|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
OP
|
$1,504.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$300.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$300.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$386.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$615.83
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,203.20
|
| Rate for Payer: Cigna of CA HMO |
$962.56
|
| Rate for Payer: Cigna of CA PPO |
$1,112.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$425.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$521.77
|
| Rate for Payer: EPIC Health Plan Senior |
$386.50
|
| Rate for Payer: Galaxy Health WC |
$1,278.40
|
| Rate for Payer: Global Benefits Group Commercial |
$902.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,353.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$633.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$386.50
|
| Rate for Payer: InnovAge PACE Commercial |
$579.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,003.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$386.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$517.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$517.91
|
| Rate for Payer: Multiplan Commercial |
$1,128.00
|
| Rate for Payer: Multiplan WC |
$615.83
|
| Rate for Payer: Networks By Design Commercial |
$977.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$386.50
|
| Rate for Payer: Preferred Health Network WC |
$628.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,278.40
|
| Rate for Payer: Prime Health Services Medicare |
$409.69
|
| Rate for Payer: Prime Health Services WC |
$609.55
|
| Rate for Payer: Riverside University Health System MISP |
$425.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$902.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$752.00
|
| Rate for Payer: United Healthcare All Other HMO |
$752.00
|
| Rate for Payer: United Healthcare HMO Rider |
$752.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$752.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$386.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$425.15
|
| Rate for Payer: Vantage Medical Group Senior |
$386.50
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
IP
|
$1,504.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$300.80 |
| Max. Negotiated Rate |
$1,353.60 |
| Rate for Payer: Adventist Health Commercial |
$300.80
|
| Rate for Payer: Cash Price |
$676.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,203.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$601.60
|
| Rate for Payer: EPIC Health Plan Senior |
$601.60
|
| Rate for Payer: Galaxy Health WC |
$1,278.40
|
| Rate for Payer: Global Benefits Group Commercial |
$902.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,353.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,003.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$930.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$300.80
|
| Rate for Payer: Multiplan Commercial |
$1,128.00
|
| Rate for Payer: Networks By Design Commercial |
$977.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,278.40
|
|
|
HC CRYOGLOBULINS QUAL
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
900910978
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Adventist Health Commercial |
$30.60
|
| Rate for Payer: Cash Price |
$68.85
|
| Rate for Payer: Central Health Plan Commercial |
$122.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.20
|
| Rate for Payer: EPIC Health Plan Senior |
$61.20
|
| Rate for Payer: Galaxy Health WC |
$130.05
|
| Rate for Payer: Global Benefits Group Commercial |
$91.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$137.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$94.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$114.75
|
| Rate for Payer: Networks By Design Commercial |
$99.45
|
| Rate for Payer: Prime Health Services Commercial |
$130.05
|
|
|
HC CRYOGLOBULINS QUAL
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
900910978
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Adventist Health Commercial |
$12.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.30
|
| Rate for Payer: Blue Shield of California Commercial |
$37.63
|
| Rate for Payer: Blue Shield of California EPN |
$24.61
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Cash Price |
$27.90
|
| Rate for Payer: Central Health Plan Commercial |
$49.60
|
| Rate for Payer: Cigna of CA HMO |
$39.68
|
| Rate for Payer: Cigna of CA PPO |
$45.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.73
|
| Rate for Payer: EPIC Health Plan Senior |
$6.47
|
| Rate for Payer: Galaxy Health WC |
$52.70
|
| Rate for Payer: Global Benefits Group Commercial |
$37.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: InnovAge PACE Commercial |
$9.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$46.50
|
| Rate for Payer: Networks By Design Commercial |
$40.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.47
|
| Rate for Payer: Prime Health Services Commercial |
$52.70
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
|
HC CSF LEAKAGE
|
Facility
|
OP
|
$1,590.00
|
|
|
Service Code
|
CPT 78650
|
| Hospital Charge Code |
909301416
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$254.47 |
| Max. Negotiated Rate |
$2,720.33 |
| Rate for Payer: Adventist Health Commercial |
$318.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,658.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$965.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,658.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$953.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$933.81
|
| Rate for Payer: Blue Shield of California Commercial |
$965.13
|
| Rate for Payer: Blue Shield of California EPN |
$631.23
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: Cigna of CA HMO |
$1,017.60
|
| Rate for Payer: Cigna of CA PPO |
$1,176.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,824.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,658.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,239.30
|
| Rate for Payer: EPIC Health Plan Senior |
$1,658.74
