|
HC COLLAR PLASTIC FLEXIBLE MOLDED
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT L0130
|
| Hospital Charge Code |
905350130
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$51.80 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Blue Shield of California Commercial |
$200.21
|
| Rate for Payer: Blue Shield of California EPN |
$130.54
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Central Health Plan Commercial |
$207.20
|
| Rate for Payer: Cigna of CA HMO |
$181.30
|
| Rate for Payer: Cigna of CA PPO |
$181.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$160.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.80
|
| Rate for Payer: Multiplan Commercial |
$194.25
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$97.20
|
| Rate for Payer: United Healthcare All Other HMO |
$94.61
|
| Rate for Payer: United Healthcare HMO Rider |
$92.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.82
|
|
|
HC COLLAR PLASTIC FLEXIBLE MOLDED
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT L0130
|
| Hospital Charge Code |
905350130
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$84.82 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Adventist Health Commercial |
$106.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$194.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.11
|
| Rate for Payer: Blue Shield of California Commercial |
$200.21
|
| Rate for Payer: Blue Shield of California EPN |
$130.54
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Central Health Plan Commercial |
$207.20
|
| Rate for Payer: Cigna of CA HMO |
$181.30
|
| Rate for Payer: Cigna of CA PPO |
$181.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$220.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$220.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.45
|
| Rate for Payer: InnovAge PACE Commercial |
$129.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$160.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.30
|
| Rate for Payer: Multiplan Commercial |
$194.25
|
| Rate for Payer: Networks By Design Commercial |
$129.50
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: Riverside University Health System MISP |
$103.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$97.20
|
| Rate for Payer: United Healthcare All Other HMO |
$94.61
|
| Rate for Payer: United Healthcare HMO Rider |
$92.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.15
|
| Rate for Payer: Vantage Medical Group Senior |
$220.15
|
|
|
HC COLLAR PLASTIC FLEXIBLE MOLDED
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT L0130
|
| Hospital Charge Code |
915350130
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$84.82 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Adventist Health Commercial |
$106.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$194.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.11
|
| Rate for Payer: Blue Shield of California Commercial |
$200.21
|
| Rate for Payer: Blue Shield of California EPN |
$130.54
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Central Health Plan Commercial |
$207.20
|
| Rate for Payer: Cigna of CA HMO |
$181.30
|
| Rate for Payer: Cigna of CA PPO |
$181.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$220.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$220.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.45
|
| Rate for Payer: InnovAge PACE Commercial |
$129.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$160.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.30
|
| Rate for Payer: Multiplan Commercial |
$194.25
|
| Rate for Payer: Networks By Design Commercial |
$129.50
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: Riverside University Health System MISP |
$103.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$97.20
|
| Rate for Payer: United Healthcare All Other HMO |
$94.61
|
| Rate for Payer: United Healthcare HMO Rider |
$92.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.15
|
| Rate for Payer: Vantage Medical Group Senior |
$220.15
|
|
|
HC COLLAR PLASTIC FLEXIBLE MOLDED
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT L0130
|
| Hospital Charge Code |
915350130
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$51.80 |
| Max. Negotiated Rate |
$233.10 |
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Blue Shield of California Commercial |
$200.21
|
| Rate for Payer: Blue Shield of California EPN |
$130.54
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Central Health Plan Commercial |
$207.20
|
| Rate for Payer: Cigna of CA HMO |
$181.30
|
| Rate for Payer: Cigna of CA PPO |
$181.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$160.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.80
|
| Rate for Payer: Multiplan Commercial |
$194.25
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$97.20
|
| Rate for Payer: United Healthcare All Other HMO |
$94.61
|
| Rate for Payer: United Healthcare HMO Rider |
$92.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.82
|
|
|
HC COLLAR PLASTIC SEMI-RIGID
|
Facility
|
IP
|
$262.00
|
|
|
Service Code
|
CPT L0140
|
| Hospital Charge Code |
905350140
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$235.80 |
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Blue Shield of California Commercial |
$202.53
|
| Rate for Payer: Blue Shield of California EPN |
$132.05
|
| Rate for Payer: Cash Price |
$144.10
|
| Rate for Payer: Central Health Plan Commercial |
$209.60
|
| Rate for Payer: Cigna of CA HMO |
$183.40
|
| Rate for Payer: Cigna of CA PPO |
$183.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.80
|
| Rate for Payer: EPIC Health Plan Senior |
$104.80
|
| Rate for Payer: Galaxy Health WC |
$222.70
|
| Rate for Payer: Global Benefits Group Commercial |
