|
HC COLLAR CERVICAL X-LG 4.0 X 22
|
Facility
|
IP
|
$43.13
|
|
|
Service Code
|
CPT L0120
|
| Hospital Charge Code |
901606824
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8.63 |
| Max. Negotiated Rate |
$38.82 |
| Rate for Payer: Adventist Health Commercial |
$8.63
|
| Rate for Payer: Blue Shield of California Commercial |
$33.34
|
| Rate for Payer: Blue Shield of California EPN |
$21.74
|
| Rate for Payer: Cash Price |
$23.72
|
| Rate for Payer: Central Health Plan Commercial |
$34.50
|
| Rate for Payer: Cigna of CA HMO |
$30.19
|
| Rate for Payer: Cigna of CA PPO |
$30.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.25
|
| Rate for Payer: EPIC Health Plan Senior |
$17.25
|
| Rate for Payer: Galaxy Health WC |
$36.66
|
| Rate for Payer: Global Benefits Group Commercial |
$25.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.63
|
| Rate for Payer: Multiplan Commercial |
$32.35
|
| Rate for Payer: Networks By Design Commercial |
$28.03
|
| Rate for Payer: Prime Health Services Commercial |
$36.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.19
|
| Rate for Payer: United Healthcare All Other HMO |
$15.76
|
| Rate for Payer: United Healthcare HMO Rider |
$15.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.13
|
|
|
HC COLLAR CERVICAL X-LG 4.0 X 22
|
Facility
|
OP
|
$43.13
|
|
|
Service Code
|
CPT L0120
|
| Hospital Charge Code |
901606824
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$14.13 |
| Max. Negotiated Rate |
$40.47 |
| Rate for Payer: Adventist Health Commercial |
$17.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.33
|
| Rate for Payer: Blue Shield of California Commercial |
$33.34
|
| Rate for Payer: Blue Shield of California EPN |
$21.74
|
| Rate for Payer: Cash Price |
$23.72
|
| Rate for Payer: Cash Price |
$23.72
|
| Rate for Payer: Central Health Plan Commercial |
$34.50
|
| Rate for Payer: Cigna of CA HMO |
$30.19
|
| Rate for Payer: Cigna of CA PPO |
$30.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$36.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.25
|
| Rate for Payer: EPIC Health Plan Senior |
$17.25
|
| Rate for Payer: Galaxy Health WC |
$36.66
|
| Rate for Payer: Global Benefits Group Commercial |
$25.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.64
|
| Rate for Payer: InnovAge PACE Commercial |
$21.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.19
|
| Rate for Payer: Multiplan Commercial |
$32.35
|
| Rate for Payer: Networks By Design Commercial |
$21.57
|
| Rate for Payer: Prime Health Services Commercial |
$36.66
|
| Rate for Payer: Riverside University Health System MISP |
$17.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.19
|
| Rate for Payer: United Healthcare All Other HMO |
$15.76
|
| Rate for Payer: United Healthcare HMO Rider |
$15.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.66
|
| Rate for Payer: Vantage Medical Group Senior |
$36.66
|
|
|
HC COLLAR FLEXIBLE FOAM
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
CPT L0120
|
| Hospital Charge Code |
915350120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Adventist Health Commercial |
$13.60
|
| Rate for Payer: Blue Shield of California Commercial |
$52.56
|
| Rate for Payer: Blue Shield of California EPN |
$34.27
|
| Rate for Payer: Cash Price |
$37.40
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: Cigna of CA HMO |
$47.60
|
| Rate for Payer: Cigna of CA PPO |
$47.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.20
|
| Rate for Payer: EPIC Health Plan Senior |
$27.20
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.60
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Networks By Design Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.52
|
| Rate for Payer: United Healthcare All Other HMO |
$24.84
|
| Rate for Payer: United Healthcare HMO Rider |
$24.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.27
|
|
|
HC COLLAR FLEXIBLE FOAM
|
Facility
|
IP
|
$68.00
|
|
|
Service Code
|
CPT L0120
|
| Hospital Charge Code |
905350120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Adventist Health Commercial |
$13.60
|
| Rate for Payer: Blue Shield of California Commercial |
$52.56
|
| Rate for Payer: Blue Shield of California EPN |
$34.27
|
| Rate for Payer: Cash Price |
$37.40
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: Cigna of CA HMO |
$47.60
|
| Rate for Payer: Cigna of CA PPO |
$47.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.20
|
| Rate for Payer: EPIC Health Plan Senior |
$27.20
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.60
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Networks By Design Commercial |
