|
HC ATHRECTOMY VISCERAL
|
Facility
|
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
906820161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,268.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27,511.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,801.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,801.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$19,419.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: Cigna of CA PPO |
$23,950.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27,511.10
|
| Rate for Payer: Dignity Health Media |
$27,511.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,511.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,946.40
|
| Rate for Payer: Galaxy Health WC |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24,274.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,328.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,331.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
| Rate for Payer: Riverside University Health System MISP |
$12,946.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,511.10
|
| Rate for Payer: Vantage Medical Group Senior |
$27,511.10
|
|
|
HC ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
OP
|
$10,462.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906820317
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$238.39 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,138.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,892.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,754.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,754.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,277.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Cash Price |
$4,707.90
|
| Rate for Payer: Cash Price |
$4,707.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,369.60
|
| Rate for Payer: Cigna of CA PPO |
$7,741.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,892.70
|
| Rate for Payer: Dignity Health Media |
$8,892.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,892.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,184.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,184.80
|
| Rate for Payer: Galaxy Health WC |
$8,892.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,415.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,846.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,661.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,978.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$238.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,092.40
|
| Rate for Payer: Multiplan Commercial |
$7,846.50
|
| Rate for Payer: Networks By Design Commercial |
$6,800.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,892.70
|
| Rate for Payer: Riverside University Health System MISP |
$4,184.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,277.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,892.70
|
| Rate for Payer: Vantage Medical Group Senior |
$8,892.70
|
|
|
HC ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
IP
|
$10,462.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906811741
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,092.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$4,707.90
|
| Rate for Payer: Cash Price |
$4,707.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,369.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,184.80
|
| Rate for Payer: Galaxy Health WC |
$8,892.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,415.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,978.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,986.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,092.40
|
| Rate for Payer: Multiplan Commercial |
$7,846.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,892.70
|
|
|
HC ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
OP
|
$10,462.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906811741
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$238.39 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,138.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,892.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,754.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,754.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,277.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Cash Price |
$4,707.90
|
| Rate for Payer: Cash Price |
$4,707.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,369.60
|
| Rate for Payer: Cigna of CA PPO |
$7,741.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,892.70
|
| Rate for Payer: Dignity Health Media |
$8,892.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,892.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,184.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,184.80
|
| Rate for Payer: Galaxy Health WC |
$8,892.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,415.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,846.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,661.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,978.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$238.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,092.40
|
| Rate for Payer: Multiplan Commercial |
$7,846.50
|
| Rate for Payer: Networks By Design Commercial |
$6,800.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,892.70
|
| Rate for Payer: Riverside University Health System MISP |
$4,184.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,277.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,892.70
|
| Rate for Payer: Vantage Medical Group Senior |
$8,892.70
|
|
|
HC ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
IP
|
$10,462.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906820317
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,092.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$4,707.90
|
| Rate for Payer: Cash Price |
$4,707.90
|
| Rate for Payer: Central Health Plan Commercial |
$8,369.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,184.80
|
| Rate for Payer: Galaxy Health WC |
$8,892.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,415.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,978.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,986.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,092.40
|
| Rate for Payer: Multiplan Commercial |
$7,846.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,892.70
|
|
|
HC AUD EP NRO DGNTC W INT AND RPT
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 92653
|
| Hospital Charge Code |
900600653
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$146.15 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$516.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$477.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$582.53
|
| Rate for Payer: Blue Distinction Transplant |
$591.60
|
| Rate for Payer: Blue Shield of California Commercial |
$609.35
|
| Rate for Payer: Blue Shield of California EPN |
$479.20
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Central Health Plan Commercial |
$788.80
|
| Rate for Payer: Cigna of CA HMO |
$631.04
|
| Rate for Payer: Cigna of CA PPO |
$729.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: Dignity Health Media |
