|
HC DEB SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$2,341.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
900501012
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$468.20 |
| Max. Negotiated Rate |
$2,106.90 |
| Rate for Payer: Adventist Health Commercial |
$468.20
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,638.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.40
|
| Rate for Payer: EPIC Health Plan Senior |
$936.40
|
| Rate for Payer: Galaxy Health WC |
$1,989.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,486.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,381.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.20
|
| Rate for Payer: Multiplan Commercial |
$1,755.75
|
| Rate for Payer: Networks By Design Commercial |
$1,521.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.85
|
|
|
HC DEB SKIN & SUBQ TISSUE
|
Facility
|
OP
|
$2,341.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
900501012
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$197.35 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$468.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.80
|
| Rate for Payer: Cigna of CA HMO |
$1,498.24
|
| Rate for Payer: Cigna of CA PPO |
$1,732.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,638.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,989.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,486.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$197.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$1,755.75
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,521.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.85
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,404.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,170.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,170.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,170.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,170.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC DEB SKIN & SUBQ TISSUE
|
Facility
|
IP
|
$2,341.00
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
900501012
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$468.20 |
| Max. Negotiated Rate |
$2,106.90 |
| Rate for Payer: Adventist Health Commercial |
$468.20
|
| Rate for Payer: Cash Price |
$1,053.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,872.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,638.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.40
|
| Rate for Payer: EPIC Health Plan Senior |
$936.40
|
| Rate for Payer: Galaxy Health WC |
$1,989.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,106.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,486.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,381.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$468.20
|
| Rate for Payer: Multiplan Commercial |
$1,755.75
|
| Rate for Payer: Networks By Design Commercial |
$1,521.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.85
|
|
|
HC DEB SUBQ AND DERMIS TISSUE EACH ADDL 20 SQ CM
|
Facility
|
OP
|
$704.00
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
900101491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$140.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$95.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$598.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$387.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$528.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$446.34
|
| Rate for Payer: Blue Shield of California EPN |
$280.90
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Central Health Plan Commercial |
$563.20
|
| Rate for Payer: Cigna of CA HMO |
$450.56
|
| Rate for Payer: Cigna of CA PPO |
$520.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$598.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$598.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$598.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$492.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$281.60
|
| Rate for Payer: EPIC Health Plan Senior |
$281.60
|
| Rate for Payer: Galaxy Health WC |
$598.40
|
| Rate for Payer: Global Benefits Group Commercial |
$422.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$633.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$24.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$447.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$415.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$492.80
|
| Rate for Payer: Multiplan Commercial |
$528.00
|
| Rate for Payer: Networks By Design Commercial |
$457.60
|
| Rate for Payer: Prime Health Services Commercial |
$598.40
|
| Rate for Payer: Riverside University Health System MISP |
$281.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$422.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.00
|
| Rate for Payer: United Healthcare All Other HMO |
$352.00
|
| Rate for Payer: United Healthcare HMO Rider |
$352.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$352.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$598.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$598.40
|
| Rate for Payer: Vantage Medical Group Senior |
$598.40
|
|
|
HC DEB SUBQ AND DERMIS TISSUE EACH ADDL 20 SQ CM
|
Facility
|
IP
|
$704.00
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
900101491
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.80 |
| Max. Negotiated Rate |
$633.60 |
| Rate for Payer: Adventist Health Commercial |
$140.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Central Health Plan Commercial |
$563.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$492.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$281.60
|
| Rate for Payer: EPIC Health Plan Senior |
$281.60
|
| Rate for Payer: Galaxy Health WC |
$598.40
|
| Rate for Payer: Global Benefits Group Commercial |
$422.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$633.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$447.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$415.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$140.80
|
| Rate for Payer: Multiplan Commercial |
$528.00
|
| Rate for Payer: Networks By Design Commercial |
$457.60
|
| Rate for Payer: Prime Health Services Commercial |
$598.40
|
|
|
HC DECALCIFICATION PG
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
903800209
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$42.34 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.40
|
| Rate for Payer: Blue Shield of California Commercial |
$8.82
|
| Rate for Payer: Blue Shield of California EPN |
$5.56
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Central Health Plan Commercial |
$11.20
|
| Rate for Payer: Cigna of CA HMO |
$8.96
|
| Rate for Payer: Cigna of CA PPO |
$10.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5.60
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.80
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
| Rate for Payer: Riverside University Health System MISP |
$5.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.90
|
| Rate for Payer: Vantage Medical Group Senior |
$11.90
|
|
|
HC DECALCIFICATION PG
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
903800209
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Central Health Plan Commercial |
$11.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5.60
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
|
|
HC DECALCIFICATION PROCEDURE