$157.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$235.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$162.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.40
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
| Rate for Payer: Networks By Design Commercial |
$170.30
|
| Rate for Payer: Prime Health Services Commercial |
$222.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.33
|
| Rate for Payer: United Healthcare All Other HMO |
$95.71
|
| Rate for Payer: United Healthcare HMO Rider |
$93.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.81
|
|
|
HC COLLAR PLASTIC SEMI-RIGID
|
Facility
|
OP
|
$262.00
|
|
|
Service Code
|
CPT L0140
|
| Hospital Charge Code |
905350140
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$66.31 |
| Max. Negotiated Rate |
$235.80 |
| Rate for Payer: Adventist Health Commercial |
$107.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$222.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$144.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$196.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.87
|
| Rate for Payer: Blue Shield of California Commercial |
$202.53
|
| Rate for Payer: Blue Shield of California EPN |
$132.05
|
| Rate for Payer: Cash Price |
$144.10
|
| Rate for Payer: Cash Price |
$144.10
|
| Rate for Payer: Central Health Plan Commercial |
$209.60
|
| Rate for Payer: Cigna of CA HMO |
$183.40
|
| Rate for Payer: Cigna of CA PPO |
$183.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$222.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$222.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$222.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.80
|
| Rate for Payer: EPIC Health Plan Senior |
$104.80
|
| Rate for Payer: Galaxy Health WC |
$222.70
|
| Rate for Payer: Global Benefits Group Commercial |
$157.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$235.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$66.31
|
| Rate for Payer: InnovAge PACE Commercial |
$131.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$162.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$183.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$183.40
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
| Rate for Payer: Networks By Design Commercial |
$131.00
|
| Rate for Payer: Prime Health Services Commercial |
$222.70
|
| Rate for Payer: Riverside University Health System MISP |
$104.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$157.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$157.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.33
|
| Rate for Payer: United Healthcare All Other HMO |
$95.71
|
| Rate for Payer: United Healthcare HMO Rider |
$93.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$222.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$222.70
|
| Rate for Payer: Vantage Medical Group Senior |
$222.70
|
|
|
HC COLLAR PLASTIC SEMI-RIGID
|
Facility
|
OP
|
$262.00
|
|
|
Service Code
|
CPT L0140
|
| Hospital Charge Code |
915350140
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$66.31 |
| Max. Negotiated Rate |
$235.80 |
| Rate for Payer: Adventist Health Commercial |
$107.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$222.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$144.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$196.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.87
|
| Rate for Payer: Blue Shield of California Commercial |
$202.53
|
| Rate for Payer: Blue Shield of California EPN |
$132.05
|
| Rate for Payer: Cash Price |
$144.10
|
| Rate for Payer: Cash Price |
$144.10
|
| Rate for Payer: Central Health Plan Commercial |
$209.60
|
| Rate for Payer: Cigna of CA HMO |
$183.40
|
| Rate for Payer: Cigna of CA PPO |
$183.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$222.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$222.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$222.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.80
|
| Rate for Payer: EPIC Health Plan Senior |
$104.80
|
| Rate for Payer: Galaxy Health WC |
$222.70
|
| Rate for Payer: Global Benefits Group Commercial |
$157.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$235.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$66.31
|
| Rate for Payer: InnovAge PACE Commercial |
$131.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$162.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$183.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$183.40
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
| Rate for Payer: Networks By Design Commercial |
$131.00
|
| Rate for Payer: Prime Health Services Commercial |
$222.70
|
| Rate for Payer: Riverside University Health System MISP |
$104.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$157.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$157.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.33
|
| Rate for Payer: United Healthcare All Other HMO |
$95.71
|
| Rate for Payer: United Healthcare HMO Rider |
$93.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$222.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$222.70
|
| Rate for Payer: Vantage Medical Group Senior |
$222.70
|
|
|
HC COLLAR PLASTIC SEMI-RIGID
|
Facility
|
IP
|
$262.00
|
|
|
Service Code
|
CPT L0140
|
| Hospital Charge Code |
915350140
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$235.80 |
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Blue Shield of California Commercial |
$202.53
|
| Rate for Payer: Blue Shield of California EPN |
$132.05
|
| Rate for Payer: Cash Price |
$144.10
|
| Rate for Payer: Central Health Plan Commercial |
$209.60
|
| Rate for Payer: Cigna of CA HMO |
$183.40
|
| Rate for Payer: Cigna of CA PPO |
$183.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.80
|
| Rate for Payer: EPIC Health Plan Senior |