$392.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$887.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$739.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$647.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$392.17
|
| Rate for Payer: InnovAge PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$739.50
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Riverside University Health System MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$591.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$591.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$221.00
|
| Rate for Payer: United Healthcare All Other HMO |
$215.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$493.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC AUD EP NRO DGNTC W INT AND RPT
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 92653
|
| Hospital Charge Code |
900600653
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$197.20 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Central Health Plan Commercial |
$788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$394.40
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$887.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$375.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.20
|
| Rate for Payer: Multiplan Commercial |
$739.50
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
|
|
HC AUD EP SCRN AP W/BB STIMULI AA
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
900600650
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$48.79 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$171.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$838.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$542.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$542.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$477.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$582.53
|
| Rate for Payer: Blue Distinction Transplant |
$591.60
|
| Rate for Payer: Blue Shield of California Commercial |
$609.35
|
| Rate for Payer: Blue Shield of California EPN |
$479.20
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Central Health Plan Commercial |
$788.80
|
| Rate for Payer: Cigna of CA HMO |
$631.04
|
| Rate for Payer: Cigna of CA PPO |
$729.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$838.10
|
| Rate for Payer: Dignity Health Media |
$838.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$838.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$394.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$394.40
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$887.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$739.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$345.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.20
|
| Rate for Payer: Multiplan Commercial |
$739.50
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
| Rate for Payer: Riverside University Health System MISP |
$394.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$591.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$591.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$221.00
|
| Rate for Payer: United Healthcare All Other HMO |
$215.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$838.10
|
| Rate for Payer: Vantage Medical Group Senior |
$838.10
|
|
|
HC AUD EP SCRN AP W/BB STIMULI AA
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 92650
|
| Hospital Charge Code |
900600650
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$197.20 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Central Health Plan Commercial |
$788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$394.40
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$887.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$375.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.20
|
| Rate for Payer: Multiplan Commercial |
$739.50
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
|
|
HC AUDIOLOGIC EVAL PURE TONE
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
905601816
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$179.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$158.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$193.19
|
| Rate for Payer: Blue Distinction Transplant |
$196.20
|
| Rate for Payer: Blue Shield of California Commercial |
$202.09
|
| Rate for Payer: Blue Shield of California EPN |
$158.92
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA HMO |
$209.28
|
| Rate for Payer: Cigna of CA PPO |
$241.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Media |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$245.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$114.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
| Rate for Payer: Riverside University Health System MISP |
$130.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$221.00
|
| Rate for Payer: United Healthcare All Other HMO |
$215.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$163.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC AUDIOLOGIC EVAL PURE TONE
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
905601816
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
|
HC AUDIOLOGIC EVAL PURE TONE 30M
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
905601900
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
|
HC AUDIOLOGIC EVAL PURE TONE 30M
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 92551
|
| Hospital Charge Code |
905601900
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$179.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$158.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$193.19
|
| Rate for Payer: Blue Distinction Transplant |
$196.20
|
| Rate for Payer: Blue Shield of California Commercial |
$202.09
|
| Rate for Payer: Blue Shield of California EPN |
$158.92
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA HMO |
$209.28
|
| Rate for Payer: Cigna of CA PPO |
$241.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Media |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$245.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$114.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
| Rate for Payer: Riverside University Health System MISP |
$130.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$221.00
|
| Rate for Payer: United Healthcare All Other HMO |
$215.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$163.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC AUG/ALTR COMM
|
Facility
|
OP
|
$229.00
|
|
| Hospital Charge Code |
905601807
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$80.15 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$139.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$194.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$125.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$125.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$137.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Central Health Plan Commercial |
$183.20
|
| Rate for Payer: Cigna of CA HMO |
$146.56
|
| Rate for Payer: Cigna of CA PPO |
$169.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$194.65
|
| Rate for Payer: Dignity Health Media |
$194.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$194.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$91.60
|
| Rate for Payer: Galaxy Health WC |
$194.65
|
| Rate for Payer: Global Benefits Group Commercial |