$44.20
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.52
|
| Rate for Payer: United Healthcare All Other HMO |
$24.84
|
| Rate for Payer: United Healthcare HMO Rider |
$24.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.27
|
|
|
HC COLLAR FLEXIBLE FOAM
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT L0120
|
| Hospital Charge Code |
915350120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$22.27 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Adventist Health Commercial |
$27.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$57.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.94
|
| Rate for Payer: Blue Shield of California Commercial |
$52.56
|
| Rate for Payer: Blue Shield of California EPN |
$34.27
|
| Rate for Payer: Cash Price |
$37.40
|
| Rate for Payer: Cash Price |
$37.40
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: Cigna of CA HMO |
$47.60
|
| Rate for Payer: Cigna of CA PPO |
$47.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$57.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$57.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.20
|
| Rate for Payer: EPIC Health Plan Senior |
$27.20
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.64
|
| Rate for Payer: InnovAge PACE Commercial |
$34.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Networks By Design Commercial |
$34.00
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
| Rate for Payer: Riverside University Health System MISP |
$27.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.52
|
| Rate for Payer: United Healthcare All Other HMO |
$24.84
|
| Rate for Payer: United Healthcare HMO Rider |
$24.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$57.80
|
| Rate for Payer: Vantage Medical Group Senior |
$57.80
|
|
|
HC COLLAR FLEXIBLE FOAM
|
Facility
|
OP
|
$68.00
|
|
|
Service Code
|
CPT L0120
|
| Hospital Charge Code |
905350120
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$22.27 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Adventist Health Commercial |
$27.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$57.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$37.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.94
|
| Rate for Payer: Blue Shield of California Commercial |
$52.56
|
| Rate for Payer: Blue Shield of California EPN |
$34.27
|
| Rate for Payer: Cash Price |
$37.40
|
| Rate for Payer: Cash Price |
$37.40
|
| Rate for Payer: Central Health Plan Commercial |
$54.40
|
| Rate for Payer: Cigna of CA HMO |
$47.60
|
| Rate for Payer: Cigna of CA PPO |
$47.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$57.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$57.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.20
|
| Rate for Payer: EPIC Health Plan Senior |
$27.20
|
| Rate for Payer: Galaxy Health WC |
$57.80
|
| Rate for Payer: Global Benefits Group Commercial |
$40.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$61.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36.64
|
| Rate for Payer: InnovAge PACE Commercial |
$34.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$45.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$47.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47.60
|
| Rate for Payer: Multiplan Commercial |
$51.00
|
| Rate for Payer: Networks By Design Commercial |
$34.00
|
| Rate for Payer: Prime Health Services Commercial |
$57.80
|
| Rate for Payer: Riverside University Health System MISP |
$27.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.52
|
| Rate for Payer: United Healthcare All Other HMO |
$24.84
|
| Rate for Payer: United Healthcare HMO Rider |
$24.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$57.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$57.80
|
| Rate for Payer: Vantage Medical Group Senior |
$57.80
|
|
|
HC COLLAR MIAMI J ACCESSORY
|
Facility
|
IP
|
$591.42
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605850
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$118.28 |
| Max. Negotiated Rate |
$532.28 |
| Rate for Payer: Adventist Health Commercial |
$118.28
|
| Rate for Payer: Blue Shield of California Commercial |
$457.17
|
| Rate for Payer: Blue Shield of California EPN |
$298.08
|
| Rate for Payer: Cash Price |
$325.28
|
| Rate for Payer: Central Health Plan Commercial |
$473.14
|
| Rate for Payer: Cigna of CA HMO |
$413.99
|
| Rate for Payer: Cigna of CA PPO |
$413.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.57
|
| Rate for Payer: EPIC Health Plan Senior |
$236.57
|
| Rate for Payer: Galaxy Health WC |
$502.71
|
| Rate for Payer: Global Benefits Group Commercial |