$104.80
|
| Rate for Payer: Galaxy Health WC |
$222.70
|
| Rate for Payer: Global Benefits Group Commercial |
$157.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$235.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$162.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.40
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
| Rate for Payer: Networks By Design Commercial |
$170.30
|
| Rate for Payer: Prime Health Services Commercial |
$222.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.33
|
| Rate for Payer: United Healthcare All Other HMO |
$95.71
|
| Rate for Payer: United Healthcare HMO Rider |
$93.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$85.81
|
|
|
HC COLLAR SEMI-RIGID 2-PIECE FOAM
|
Facility
|
IP
|
$314.00
|
|
|
Service Code
|
CPT L0172
|
| Hospital Charge Code |
905350172
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$282.60 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Blue Shield of California Commercial |
$242.72
|
| Rate for Payer: Blue Shield of California EPN |
$158.26
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Central Health Plan Commercial |
$251.20
|
| Rate for Payer: Cigna of CA HMO |
$219.80
|
| Rate for Payer: Cigna of CA PPO |
$219.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$282.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.80
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.84
|
| Rate for Payer: United Healthcare All Other HMO |
$114.70
|
| Rate for Payer: United Healthcare HMO Rider |
$112.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$102.83
|
|
|
HC COLLAR SEMI-RIGID 2-PIECE FOAM
|
Facility
|
OP
|
$314.00
|
|
|
Service Code
|
CPT L0172
|
| Hospital Charge Code |
915350172
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$102.83 |
| Max. Negotiated Rate |
$282.60 |
| Rate for Payer: Adventist Health Commercial |
$128.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$266.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$172.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$235.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.41
|
| Rate for Payer: Blue Shield of California Commercial |
$242.72
|
| Rate for Payer: Blue Shield of California EPN |
$158.26
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Central Health Plan Commercial |
$251.20
|
| Rate for Payer: Cigna of CA HMO |
$219.80
|
| Rate for Payer: Cigna of CA PPO |
$219.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$266.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$266.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$266.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$282.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$156.19
|
| Rate for Payer: InnovAge PACE Commercial |
$157.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.80
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: Networks By Design Commercial |
$157.00
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
| Rate for Payer: Riverside University Health System MISP |
$125.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$188.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.84
|
| Rate for Payer: United Healthcare All Other HMO |
$114.70
|
| Rate for Payer: United Healthcare HMO Rider |
$112.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$102.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$266.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$266.90
|
| Rate for Payer: Vantage Medical Group Senior |
$266.90
|
|
|
HC COLLAR SEMI-RIGID 2-PIECE FOAM
|
Facility
|
OP
|
$314.00
|
|
|
Service Code
|
CPT L0172
|
| Hospital Charge Code |
905350172
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$102.83 |
| Max. Negotiated Rate |
$282.60 |
| Rate for Payer: Adventist Health Commercial |
$128.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$266.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$172.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$235.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.41
|
| Rate for Payer: Blue Shield of California Commercial |
$242.72
|
| Rate for Payer: Blue Shield of California EPN |
$158.26
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Central Health Plan Commercial |
$251.20
|
| Rate for Payer: Cigna of CA HMO |
$219.80
|
| Rate for Payer: Cigna of CA PPO |
$219.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$266.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$266.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$266.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$282.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$156.19
|
| Rate for Payer: InnovAge PACE Commercial |
$157.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$172.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.80
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: Networks By Design Commercial |
$157.00
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
| Rate for Payer: Riverside University Health System MISP |
$125.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$188.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.84
|
| Rate for Payer: United Healthcare All Other HMO |
$114.70
|
| Rate for Payer: United Healthcare HMO Rider |
$112.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$102.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$266.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$266.90
|
| Rate for Payer: Vantage Medical Group Senior |
$266.90
|
|
|
HC COLLAR SEMI-RIGID 2-PIECE FOAM
|
Facility
|
IP
|
$314.00
|
|
|
Service Code
|
CPT L0172
|
| Hospital Charge Code |
915350172
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$282.60 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Blue Shield of California Commercial |
$242.72
|
| Rate for Payer: Blue Shield of California EPN |