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,720.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$254.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,658.74
|
| Rate for Payer: InnovAge PACE Commercial |
$2,488.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,060.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$281.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,658.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,222.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,222.71
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,658.74
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,758.26
|
| Rate for Payer: Riverside University Health System MISP |
$1,824.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$954.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$954.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,570.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,570.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,570.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,570.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,658.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,488.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,824.61
|
| Rate for Payer: Vantage Medical Group Senior |
$1,658.74
|
|
|
HC CSF LEAKAGE
|
Facility
|
IP
|
$1,590.00
|
|
|
Service Code
|
CPT 78650
|
| Hospital Charge Code |
909301416
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$318.00 |
| Max. Negotiated Rate |
$1,431.00 |
| Rate for Payer: Adventist Health Commercial |
$318.00
|
| Rate for Payer: Cash Price |
$715.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,272.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$636.00
|
| Rate for Payer: EPIC Health Plan Senior |
$636.00
|
| Rate for Payer: Galaxy Health WC |
$1,351.50
|
| Rate for Payer: Global Benefits Group Commercial |
$954.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,431.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,060.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$605.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$984.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$318.00
|
| Rate for Payer: Multiplan Commercial |
$1,192.50
|
| Rate for Payer: Networks By Design Commercial |
$1,033.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,351.50
|
|
|
HC C SPINE W/FLEX AND EXT COMPLETE
|
Facility
|
IP
|
$1,850.00
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
909001303
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$370.00 |
| Max. Negotiated Rate |
$1,665.00 |
| Rate for Payer: Adventist Health Commercial |
$370.00
|
| Rate for Payer: Cash Price |
$832.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,480.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.00
|
| Rate for Payer: EPIC Health Plan Senior |
$740.00
|
| Rate for Payer: Galaxy Health WC |
$1,572.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,110.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,665.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,233.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$704.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,145.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.00
|
| Rate for Payer: Multiplan Commercial |
$1,387.50
|
| Rate for Payer: Networks By Design Commercial |
$1,202.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,572.50
|
|
|
HC C SPINE W/FLEX AND EXT COMPLETE
|
Facility
|
OP
|
$1,850.00
|
|
|
Service Code
|
CPT 72052
|
| Hospital Charge Code |
909001303
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.82 |
| Max. Negotiated Rate |
$1,665.00 |
| Rate for Payer: Adventist Health Commercial |
$370.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,123.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$235.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.82
|
| Rate for Payer: Blue Shield of California Commercial |
$1,122.95
|
| Rate for Payer: Blue Shield of California EPN |
$734.45
|
| Rate for Payer: Cash Price |
$832.50
|
| Rate for Payer: Cash Price |
$832.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,480.00
|
| Rate for Payer: Cigna of CA HMO |
$1,184.00
|
| Rate for Payer: Cigna of CA PPO |
$1,369.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,572.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,110.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,665.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$86.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,233.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$370.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,387.50
|
| Rate for Payer: Networks By Design Commercial |
$1,202.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,572.50
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,110.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,110.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$193.23
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$193.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC CT ABDOMEN & PELVIS W/CONTRAST
|
Facility
|
IP
|
$7,066.00
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
909202002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,413.20 |
| Max. Negotiated Rate |
$6,359.40 |
| Rate for Payer: Adventist Health Commercial |
$1,413.20
|
| Rate for Payer: Cash Price |
$3,179.70
|
| Rate for Payer: Central Health Plan Commercial |
$5,652.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,826.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,826.40
|
| Rate for Payer: Galaxy Health WC |
$6,006.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,239.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,359.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,713.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,692.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,373.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,413.20
|
| Rate for Payer: Multiplan Commercial |
$5,299.50
|
| Rate for Payer: Networks By Design Commercial |
$4,592.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,006.10
|
|
|
HC CT ABDOMEN & PELVIS W/CONTRAST
|
Facility
|
OP
|
$3,967.00