$354.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$532.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$394.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$225.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$366.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.28
|
| Rate for Payer: Multiplan Commercial |
$443.56
|
| Rate for Payer: Networks By Design Commercial |
$384.42
|
| Rate for Payer: Prime Health Services Commercial |
$502.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$221.96
|
| Rate for Payer: United Healthcare All Other HMO |
$216.05
|
| Rate for Payer: United Healthcare HMO Rider |
$211.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.69
|
|
|
HC COLLAR MIAMI J ACCESSORY
|
Facility
|
OP
|
$591.42
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605850
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$193.69 |
| Max. Negotiated Rate |
$532.28 |
| Rate for Payer: Adventist Health Commercial |
$242.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$502.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$325.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$443.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.34
|
| Rate for Payer: Blue Shield of California Commercial |
$457.17
|
| Rate for Payer: Blue Shield of California EPN |
$298.08
|
| Rate for Payer: Cash Price |
$325.28
|
| Rate for Payer: Cash Price |
$325.28
|
| Rate for Payer: Central Health Plan Commercial |
$473.14
|
| Rate for Payer: Cigna of CA HMO |
$413.99
|
| Rate for Payer: Cigna of CA PPO |
$413.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$502.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$502.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$502.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.57
|
| Rate for Payer: EPIC Health Plan Senior |
$236.57
|
| Rate for Payer: Galaxy Health WC |
$502.71
|
| Rate for Payer: Global Benefits Group Commercial |
$354.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$532.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$295.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$394.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$366.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$242.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$413.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.99
|
| Rate for Payer: Multiplan Commercial |
$443.56
|
| Rate for Payer: Networks By Design Commercial |
$295.71
|
| Rate for Payer: Prime Health Services Commercial |
$502.71
|
| Rate for Payer: Riverside University Health System MISP |
$236.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$354.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$354.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$221.96
|
| Rate for Payer: United Healthcare All Other HMO |
$216.05
|
| Rate for Payer: United Healthcare HMO Rider |
$211.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$502.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$502.71
|
| Rate for Payer: Vantage Medical Group Senior |
$502.71
|
|
|
HC COLLAR MIAMI J LG
|
Facility
|
OP
|
$192.22
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605403
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$62.95 |
| Max. Negotiated Rate |
$347.57 |
| Rate for Payer: Adventist Health Commercial |
$78.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$163.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$105.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$144.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.89
|
| Rate for Payer: Blue Shield of California Commercial |
$148.59
|
| Rate for Payer: Blue Shield of California EPN |
$96.88
|
| Rate for Payer: Cash Price |
$105.72
|
| Rate for Payer: Cash Price |
$105.72
|
| Rate for Payer: Central Health Plan Commercial |
$153.78
|
| Rate for Payer: Cigna of CA HMO |
$134.55
|
| Rate for Payer: Cigna of CA PPO |
$134.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$163.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$163.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.89
|
| Rate for Payer: EPIC Health Plan Senior |
$76.89
|
| Rate for Payer: Galaxy Health WC |
$163.39
|
| Rate for Payer: Global Benefits Group Commercial |
$115.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$96.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$118.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$134.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$134.55
|
| Rate for Payer: Multiplan Commercial |
$144.16
|
| Rate for Payer: Networks By Design Commercial |
$96.11
|