$137.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$206.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$171.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$80.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.89
|
| Rate for Payer: Multiplan Commercial |
$171.75
|
| Rate for Payer: Networks By Design Commercial |
$148.85
|
| Rate for Payer: Prime Health Services Commercial |
$194.65
|
| Rate for Payer: Riverside University Health System MISP |
$91.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$137.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$137.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$194.65
|
| Rate for Payer: Vantage Medical Group Senior |
$194.65
|
|
|
HC AUG/ALTR COMM
|
Facility
|
IP
|
$229.00
|
|
| Hospital Charge Code |
905601807
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$45.80 |
| Max. Negotiated Rate |
$206.10 |
| Rate for Payer: Cash Price |
$103.05
|
| Rate for Payer: Central Health Plan Commercial |
$183.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.60
|
| Rate for Payer: Galaxy Health WC |
$194.65
|
| Rate for Payer: Global Benefits Group Commercial |
$137.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$206.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$152.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$45.80
|
| Rate for Payer: Multiplan Commercial |
$171.75
|
| Rate for Payer: Networks By Design Commercial |
$148.85
|
| Rate for Payer: Prime Health Services Commercial |
$194.65
|
|
|
HC AUTO GRASP FEATURE, ADDITION
|
Facility
|
OP
|
$6,895.00
|
|
|
Service Code
|
CPT L6881
|
| Hospital Charge Code |
905356881
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,413.25 |
| Max. Negotiated Rate |
$6,205.50 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,860.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,792.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,792.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,338.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,073.57
|
| Rate for Payer: Blue Distinction Transplant |
$4,137.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,171.25
|
| Rate for Payer: Blue Shield of California EPN |
$3,750.88
|
| Rate for Payer: Cash Price |
$3,102.75
|
| Rate for Payer: Central Health Plan Commercial |
$5,516.00
|
| Rate for Payer: Cigna of CA HMO |
$4,826.50
|
| Rate for Payer: Cigna of CA PPO |
$4,826.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,860.75
|
| Rate for Payer: Dignity Health Media |
$5,860.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,860.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,758.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,758.00
|
| Rate for Payer: Galaxy Health WC |
$5,860.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,137.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,205.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,171.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,413.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,598.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,826.95
|
| Rate for Payer: Multiplan Commercial |
$5,171.25
|
| Rate for Payer: Networks By Design Commercial |
$3,447.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,860.75
|
| Rate for Payer: Riverside University Health System MISP |
$2,758.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,137.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,137.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,447.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,447.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,447.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,447.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,860.75
|
| Rate for Payer: Vantage Medical Group Senior |
$5,860.75
|
|
|
HC AUTO GRASP FEATURE, ADDITION
|
Facility
|
IP
|
$6,895.00
|
|
|
Service Code
|
CPT L6881
|
| Hospital Charge Code |
905356881
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,379.00 |
| Max. Negotiated Rate |
$6,205.50 |
| Rate for Payer: Blue Shield of California EPN |
$3,681.93
|
| Rate for Payer: Cash Price |
$3,102.75
|
| Rate for Payer: Central Health Plan Commercial |
$5,516.00
|
| Rate for Payer: Cigna of CA HMO |
$4,826.50
|
| Rate for Payer: Cigna of CA PPO |
$4,826.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,758.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,758.00
|
| Rate for Payer: Galaxy Health WC |
$5,860.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,137.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,205.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,598.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,627.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,379.00
|
| Rate for Payer: Multiplan Commercial |
$5,171.25
|
| Rate for Payer: Networks By Design Commercial |
$3,447.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,860.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,603.55
|
| Rate for Payer: United Healthcare All Other HMO |
$2,542.88
|
| Rate for Payer: United Healthcare HMO Rider |
$2,487.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,275.35
|
|
|
HC AVELLE NPWT DRSNG 12 X 31CM
|
Facility
|
OP
|
$273.91
|
|
| Hospital Charge Code |
901698548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.78 |
| Max. Negotiated Rate |
$246.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$166.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$232.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$150.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$132.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.83
|
| Rate for Payer: Blue Distinction Transplant |
$164.35
|
| Rate for Payer: Blue Shield of California Commercial |
$172.29
|
| Rate for Payer: Blue Shield of California EPN |
$133.94
|
| Rate for Payer: Cash Price |
$123.26
|
| Rate for Payer: Central Health Plan Commercial |
$219.13
|
| Rate for Payer: Cigna of CA HMO |
$175.30
|
| Rate for Payer: Cigna of CA PPO |
$202.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$232.82
|
| Rate for Payer: Dignity Health Media |
$232.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$232.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$109.56
|
| Rate for Payer: Galaxy Health WC |
$232.82
|
| Rate for Payer: Global Benefits Group Commercial |
$164.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$246.52
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$205.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$95.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.78
|
| Rate for Payer: Multiplan Commercial |
$205.43
|
| Rate for Payer: Networks By Design Commercial |
$178.04
|
| Rate for Payer: Prime Health Services Commercial |
$232.82
|
| Rate for Payer: Riverside University Health System MISP |
$109.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$164.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$164.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$136.96
|
| Rate for Payer: United Healthcare All Other HMO |
$136.96
|
| Rate for Payer: United Healthcare HMO Rider |
$136.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.82
|
| Rate for Payer: Vantage Medical Group Senior |
$232.82
|
|
|
HC AVELLE NPWT DRSNG 12 X 31CM
|
Facility
|
IP
|
$273.91
|
|
| Hospital Charge Code |
901698548
