Design Commercial |
$40.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: Prime Health Services Commercial |
$52.70
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC CRYOGLOBULINS QUAL
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
900910978
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC CSF LEAKAGE
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
CPT 78650
|
| Hospital Charge Code |
909301416
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$318.00 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Adventist Health Commercial |
$318.00
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,113.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$636.00
|
| Rate for Payer: EPIC Health Plan Senior |
$636.00
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,009.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$938.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
|
|
HC CSF LEAKAGE
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
CPT 78650
|
| Hospital Charge Code |
909301416
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$254.47 |
| Max. Negotiated Rate |
$2,747.46 |
| Rate for Payer: Adventist Health Commercial |
$318.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,665.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,901.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,665.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$953.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$924.90
|
| Rate for Payer: Blue Shield of California Commercial |
$1,001.70
|
| Rate for Payer: Blue Shield of California EPN |
$631.23
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: Cigna of CA HMO |
$1,017.60
|
| Rate for Payer: Cigna of CA PPO |
$1,176.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,831.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,665.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,113.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,747.46
|
| Rate for Payer: EPIC Health Plan Senior |
$1,831.64
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,730.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$254.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,009.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,331.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,231.27
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,765.04
|
| Rate for Payer: Riverside University Health System MISP |
$1,831.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$954.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$954.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,570.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,570.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,570.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,570.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,665.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,665.13
|
|