| Rate for Payer: Prime Health Services Commercial |
$163.39
|
| Rate for Payer: Riverside University Health System MISP |
$76.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.14
|
| Rate for Payer: United Healthcare All Other HMO |
$70.22
|
| Rate for Payer: United Healthcare HMO Rider |
$68.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$163.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$163.39
|
| Rate for Payer: Vantage Medical Group Senior |
$163.39
|
|
|
HC COLLAR MIAMI J LG
|
Facility
|
IP
|
$192.22
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605403
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$38.44 |
| Max. Negotiated Rate |
$173.00 |
| Rate for Payer: Adventist Health Commercial |
$38.44
|
| Rate for Payer: Blue Shield of California Commercial |
$148.59
|
| Rate for Payer: Blue Shield of California EPN |
$96.88
|
| Rate for Payer: Cash Price |
$105.72
|
| Rate for Payer: Central Health Plan Commercial |
$153.78
|
| Rate for Payer: Cigna of CA HMO |
$134.55
|
| Rate for Payer: Cigna of CA PPO |
$134.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.89
|
| Rate for Payer: EPIC Health Plan Senior |
$76.89
|
| Rate for Payer: Galaxy Health WC |
$163.39
|
| Rate for Payer: Global Benefits Group Commercial |
$115.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$118.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.44
|
| Rate for Payer: Multiplan Commercial |
$144.16
|
| Rate for Payer: Networks By Design Commercial |
$124.94
|
| Rate for Payer: Prime Health Services Commercial |
$163.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.14
|
| Rate for Payer: United Healthcare All Other HMO |
$70.22
|
| Rate for Payer: United Healthcare HMO Rider |
$68.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.95
|
|
|
HC COLLAR MIAMI J MED
|
Facility
|
IP
|
$192.22
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605401
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$38.44 |
| Max. Negotiated Rate |
$173.00 |
| Rate for Payer: Adventist Health Commercial |
$38.44
|
| Rate for Payer: Blue Shield of California Commercial |
$148.59
|
| Rate for Payer: Blue Shield of California EPN |
$96.88
|
| Rate for Payer: Cash Price |
$105.72
|
| Rate for Payer: Central Health Plan Commercial |
$153.78
|
| Rate for Payer: Cigna of CA HMO |
$134.55
|
| Rate for Payer: Cigna of CA PPO |
$134.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.89
|
| Rate for Payer: EPIC Health Plan Senior |
$76.89
|
| Rate for Payer: Galaxy Health WC |
$163.39
|
| Rate for Payer: Global Benefits Group Commercial |
$115.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$118.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.44
|
| Rate for Payer: Multiplan Commercial |
$144.16
|
| Rate for Payer: Networks By Design Commercial |
$124.94
|
| Rate for Payer: Prime Health Services Commercial |
$163.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.14
|
| Rate for Payer: United Healthcare All Other HMO |
$70.22
|
| Rate for Payer: United Healthcare HMO Rider |
$68.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.95
|
|
|
HC COLLAR MIAMI J MED
|
Facility
|
OP
|
$192.22
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605401
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$62.95 |
| Max. Negotiated Rate |
$347.57 |
| Rate for Payer: Adventist Health Commercial |
$78.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$163.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$105.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$144.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.89
|
| Rate for Payer: Blue Shield of California Commercial |
$148.59
|
| Rate for Payer: Blue Shield of California EPN |
$96.88
|
| Rate for Payer: Cash Price |
$105.72
|
| Rate for Payer: Cash Price |
$105.72
|
| Rate for Payer: Central Health Plan Commercial |
$153.78
|
| Rate for Payer: Cigna of CA HMO |
$134.55
|
| Rate for Payer: Cigna of CA PPO |
$134.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$163.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$163.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.89
|
| Rate for Payer: EPIC Health Plan Senior |
$76.89
|
| Rate for Payer: Galaxy Health WC |
$163.39
|
| Rate for Payer: Global Benefits Group Commercial |
$115.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$96.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$118.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$134.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$134.55
|
| Rate for Payer: Multiplan Commercial |
$144.16
|
| Rate for Payer: Networks By Design Commercial |
$96.11