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.78 |
| Max. Negotiated Rate |
$246.52 |
| Rate for Payer: Cash Price |
$123.26
|
| Rate for Payer: Central Health Plan Commercial |
$219.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.56
|
| Rate for Payer: Galaxy Health WC |
$232.82
|
| Rate for Payer: Global Benefits Group Commercial |
$164.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$246.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.78
|
| Rate for Payer: Multiplan Commercial |
$205.43
|
| Rate for Payer: Networks By Design Commercial |
$178.04
|
| Rate for Payer: Prime Health Services Commercial |
$232.82
|
|
|
HC AVELLE NPWT DRSNG 12 X 41CM
|
Facility
|
IP
|
$333.13
|
|
| Hospital Charge Code |
901698549
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.63 |
| Max. Negotiated Rate |
$299.82 |
| Rate for Payer: Cash Price |
$149.91
|
| Rate for Payer: Central Health Plan Commercial |
$266.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.25
|
| Rate for Payer: Galaxy Health WC |
$283.16
|
| Rate for Payer: Global Benefits Group Commercial |
$199.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$299.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$222.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.63
|
| Rate for Payer: Multiplan Commercial |
$249.85
|
| Rate for Payer: Networks By Design Commercial |
$216.53
|
| Rate for Payer: Prime Health Services Commercial |
$283.16
|
|
|
HC AVELLE NPWT DRSNG 12 X 41CM
|
Facility
|
OP
|
$333.13
|
|
| Hospital Charge Code |
901698549
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.63 |
| Max. Negotiated Rate |
$299.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$202.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$283.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$183.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$183.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$161.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$196.81
|
| Rate for Payer: Blue Distinction Transplant |
$199.88
|
| Rate for Payer: Blue Shield of California Commercial |
$209.54
|
| Rate for Payer: Blue Shield of California EPN |
$162.90
|
| Rate for Payer: Cash Price |
$149.91
|
| Rate for Payer: Central Health Plan Commercial |
$266.50
|
| Rate for Payer: Cigna of CA HMO |
$213.20
|
| Rate for Payer: Cigna of CA PPO |
$246.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$283.16
|
| Rate for Payer: Dignity Health Media |
$283.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$133.25
|
| Rate for Payer: Galaxy Health WC |
$283.16
|
| Rate for Payer: Global Benefits Group Commercial |
$199.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$299.82
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$249.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$116.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$222.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.63
|
| Rate for Payer: Multiplan Commercial |
$249.85
|
| Rate for Payer: Networks By Design Commercial |
$216.53
|
| Rate for Payer: Prime Health Services Commercial |
$283.16
|
| Rate for Payer: Riverside University Health System MISP |
$133.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$199.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$199.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.56
|
| Rate for Payer: United Healthcare All Other HMO |
$166.56
|
| Rate for Payer: United Healthcare HMO Rider |
$166.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$166.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.16
|
| Rate for Payer: Vantage Medical Group Senior |
$283.16
|
|
|
HC AVUL OF NAIL PL PART OR COMPL
|
Facility
|
OP
|
$791.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
900501015
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$474.60
|
| Rate for Payer: Blue Shield of California Commercial |
$497.54
|
| Rate for Payer: Blue Shield of California EPN |
$386.80
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Central Health Plan Commercial |
$632.80
|
| Rate for Payer: Cigna of CA HMO |
$506.24
|
| Rate for Payer: Cigna of CA PPO |
$585.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$672.35
|
| Rate for Payer: Global Benefits Group Commercial |
$474.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$711.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$593.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$593.25
|
| Rate for Payer: Networks By Design Commercial |
$514.15
|
| Rate for Payer: Prime Health Services Commercial |
$672.35
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$395.50
|
| Rate for Payer: United Healthcare All Other HMO |
$395.50
|
| Rate for Payer: United Healthcare HMO Rider |
$395.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC AVUL OF NAIL PL PART OR COMPL
|
Facility
|
IP
|
$791.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
900501015
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$158.20 |
| Max. Negotiated Rate |
$711.90 |
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Central Health Plan Commercial |
$632.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.40
|
| Rate for Payer: Galaxy Health WC |
$672.35
|
| Rate for Payer: Global Benefits Group Commercial |
$474.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$711.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.20
|
| Rate for Payer: Multiplan Commercial |
$593.25
|
| Rate for Payer: Networks By Design Commercial |
$514.15
|
| Rate for Payer: Prime Health Services Commercial |
$672.35
|
|
|
HC AVUL OF NAIL PL PART OR COMPL
|
Facility
|
OP
|
$791.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
900501015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.84 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$474.60
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Central Health Plan Commercial |
$632.80
|
| Rate for Payer: Cigna of CA PPO |
$585.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$672.35
|
| Rate for Payer: Global Benefits Group Commercial |
$474.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$711.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$593.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$593.25
|
| Rate for Payer: Networks By Design Commercial |
$514.15
|
| Rate for Payer: Prime Health Services Commercial |
$672.35
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$395.50
|
| Rate for Payer: United Healthcare All Other HMO |
$395.50
|
| Rate for Payer: United Healthcare HMO Rider |
$395.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC AVUL OF NAIL PL PART OR COMPL
|
Facility
|
IP
|
$791.00
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
900501015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$158.20 |
| Max. Negotiated Rate |
$711.90 |
| Rate for Payer: Cash Price |
$355.95
|
| Rate for Payer: Central Health Plan Commercial |
$632.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.40
|
| Rate for Payer: Galaxy Health WC |
$672.35
|
| Rate for Payer: Global Benefits Group Commercial |
$474.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$711.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.20
|
| Rate for Payer: Multiplan Commercial |
$593.25
|
| Rate for Payer: Networks By Design Commercial |
$514.15
|
| Rate for Payer: Prime Health Services Commercial |
$672.35
|
|