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
909202002
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$453.77 |
| Max. Negotiated Rate |
$3,570.30 |
| Rate for Payer: Adventist Health Commercial |
$793.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$453.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,459.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,329.82
|
| Rate for Payer: Blue Shield of California Commercial |
$2,407.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,574.90
|
| Rate for Payer: Cash Price |
$1,785.15
|
| Rate for Payer: Cash Price |
$1,785.15
|
| Rate for Payer: Cash Price |
$1,785.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,173.60
|
| Rate for Payer: Cigna of CA HMO |
$2,538.88
|
| Rate for Payer: Cigna of CA PPO |
$2,935.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$3,371.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,380.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,570.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$484.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: InnovAge PACE Commercial |
$680.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,645.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$535.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$793.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$2,975.25
|
| Rate for Payer: Networks By Design Commercial |
$2,578.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$453.77
|
| Rate for Payer: Prime Health Services Commercial |
$3,371.95
|
| Rate for Payer: Prime Health Services Medicare |
$481.00
|
| Rate for Payer: Riverside University Health System MISP |
$499.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,380.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,380.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CT ABDOMEN & PELVIS W/O CONTRA
|
Facility
|
IP
|
$6,381.00
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
909202001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,276.20 |
| Max. Negotiated Rate |
$5,742.90 |
| Rate for Payer: Adventist Health Commercial |
$1,276.20
|
| Rate for Payer: Cash Price |
$2,871.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,104.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,552.40
|
| Rate for Payer: Galaxy Health WC |
$5,423.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,828.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,742.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,256.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,431.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,949.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,276.20
|
| Rate for Payer: Multiplan Commercial |
$4,785.75
|
| Rate for Payer: Networks By Design Commercial |
$4,147.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,423.85
|
|
|
HC CT ABDOMEN & PELVIS W/O CONTRA
|
Facility
|
OP
|
$3,581.00
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
909202001
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$299.81 |
| Max. Negotiated Rate |
$3,222.90 |
| Rate for Payer: Adventist Health Commercial |
$716.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$307.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$765.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,103.12
|
| Rate for Payer: Blue Shield of California Commercial |
$2,173.67
|
| Rate for Payer: Blue Shield of California EPN |
$1,421.66
|
| Rate for Payer: Cash Price |
$1,611.45
|
| Rate for Payer: Cash Price |
$1,611.45
|
| Rate for Payer: Cash Price |
$1,611.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,864.80
|
| Rate for Payer: Cigna of CA HMO |
$2,291.84
|
| Rate for Payer: Cigna of CA PPO |
$2,649.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.63
|
| Rate for Payer: EPIC Health Plan Senior |
$307.13
|
| Rate for Payer: Galaxy Health WC |
$3,043.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,148.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,222.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$299.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$307.13
|
| Rate for Payer: InnovAge PACE Commercial |
$460.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,388.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$307.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$716.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$411.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.55
|
| Rate for Payer: Multiplan Commercial |
$2,685.75
|
| Rate for Payer: Networks By Design Commercial |
$2,327.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$307.13
|
| Rate for Payer: Prime Health Services Commercial |
$3,043.85
|
| Rate for Payer: Prime Health Services Medicare |
$325.56
|
| Rate for Payer: Riverside University Health System MISP |
$337.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,148.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,148.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,037.23
|
| Rate for Payer: United Healthcare All Other HMO |
$1,037.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1,037.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,037.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$307.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Vantage Medical Group Senior |
$307.13
|
|
|
HC CT ABDOMEN & PELVIS W & W/O CO
|
Facility
|
OP
|
$4,306.00
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
909202003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$453.77 |
| Max. Negotiated Rate |
$3,875.40 |
| Rate for Payer: Adventist Health Commercial |
$861.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$453.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,929.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,528.91
|
| Rate for Payer: Blue Shield of California Commercial |
$2,613.74
|
| Rate for Payer: Blue Shield of California EPN |
$1,709.48
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,444.80
|
| Rate for Payer: Cigna of CA HMO |
$2,755.84
|
| Rate for Payer: Cigna of CA PPO |