$158.26
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Central Health Plan Commercial |
$251.20
|
| Rate for Payer: Cigna of CA HMO |
$219.80
|
| Rate for Payer: Cigna of CA PPO |
$219.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$282.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.80
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.84
|
| Rate for Payer: United Healthcare All Other HMO |
$114.70
|
| Rate for Payer: United Healthcare HMO Rider |
$112.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$102.83
|
|
|
HC COLLAR SEMI-RIGID WIRE FRAME
|
Facility
|
OP
|
$485.00
|
|
|
Service Code
|
CPT L0160
|
| Hospital Charge Code |
915350160
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$131.55 |
| Max. Negotiated Rate |
$436.50 |
| Rate for Payer: Adventist Health Commercial |
$198.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$412.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$266.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$363.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.84
|
| Rate for Payer: Blue Shield of California Commercial |
$374.90
|
| Rate for Payer: Blue Shield of California EPN |
$244.44
|
| Rate for Payer: Cash Price |
$266.75
|
| Rate for Payer: Cash Price |
$266.75
|
| Rate for Payer: Central Health Plan Commercial |
$388.00
|
| Rate for Payer: Cigna of CA HMO |
$339.50
|
| Rate for Payer: Cigna of CA PPO |
$339.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$412.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$412.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.00
|
| Rate for Payer: EPIC Health Plan Senior |
$194.00
|
| Rate for Payer: Galaxy Health WC |
$412.25
|
| Rate for Payer: Global Benefits Group Commercial |
$291.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$436.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$131.55
|
| Rate for Payer: InnovAge PACE Commercial |
$242.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$323.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$339.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$339.50
|
| Rate for Payer: Multiplan Commercial |
$363.75
|
| Rate for Payer: Networks By Design Commercial |
$242.50
|
| Rate for Payer: Prime Health Services Commercial |
$412.25
|
| Rate for Payer: Riverside University Health System MISP |
$194.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$291.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$291.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.02
|
| Rate for Payer: United Healthcare All Other HMO |
$177.17
|
| Rate for Payer: United Healthcare HMO Rider |
$173.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$158.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$412.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.25
|
| Rate for Payer: Vantage Medical Group Senior |
$412.25
|
|
|
HC COLLAR SEMI-RIGID WIRE FRAME
|
Facility
|
IP
|
$485.00
|
|
|
Service Code
|
CPT L0160
|
| Hospital Charge Code |
915350160
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$97.00 |
| Max. Negotiated Rate |
$436.50 |
| Rate for Payer: Adventist Health Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California Commercial |
$374.90
|
| Rate for Payer: Blue Shield of California EPN |
$244.44
|
| Rate for Payer: Cash Price |
$266.75
|
| Rate for Payer: Central Health Plan Commercial |
$388.00
|
| Rate for Payer: Cigna of CA HMO |
$339.50
|
| Rate for Payer: Cigna of CA PPO |
$339.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.00
|
| Rate for Payer: EPIC Health Plan Senior |
$194.00
|
| Rate for Payer: Galaxy Health WC |
$412.25
|
| Rate for Payer: Global Benefits Group Commercial |
$291.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$436.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$323.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.00
|
| Rate for Payer: Multiplan Commercial |
$363.75
|
| Rate for Payer: Networks By Design Commercial |
$315.25
|
| Rate for Payer: Prime Health Services Commercial |
$412.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.02
|
| Rate for Payer: United Healthcare All Other HMO |
$177.17
|
| Rate for Payer: United Healthcare HMO Rider |
$173.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$158.84
|
|
|
HC COLLAR SEMI-RIGID WIRE FRAME
|
Facility
|
OP
|
$485.00
|
|
|
Service Code
|
CPT L0160
|
| Hospital Charge Code |
905350160
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$131.55 |
| Max. Negotiated Rate |
$436.50 |
| Rate for Payer: Adventist Health Commercial |
$198.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$412.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$266.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$363.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.84
|
| Rate for Payer: Blue Shield of California Commercial |
$374.90
|
| Rate for Payer: Blue Shield of California EPN |
$244.44
|
| Rate for Payer: Cash Price |
$266.75
|
| Rate for Payer: Cash Price |
$266.75
|
| Rate for Payer: Central Health Plan Commercial |
$388.00
|
| Rate for Payer: Cigna of CA HMO |
$339.50
|
| Rate for Payer: Cigna of CA PPO |
$339.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$412.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$412.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$412.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.00
|
| Rate for Payer: EPIC Health Plan Senior |
$194.00
|
| Rate for Payer: Galaxy Health WC |
$412.25
|
| Rate for Payer: Global Benefits Group Commercial |
$291.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$436.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$131.55
|
| Rate for Payer: InnovAge PACE Commercial |
$242.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$323.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$339.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$339.50