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
903800028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.80
|
| Rate for Payer: EPIC Health Plan Senior |
$72.80
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$107.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
|
|
HC DECALCIFICATION PROCEDURE
|
Facility
|
OP
|
$38.00
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
903800028
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$42.34 |
| Rate for Payer: Adventist Health Commercial |
$7.60
|
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$154.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$100.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$136.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.40
|
| Rate for Payer: Blue Shield of California Commercial |
$114.66
|
| Rate for Payer: Blue Shield of California Commercial |
$23.94
|
| Rate for Payer: Blue Shield of California EPN |
$72.25
|
| Rate for Payer: Blue Shield of California EPN |
$15.09
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Cash Price |
$17.10
|
| Rate for Payer: Central Health Plan Commercial |
$30.40
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Cigna of CA HMO |
$116.48
|
| Rate for Payer: Cigna of CA HMO |
$24.32
|
| Rate for Payer: Cigna of CA PPO |
$134.68
|
| Rate for Payer: Cigna of CA PPO |
$28.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$154.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$154.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$154.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.80
|
| Rate for Payer: EPIC Health Plan Senior |
$15.20
|
| Rate for Payer: EPIC Health Plan Senior |
$72.80
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Galaxy Health WC |
$32.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.80
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$107.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$127.40
|
| Rate for Payer: Multiplan Commercial |
$28.50
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$24.70
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$32.30
|
| Rate for Payer: Riverside University Health System MISP |
$15.20
|
| Rate for Payer: Riverside University Health System MISP |
$72.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$109.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$109.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$154.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.70
|
| Rate for Payer: Vantage Medical Group Senior |
$154.70
|
| Rate for Payer: Vantage Medical Group Senior |
$32.30
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
IP
|
$773.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
947100110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.60 |
| Max. Negotiated Rate |
$695.70 |
| Rate for Payer: Adventist Health Commercial |
$154.60
|
| Rate for Payer: Cash Price |
$347.85
|
| Rate for Payer: Central Health Plan Commercial |
$618.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.20
|
| Rate for Payer: EPIC Health Plan Senior |
$309.20
|
| Rate for Payer: Galaxy Health WC |
$657.05
|
| Rate for Payer: Global Benefits Group Commercial |
$463.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$695.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$490.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.60
|
| Rate for Payer: Multiplan Commercial |
$579.75
|
| Rate for Payer: Networks By Design Commercial |
$502.45
|
| Rate for Payer: Prime Health Services Commercial |
$657.05
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
946000110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
940100110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
948100110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
910100004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
947300110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
948100110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
947000110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
947200110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
947000110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
947300110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
946100110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
901200077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$189.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,347.88
|
| Rate for Payer: Blue Shield of California EPN |
$848.27
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,063.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,063.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,063.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
IP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
949000302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$425.20 |
| Max. Negotiated Rate |
$1,913.40 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$850.40
|
| Rate for Payer: EPIC Health Plan Senior |
$850.40
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
940100110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
|
HC DECLOT VAD CATH THROMBOLYTIC AGENT
|
Facility
|
OP
|
$2,126.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
945000110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$57.64 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$425.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$424.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$671.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Cash Price |
$956.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,700.80
|
| Rate for Payer: Cigna of CA HMO |
$1,360.64
|
| Rate for Payer: Cigna of CA PPO |
$1,573.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$637.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$467.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$424.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,488.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$700.97
|
| Rate for Payer: EPIC Health Plan Senior |
$467.31
|
| Rate for Payer: Galaxy Health WC |
$1,807.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,275.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,913.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$696.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$57.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$424.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$594.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$425.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$569.27
|
| Rate for Payer: Multiplan Commercial |
$1,594.50
|
| Rate for Payer: Multiplan WC |
$671.50
|
| Rate for Payer: Networks By Design Commercial |
$1,381.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$424.83
|
| Rate for Payer: Preferred Health Network WC |
$685.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,807.10
|
| Rate for Payer: Prime Health Services Medicare |
$450.32
|
| Rate for Payer: Prime Health Services WC |
$664.64
|
| Rate for Payer: Riverside University Health System MISP |
$467.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,275.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,063.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$424.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$637.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$467.31
|
| Rate for Payer: Vantage Medical Group Senior |
$424.83
|
|
