|
HC BINDER ABD 9IN TRI-PANEL S/M
|
Facility
|
OP
|
$152.00
|
|
| Hospital Charge Code |
901698665
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.80
|
| Rate for Payer: Blue Distinction Transplant |
$91.20
|
| Rate for Payer: Blue Shield of California Commercial |
$95.61
|
| Rate for Payer: Blue Shield of California EPN |
$74.33
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.20
|
| Rate for Payer: Dignity Health Media |
$129.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$114.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Riverside University Health System MISP |
$60.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.00
|
| Rate for Payer: United Healthcare All Other HMO |
$76.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.20
|
| Rate for Payer: Vantage Medical Group Senior |
$129.20
|
|
|
HC BINDER ABD 9IN TRI-PANEL S/M
|
Facility
|
IP
|
$152.00
|
|
| Hospital Charge Code |
901698665
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$136.80 |
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Central Health Plan Commercial |
$121.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.40
|
| Rate for Payer: Multiplan Commercial |
$114.00
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC BIOBAG LARVAE 10X10CM
|
Facility
|
IP
|
$713.00
|
|
| Hospital Charge Code |
901698179
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$142.60 |
| Max. Negotiated Rate |
$641.70 |
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Central Health Plan Commercial |
$570.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$285.20
|
| Rate for Payer: Galaxy Health WC |
$606.05
|
| Rate for Payer: Global Benefits Group Commercial |
$427.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$641.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$475.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$271.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.60
|
| Rate for Payer: Multiplan Commercial |
$534.75
|
| Rate for Payer: Networks By Design Commercial |
$463.45
|
| Rate for Payer: Prime Health Services Commercial |
$606.05
|
|
|
HC BIOBAG LARVAE 10X10CM
|
Facility
|
OP
|
$713.00
|
|
| Hospital Charge Code |
901698179
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$142.60 |
| Max. Negotiated Rate |
$641.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$433.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$606.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$392.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$392.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$345.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$421.24
|
| Rate for Payer: Blue Distinction Transplant |
$427.80
|
| Rate for Payer: Blue Shield of California Commercial |
$448.48
|
| Rate for Payer: Blue Shield of California EPN |
$348.66
|
| Rate for Payer: Cash Price |
$320.85
|
| Rate for Payer: Central Health Plan Commercial |
$570.40
|
| Rate for Payer: Cigna of CA HMO |
$456.32
|
| Rate for Payer: Cigna of CA PPO |
$527.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$606.05
|
| Rate for Payer: Dignity Health Media |
$606.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$606.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$285.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$285.20
|
| Rate for Payer: Galaxy Health WC |
$606.05
|
| Rate for Payer: Global Benefits Group Commercial |
$427.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$641.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$534.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$249.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$475.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$271.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.60
|
| Rate for Payer: Multiplan Commercial |
$534.75
|
| Rate for Payer: Networks By Design Commercial |
$463.45
|
| Rate for Payer: Prime Health Services Commercial |
$606.05
|
| Rate for Payer: Riverside University Health System MISP |
$285.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$427.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$427.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$356.50
|
| Rate for Payer: United Healthcare All Other HMO |
$356.50
|
| Rate for Payer: United Healthcare HMO Rider |
$356.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$356.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$606.05
|
| Rate for Payer: Vantage Medical Group Senior |
$606.05
|
|
|
HC BIOBAG LARVAE 12X6CM
|
Facility
|
IP
|
$2,001.00
|
|
| Hospital Charge Code |
901698178
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$400.20 |
| Max. Negotiated Rate |
$1,800.90 |
| Rate for Payer: Cash Price |
$900.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,600.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$800.40
|
| Rate for Payer: Galaxy Health WC |
$1,700.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,200.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,800.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,334.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$762.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$400.20
|
| Rate for Payer: Multiplan Commercial |
$1,500.75
|
| Rate for Payer: Networks By Design Commercial |
$1,300.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,700.85
|
|
|
HC BIOBAG LARVAE 12X6CM
|
Facility
|
OP
|
$2,001.00
|
|
| Hospital Charge Code |
901698178
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$400.20 |
| Max. Negotiated Rate |
$1,800.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,215.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,700.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,100.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,100.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$968.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,182.19
|
| Rate for Payer: Blue Distinction Transplant |
$1,200.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,258.63
|
| Rate for Payer: Blue Shield of California EPN |
$978.49
|
| Rate for Payer: Cash Price |
$900.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,600.80
|
| Rate for Payer: Cigna of CA HMO |
$1,280.64
|
| Rate for Payer: Cigna of CA PPO |
$1,480.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,700.85
|
| Rate for Payer: Dignity Health Media |
$1,700.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,700.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$800.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$800.40
|
| Rate for Payer: Galaxy Health WC |
$1,700.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,200.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,800.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,500.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$700.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,334.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$762.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$400.20
|
| Rate for Payer: Multiplan Commercial |
$1,500.75
|
| Rate for Payer: Networks By Design Commercial |
$1,300.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,700.85
|
| Rate for Payer: Riverside University Health System MISP |
$800.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,200.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,200.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,000.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,000.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,000.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,700.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,700.85