|
| Rate for Payer: Multiplan Commercial |
$363.75
|
| Rate for Payer: Networks By Design Commercial |
$242.50
|
| Rate for Payer: Prime Health Services Commercial |
$412.25
|
| Rate for Payer: Riverside University Health System MISP |
$194.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$291.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$291.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.02
|
| Rate for Payer: United Healthcare All Other HMO |
$177.17
|
| Rate for Payer: United Healthcare HMO Rider |
$173.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$158.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$412.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$412.25
|
| Rate for Payer: Vantage Medical Group Senior |
$412.25
|
|
|
HC COLLAR SEMI-RIGID WIRE FRAME
|
Facility
|
IP
|
$485.00
|
|
|
Service Code
|
CPT L0160
|
| Hospital Charge Code |
905350160
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$97.00 |
| Max. Negotiated Rate |
$436.50 |
| Rate for Payer: Adventist Health Commercial |
$97.00
|
| Rate for Payer: Blue Shield of California Commercial |
$374.90
|
| Rate for Payer: Blue Shield of California EPN |
$244.44
|
| Rate for Payer: Cash Price |
$266.75
|
| Rate for Payer: Central Health Plan Commercial |
$388.00
|
| Rate for Payer: Cigna of CA HMO |
$339.50
|
| Rate for Payer: Cigna of CA PPO |
$339.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$194.00
|
| Rate for Payer: EPIC Health Plan Senior |
$194.00
|
| Rate for Payer: Galaxy Health WC |
$412.25
|
| Rate for Payer: Global Benefits Group Commercial |
$291.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$436.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$323.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$300.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.00
|
| Rate for Payer: Multiplan Commercial |
$363.75
|
| Rate for Payer: Networks By Design Commercial |
$315.25
|
| Rate for Payer: Prime Health Services Commercial |
$412.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$182.02
|
| Rate for Payer: United Healthcare All Other HMO |
$177.17
|
| Rate for Payer: United Healthcare HMO Rider |
$173.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$158.84
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
945000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
948100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.35
|
| Rate for Payer: Blue Shield of California Commercial |
$277.40
|
| Rate for Payer: Blue Shield of California EPN |
$181.43
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
901200035
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.35
|
| Rate for Payer: Blue Shield of California Commercial |
$277.40
|
| Rate for Payer: Blue Shield of California EPN |
$181.43
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
949000301
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.35
|
| Rate for Payer: Blue Shield of California Commercial |
$277.40
|
| Rate for Payer: Blue Shield of California EPN |
$181.43
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
947300108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
940100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.80
|
| Rate for Payer: EPIC Health Plan Senior |
$182.80
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$282.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
940100108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.35
|
| Rate for Payer: Blue Shield of California Commercial |
$277.40
|
| Rate for Payer: Blue Shield of California EPN |
$181.43
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
947300108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.35
|
| Rate for Payer: Blue Shield of California Commercial |
$277.40
|
| Rate for Payer: Blue Shield of California EPN |
$181.43
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$457.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
944000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$411.30 |
| Rate for Payer: Adventist Health Commercial |
$91.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$163.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$179.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.35
|
| Rate for Payer: Blue Shield of California Commercial |
$277.40
|
| Rate for Payer: Blue Shield of California EPN |
$181.43
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Cash Price |
$251.35
|
| Rate for Payer: Central Health Plan Commercial |
$365.60
|
| Rate for Payer: Cigna of CA HMO |
$292.48
|
| Rate for Payer: Cigna of CA PPO |
$338.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$388.45
|
| Rate for Payer: Global Benefits Group Commercial |
$274.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$411.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: InnovAge PACE Commercial |
$245.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$304.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$174.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$342.75
|
| Rate for Payer: Networks By Design Commercial |
$297.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$163.78
|
| Rate for Payer: Prime Health Services Commercial |
$388.45
|
| Rate for Payer: Prime Health Services Medicare |
$173.61
|
| Rate for Payer: Riverside University Health System MISP |
$180.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$274.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$274.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$228.50
|
| Rate for Payer: United Healthcare All Other HMO |
$228.50
|
| Rate for Payer: United Healthcare HMO Rider |
$228.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$228.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