$3,186.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$3,660.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,583.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,875.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$549.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: InnovAge PACE Commercial |
$680.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,872.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$606.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$861.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$3,229.50
|
| Rate for Payer: Networks By Design Commercial |
$2,798.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$453.77
|
| Rate for Payer: Prime Health Services Commercial |
$3,660.10
|
| Rate for Payer: Prime Health Services Medicare |
$481.00
|
| Rate for Payer: Riverside University Health System MISP |
$499.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,583.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,583.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CT ABDOMEN & PELVIS W & W/O CO
|
Facility
|
IP
|
$7,670.00
|
|
|
Service Code
|
CPT 74178
|
| Hospital Charge Code |
909202003
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,534.00 |
| Max. Negotiated Rate |
$6,903.00 |
| Rate for Payer: Adventist Health Commercial |
$1,534.00
|
| Rate for Payer: Cash Price |
$3,451.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,068.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,068.00
|
| Rate for Payer: Galaxy Health WC |
$6,519.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,602.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,903.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,115.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,922.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,747.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,534.00
|
| Rate for Payer: Multiplan Commercial |
$5,752.50
|
| Rate for Payer: Networks By Design Commercial |
$4,985.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,519.50
|
|
|
HC CT ABDOMEN W CONTRAS
|
Facility
|
IP
|
$5,781.00
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
909201928
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,156.20 |
| Max. Negotiated Rate |
$5,202.90 |
| Rate for Payer: Adventist Health Commercial |
$1,156.20
|
| Rate for Payer: Cash Price |
$2,601.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,624.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,312.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,312.40
|
| Rate for Payer: Galaxy Health WC |
$4,913.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,468.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,202.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,855.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,202.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,578.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,156.20
|
| Rate for Payer: Multiplan Commercial |
$4,335.75
|
| Rate for Payer: Networks By Design Commercial |
$3,757.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,913.85
|
|
|
HC CT ABDOMEN W CONTRAS
|
Facility
|
OP
|
$2,996.00
|
|
|
Service Code
|
CPT 74160
|
| Hospital Charge Code |
909201928
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$2,696.40 |
| Rate for Payer: Adventist Health Commercial |
$599.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,411.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,759.55
|
| Rate for Payer: Blue Shield of California Commercial |
$1,818.57
|
| Rate for Payer: Blue Shield of California EPN |
$1,189.41
|
| Rate for Payer: Cash Price |
$1,348.20
|
| Rate for Payer: Cash Price |
$1,348.20
|
| Rate for Payer: Cash Price |
$1,348.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,396.80
|
| Rate for Payer: Cigna of CA HMO |
$1,917.44
|
| Rate for Payer: Cigna of CA PPO |
$2,217.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$2,546.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,797.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,696.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$359.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,998.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$396.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$599.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,247.00
|
| Rate for Payer: Networks By Design Commercial |
$1,947.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$2,546.60
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,797.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.25
|
| Rate for Payer: United Healthcare All Other HMO |
$769.25
|
| Rate for Payer: United Healthcare HMO Rider |
$769.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$769.25
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ABDOMEN WO CONTR
|
Facility
|
OP
|
$2,665.00
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
909201927
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$135.12 |
| Max. Negotiated Rate |
$2,398.50 |
| Rate for Payer: Adventist Health Commercial |
$533.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,170.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,565.15
|
| Rate for Payer: Blue Shield of California Commercial |
$1,617.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,058.01
|
| Rate for Payer: Cash Price |
$1,199.25
|
| Rate for Payer: Cash Price |
$1,199.25
|
| Rate for Payer: Cash Price |
$1,199.25
|
| Rate for Payer: Center for Health Promotion Commercial |
$145.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,132.00
|
| Rate for Payer: Cigna of CA HMO |
$1,705.60
|
| Rate for Payer: Cigna of CA PPO |
$1,972.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$2,265.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,599.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,398.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$225.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,777.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$249.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$533.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,998.75
|
| Rate for Payer: Networks By Design Commercial |
$1,732.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$2,265.25