|
| Rate for Payer: Prime Health Services Commercial |
$163.39
|
| Rate for Payer: Riverside University Health System MISP |
$76.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.14
|
| Rate for Payer: United Healthcare All Other HMO |
$70.22
|
| Rate for Payer: United Healthcare HMO Rider |
$68.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$163.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$163.39
|
| Rate for Payer: Vantage Medical Group Senior |
$163.39
|
|
|
HC COLLAR MIAMI J OCCIAN BACK JR
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901698297
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Blue Shield of California Commercial |
$270.55
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC COLLAR MIAMI J OCCIAN BACK JR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901698297
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$114.62 |
| Max. Negotiated Rate |
$347.57 |
| Rate for Payer: Adventist Health Commercial |
$143.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.56
|
| Rate for Payer: Blue Shield of California Commercial |
$270.55
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Cash Price |
$192.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC COLLAR MIAMI J PEDS P1
|
Facility
|
OP
|
$212.73
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605407
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$69.67 |
| Max. Negotiated Rate |
$347.57 |
| Rate for Payer: Adventist Health Commercial |
$87.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.94
|
| Rate for Payer: Blue Shield of California Commercial |
$164.44
|
| Rate for Payer: Blue Shield of California EPN |
$107.22
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$148.91
|
| Rate for Payer: Cigna of CA PPO |
$148.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$106.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$148.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$148.91
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$106.36
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: Riverside University Health System MISP |
$85.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$79.84
|
| Rate for Payer: United Healthcare All Other HMO |
$77.71
|
| Rate for Payer: United Healthcare HMO Rider |
$76.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.82
|
| Rate for Payer: Vantage Medical Group Senior |
$180.82
|
|
|
HC COLLAR MIAMI J PEDS P1
|
Facility
|
IP
|
$212.73
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605407
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Blue Shield of California Commercial |
$164.44
|
| Rate for Payer: Blue Shield of California EPN |
$107.22
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$148.91
|
| Rate for Payer: Cigna of CA PPO |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$79.84
|
| Rate for Payer: United Healthcare All Other HMO |
$77.71
|
| Rate for Payer: United Healthcare HMO Rider |
$76.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.67
|
|
|
HC COLLAR MIAMI J PEDS P2
|
Facility
|
OP
|
$212.73
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605408
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$69.67 |
| Max. Negotiated Rate |
$347.57 |
| Rate for Payer: Adventist Health Commercial |
$87.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.94
|
| Rate for Payer: Blue Shield of California Commercial |
$164.44
|
| Rate for Payer: Blue Shield of California EPN |
$107.22
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$148.91
|
| Rate for Payer: Cigna of CA PPO |
$148.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$106.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$148.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$148.91
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$106.36
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: Riverside University Health System MISP |
$85.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$79.84
|
| Rate for Payer: United Healthcare All Other HMO |
$77.71
|
| Rate for Payer: United Healthcare HMO Rider |
$76.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.82
|
| Rate for Payer: Vantage Medical Group Senior |
$180.82
|
|
|
HC COLLAR MIAMI J PEDS P2
|
Facility
|
IP
|
$212.73
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605408
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Blue Shield of California Commercial |
$164.44
|
| Rate for Payer: Blue Shield of California EPN |
$107.22
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$148.91
|
| Rate for Payer: Cigna of CA PPO |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$79.84