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,599.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,599.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$491.23
|
| Rate for Payer: United Healthcare All Other HMO |
$491.23
|
| Rate for Payer: United Healthcare HMO Rider |
$491.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$491.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC CT ABDOMEN WO CONTR
|
Facility
|
IP
|
$4,791.00
|
|
|
Service Code
|
CPT 74150
|
| Hospital Charge Code |
909201927
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$958.20 |
| Max. Negotiated Rate |
$4,311.90 |
| Rate for Payer: Adventist Health Commercial |
$958.20
|
| Rate for Payer: Cash Price |
$2,155.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,832.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,916.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,916.40
|
| Rate for Payer: Galaxy Health WC |
$4,072.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,874.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,311.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,195.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,825.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,965.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$958.20
|
| Rate for Payer: Multiplan Commercial |
$3,593.25
|
| Rate for Payer: Networks By Design Commercial |
$3,114.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,072.35
|
|
|
HC CT ABDOMEN W/WO CONT
|
Facility
|
IP
|
$6,243.00
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
909201929
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,248.60 |
| Max. Negotiated Rate |
$5,618.70 |
| Rate for Payer: Adventist Health Commercial |
$1,248.60
|
| Rate for Payer: Cash Price |
$2,809.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,994.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,497.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,497.20
|
| Rate for Payer: Galaxy Health WC |
$5,306.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,745.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,618.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,164.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,378.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,864.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,248.60
|
| Rate for Payer: Multiplan Commercial |
$4,682.25
|
| Rate for Payer: Networks By Design Commercial |
$4,057.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,306.55
|
|
|
HC CT ABDOMEN W/WO CONT
|
Facility
|
OP
|
$3,505.00
|
|
|
Service Code
|
CPT 74170
|
| Hospital Charge Code |
909201929
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,154.50 |
| Rate for Payer: Adventist Health Commercial |
$701.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,747.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,058.49
|
| Rate for Payer: Blue Shield of California Commercial |
$2,127.53
|
| Rate for Payer: Blue Shield of California EPN |
$1,391.48
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,804.00
|
| Rate for Payer: Cigna of CA HMO |
$2,243.20
|
| Rate for Payer: Cigna of CA PPO |
$2,593.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$2,979.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,103.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,154.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,337.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$701.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,628.75
|
| Rate for Payer: Networks By Design Commercial |
$2,278.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$2,979.25
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,103.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,103.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$855.26
|
| Rate for Payer: United Healthcare All Other HMO |
$855.26
|
| Rate for Payer: United Healthcare HMO Rider |
$855.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$855.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO ABD AORTA-AIF W/WO CO
|
Facility
|
IP
|
$6,465.00
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
909201809
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,293.00 |
| Max. Negotiated Rate |
$5,818.50 |
| Rate for Payer: Adventist Health Commercial |
$1,293.00
|
| Rate for Payer: Cash Price |
$2,909.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,172.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,586.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,586.00
|
| Rate for Payer: Galaxy Health WC |
$5,495.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,879.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,818.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,312.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,463.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,001.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,293.00
|
| Rate for Payer: Multiplan Commercial |
$4,848.75
|
| Rate for Payer: Networks By Design Commercial |
$4,202.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,495.25
|
|
|
HC CT ANGIO ABD AORTA-AIF W/WO CO
|
Facility
|
OP
|
$4,310.00
|
|
|
Service Code
|
CPT 75635
|
| Hospital Charge Code |
909201809
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,879.00 |
| Rate for Payer: Adventist Health Commercial |
$862.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,786.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,531.26
|
| Rate for Payer: Blue Shield of California Commercial |
$2,616.17
|
| Rate for Payer: Blue Shield of California EPN |
$1,711.07
|
| Rate for Payer: Cash Price |
$1,939.50
|
| Rate for Payer: Cash Price |
$1,939.50
|
| Rate for Payer: Cash Price |
$1,939.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,448.00
|
| Rate for Payer: Cigna of CA HMO |
$2,758.40
|
| Rate for Payer: Cigna of CA PPO |
$3,189.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$3,663.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,586.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,879.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$589.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,874.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$650.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$862.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$3,232.50