|
| Rate for Payer: United Healthcare All Other HMO |
$77.71
|
| Rate for Payer: United Healthcare HMO Rider |
$76.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.67
|
|
|
HC COLLAR MIAMI J PEDS P3
|
Facility
|
IP
|
$212.73
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605409
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Blue Shield of California Commercial |
$164.44
|
| Rate for Payer: Blue Shield of California EPN |
$107.22
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$148.91
|
| Rate for Payer: Cigna of CA PPO |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$79.84
|
| Rate for Payer: United Healthcare All Other HMO |
$77.71
|
| Rate for Payer: United Healthcare HMO Rider |
$76.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.67
|
|
|
HC COLLAR MIAMI J PEDS P3
|
Facility
|
OP
|
$212.73
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605409
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$69.67 |
| Max. Negotiated Rate |
$347.57 |
| Rate for Payer: Adventist Health Commercial |
$87.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.94
|
| Rate for Payer: Blue Shield of California Commercial |
$164.44
|
| Rate for Payer: Blue Shield of California EPN |
$107.22
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$148.91
|
| Rate for Payer: Cigna of CA PPO |
$148.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$106.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$148.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$148.91
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$106.36
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: Riverside University Health System MISP |
$85.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$79.84
|
| Rate for Payer: United Healthcare All Other HMO |
$77.71
|
| Rate for Payer: United Healthcare HMO Rider |
$76.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.82
|
| Rate for Payer: Vantage Medical Group Senior |
$180.82
|
|
|
HC COLLAR MIAMI J PEDS PO
|
Facility
|
OP
|
$212.73
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605406
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$69.67 |
| Max. Negotiated Rate |
$347.57 |
| Rate for Payer: Adventist Health Commercial |
$87.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$124.94
|
| Rate for Payer: Blue Shield of California Commercial |
$164.44
|
| Rate for Payer: Blue Shield of California EPN |
$107.22
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$148.91
|
| Rate for Payer: Cigna of CA PPO |
$148.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$180.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$180.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.64
|
| Rate for Payer: InnovAge PACE Commercial |
$106.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$148.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$148.91
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$106.36
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: Riverside University Health System MISP |
$85.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$79.84
|
| Rate for Payer: United Healthcare All Other HMO |
$77.71
|
| Rate for Payer: United Healthcare HMO Rider |
$76.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$180.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.82
|
| Rate for Payer: Vantage Medical Group Senior |
$180.82
|
|
|
HC COLLAR MIAMI J PEDS PO
|
Facility
|
IP
|
$212.73
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605406
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.55 |
| Max. Negotiated Rate |
$191.46 |
| Rate for Payer: Adventist Health Commercial |
$42.55
|
| Rate for Payer: Blue Shield of California Commercial |
$164.44
|
| Rate for Payer: Blue Shield of California EPN |
$107.22
|
| Rate for Payer: Cash Price |
$117.00
|
| Rate for Payer: Central Health Plan Commercial |
$170.18
|
| Rate for Payer: Cigna of CA HMO |
$148.91
|
| Rate for Payer: Cigna of CA PPO |
$148.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.09
|
| Rate for Payer: EPIC Health Plan Senior |
$85.09
|
| Rate for Payer: Galaxy Health WC |
$180.82
|
| Rate for Payer: Global Benefits Group Commercial |
$127.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$141.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$131.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.55
|
| Rate for Payer: Multiplan Commercial |
$159.55
|
| Rate for Payer: Networks By Design Commercial |
$138.27
|
| Rate for Payer: Prime Health Services Commercial |
$180.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$79.84
|
| Rate for Payer: United Healthcare All Other HMO |
$77.71
|
| Rate for Payer: United Healthcare HMO Rider |
$76.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.67
|
|
|
HC COLLAR MIAMI J REPLACEMENT PAD
|
Facility
|
OP
|
$116.36
|
|
|
Service Code
|
CPT L9900
|
| Hospital Charge Code |
901698555
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$38.11 |
| Max. Negotiated Rate |
$104.72 |
| Rate for Payer: Adventist Health Commercial |
$47.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$98.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$87.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.34
|
| Rate for Payer: Blue Shield of California Commercial |
$89.95
|
| Rate for Payer: Blue Shield of California EPN |
$58.65
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Central Health Plan Commercial |
$93.09
|
| Rate for Payer: Cigna of CA HMO |
$81.45
|
| Rate for Payer: Cigna of CA PPO |
$81.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$98.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$98.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.54
|
| Rate for Payer: EPIC Health Plan Senior |
$46.54
|
| Rate for Payer: Galaxy Health WC |
$98.91
|
| Rate for Payer: Global Benefits Group Commercial |
$69.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.72
|
| Rate for Payer: InnovAge PACE Commercial |
$58.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$81.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$81.45
|
| Rate for Payer: Multiplan Commercial |
$87.27
|
| Rate for Payer: Networks By Design Commercial |
$58.18
|
| Rate for Payer: Prime Health Services Commercial |
$98.91
|
| Rate for Payer: Riverside University Health System MISP |
$46.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.67
|
| Rate for Payer: United Healthcare All Other HMO |
$42.51
|
| Rate for Payer: United Healthcare HMO Rider |
$41.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$98.91
|
| Rate for Payer: Vantage Medical Group Senior |
$98.91
|
|
|
HC COLLAR MIAMI J REPLACEMENT PAD
|
Facility
|
IP
|
$116.36
|
|
|
Service Code
|
CPT L9900
|
| Hospital Charge Code |
901698555
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$23.27 |
| Max. Negotiated Rate |
$104.72 |
| Rate for Payer: Adventist Health Commercial |
$23.27
|
| Rate for Payer: Blue Shield of California Commercial |
$89.95
|
| Rate for Payer: Blue Shield of California EPN |
$58.65
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Central Health Plan Commercial |
$93.09
|
| Rate for Payer: Cigna of CA HMO |
$81.45
|
| Rate for Payer: Cigna of CA PPO |
$81.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.54
|
| Rate for Payer: EPIC Health Plan Senior |
$46.54
|
| Rate for Payer: Galaxy Health WC |
$98.91
|
| Rate for Payer: Global Benefits Group Commercial |
$69.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.27
|
| Rate for Payer: Multiplan Commercial |
$87.27
|
| Rate for Payer: Networks By Design Commercial |
$75.63
|
| Rate for Payer: Prime Health Services Commercial |
$98.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.67
|
| Rate for Payer: United Healthcare All Other HMO |
$42.51
|
| Rate for Payer: United Healthcare HMO Rider |
$41.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.11
|
|
|
HC COLLAR MIAMI J SM
|
Facility
|
IP
|
$192.22
|
|
|
Service Code
|
CPT L0174
|
| Hospital Charge Code |
901605402
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$38.44 |
| Max. Negotiated Rate |
$173.00 |
| Rate for Payer: Adventist Health Commercial |
$38.44
|
| Rate for Payer: Blue Shield of California Commercial |
$148.59
|
| Rate for Payer: Blue Shield of California EPN |
$96.88
|
| Rate for Payer: Cash Price |
$105.72
|
| Rate for Payer: Central Health Plan Commercial |
$153.78
|
| Rate for Payer: Cigna of CA HMO |
$134.55
|
| Rate for Payer: Cigna of CA PPO |
$134.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.89
|
| Rate for Payer: EPIC Health Plan Senior |
$76.89
|
| Rate for Payer: Galaxy Health WC |
$163.39
|
| Rate for Payer: Global Benefits Group Commercial |
$115.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$173.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$118.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.44
|
| Rate for Payer: Multiplan Commercial |
$144.16
|
| Rate for Payer: Networks By Design Commercial |
$124.94
|
| Rate for Payer: Prime Health Services Commercial |
$163.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$72.14
|
| Rate for Payer: United Healthcare All Other HMO |
$70.22
|
| Rate for Payer: United Healthcare HMO Rider |
$68.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.95
|
|