|
| Rate for Payer: Networks By Design Commercial |
$2,801.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$3,663.50
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,586.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,586.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
|
HC CT ANGIO ABDOMEN/PELVIS
|
Facility
|
OP
|
$3,802.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
909201991
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$453.77 |
| Max. Negotiated Rate |
$3,421.80 |
| Rate for Payer: Adventist Health Commercial |
$760.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$453.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,754.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,232.91
|
| Rate for Payer: Blue Shield of California Commercial |
$2,307.81
|
| Rate for Payer: Blue Shield of California EPN |
$1,509.39
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Cash Price |
$1,710.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,041.60
|
| Rate for Payer: Cigna of CA HMO |
$2,433.28
|
| Rate for Payer: Cigna of CA PPO |
$2,813.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$3,231.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,421.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$605.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: InnovAge PACE Commercial |
$680.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,535.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$668.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$2,851.50
|
| Rate for Payer: Networks By Design Commercial |
$2,471.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$453.77
|
| Rate for Payer: Prime Health Services Commercial |
$3,231.70
|
| Rate for Payer: Prime Health Services Medicare |
$481.00
|
| Rate for Payer: Riverside University Health System MISP |
$499.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,486.18
|
| Rate for Payer: United Healthcare All Other HMO |
$1,486.18
|
| Rate for Payer: United Healthcare HMO Rider |
$1,486.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,486.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CT ANGIO ABDOMEN/PELVIS
|
Facility
|
IP
|
$6,774.00
|
|
|
Service Code
|
CPT 74174
|
| Hospital Charge Code |
909201991
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,354.80 |
| Max. Negotiated Rate |
$6,096.60 |
| Rate for Payer: Adventist Health Commercial |
$1,354.80
|
| Rate for Payer: Cash Price |
$3,048.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,419.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,709.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,709.60
|
| Rate for Payer: Galaxy Health WC |
$5,757.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,064.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,096.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,518.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,580.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,193.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,354.80
|
| Rate for Payer: Multiplan Commercial |
$5,080.50
|
| Rate for Payer: Networks By Design Commercial |
$4,403.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,757.90
|
|
|
HC CT ANGIO ABDOMEN W/WO CONTRAST
|
Facility
|
OP
|
$3,890.00
|
|
|
Service Code
|
CPT 74175
|
| Hospital Charge Code |
909201808
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$226.19 |
| Max. Negotiated Rate |
$3,501.00 |
| Rate for Payer: Adventist Health Commercial |
$778.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$226.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$226.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,786.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,284.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,361.23
|
| Rate for Payer: Blue Shield of California EPN |
$1,544.33
|
| Rate for Payer: Cash Price |
$1,750.50
|
| Rate for Payer: Cash Price |
$1,750.50
|
| Rate for Payer: Cash Price |
$1,750.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,112.00
|
| Rate for Payer: Cigna of CA HMO |
$2,489.60
|
| Rate for Payer: Cigna of CA PPO |
$2,878.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$339.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$248.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$226.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.36
|
| Rate for Payer: EPIC Health Plan Senior |
$226.19
|
| Rate for Payer: Galaxy Health WC |
$3,306.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,334.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,501.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$370.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$476.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$226.19
|
| Rate for Payer: InnovAge PACE Commercial |
$339.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,594.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$226.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$778.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$303.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$303.09
|
| Rate for Payer: Multiplan Commercial |
$2,917.50
|
| Rate for Payer: Networks By Design Commercial |
$2,528.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$226.19
|
| Rate for Payer: Prime Health Services Commercial |
$3,306.50
|
| Rate for Payer: Prime Health Services Medicare |
$239.76
|
| Rate for Payer: Riverside University Health System MISP |
$248.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,334.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,334.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.48
|
| Rate for Payer: United Healthcare All Other HMO |
$866.48
|
| Rate for Payer: United Healthcare HMO Rider |
$866.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$226.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$339.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$248.81
|
| Rate for Payer: Vantage Medical Group Senior |
$226.19
|
|