|
|
|
HC BIOBAG LARVAE 2.5 X 4CM
|
Facility
|
IP
|
$1,817.00
|
|
| Hospital Charge Code |
901698175
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$363.40 |
| Max. Negotiated Rate |
$1,635.30 |
| Rate for Payer: Cash Price |
$817.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,453.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.80
|
| Rate for Payer: Galaxy Health WC |
$1,544.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,090.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,635.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,211.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$692.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.40
|
| Rate for Payer: Multiplan Commercial |
$1,362.75
|
| Rate for Payer: Networks By Design Commercial |
$1,181.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,544.45
|
|
|
HC BIOBAG LARVAE 2.5 X 4CM
|
Facility
|
OP
|
$1,817.00
|
|
| Hospital Charge Code |
901698175
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$363.40 |
| Max. Negotiated Rate |
$1,635.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,103.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,544.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$999.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$999.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$879.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,073.48
|
| Rate for Payer: Blue Distinction Transplant |
$1,090.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,142.89
|
| Rate for Payer: Blue Shield of California EPN |
$888.51
|
| Rate for Payer: Cash Price |
$817.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,453.60
|
| Rate for Payer: Cigna of CA HMO |
$1,162.88
|
| Rate for Payer: Cigna of CA PPO |
$1,344.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,544.45
|
| Rate for Payer: Dignity Health Media |
$1,544.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,544.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$726.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$726.80
|
| Rate for Payer: Galaxy Health WC |
$1,544.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,090.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,635.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,362.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$635.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,211.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$692.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$363.40
|
| Rate for Payer: Multiplan Commercial |
$1,362.75
|
| Rate for Payer: Networks By Design Commercial |
$1,181.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,544.45
|
| Rate for Payer: Riverside University Health System MISP |
$726.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,090.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,090.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$908.50
|
| Rate for Payer: United Healthcare All Other HMO |
$908.50
|
| Rate for Payer: United Healthcare HMO Rider |
$908.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$908.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,544.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,544.45
|
|
|
HC BIOBAG LARVAE 5X4CM
|
Facility
|
OP
|
$1,863.00
|
|
| Hospital Charge Code |
901698176
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$372.60 |
| Max. Negotiated Rate |
$1,676.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,131.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,583.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,024.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,024.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$902.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,100.66
|
| Rate for Payer: Blue Distinction Transplant |
$1,117.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,171.83
|
| Rate for Payer: Blue Shield of California EPN |
$911.01
|
| Rate for Payer: Cash Price |
$838.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,490.40
|
| Rate for Payer: Cigna of CA HMO |
$1,192.32
|
| Rate for Payer: Cigna of CA PPO |
$1,378.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,583.55
|
| Rate for Payer: Dignity Health Media |
$1,583.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,583.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$745.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$745.20
|
| Rate for Payer: Galaxy Health WC |
$1,583.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,117.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,676.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,397.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$652.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,242.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$709.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$372.60
|
| Rate for Payer: Multiplan Commercial |
$1,397.25
|
| Rate for Payer: Networks By Design Commercial |
$1,210.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$745.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,117.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,117.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$931.50
|
| Rate for Payer: United Healthcare All Other HMO |
$931.50
|
| Rate for Payer: United Healthcare HMO Rider |
$931.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$931.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,583.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,583.55
|
|
|
HC BIOBAG LARVAE 5X4CM
|
Facility
|
IP
|
$1,863.00
|
|
| Hospital Charge Code |
901698176
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$372.60 |
| Max. Negotiated Rate |
$1,676.70 |
| Rate for Payer: Cash Price |
$838.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,490.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$745.20
|
| Rate for Payer: Galaxy Health WC |
$1,583.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,117.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,676.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,242.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$709.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$372.60
|
| Rate for Payer: Multiplan Commercial |
$1,397.25
|
| Rate for Payer: Networks By Design Commercial |
$1,210.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,583.55
|
|
|
HC BIOBAG LARVAE 6X5CM
|
Facility
|
IP
|
$1,909.00
|
|
| Hospital Charge Code |
901698177
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$381.80 |
| Max. Negotiated Rate |
$1,718.10 |
| Rate for Payer: Cash Price |
$859.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,527.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$763.60
|
| Rate for Payer: Galaxy Health WC |
$1,622.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,145.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,718.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,273.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$727.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$381.80
|
| Rate for Payer: Multiplan Commercial |
$1,431.75
|
| Rate for Payer: Networks By Design Commercial |
$1,240.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,622.65
|
|
|
HC BIOBAG LARVAE 6X5CM
|
Facility
|
OP
|
$1,909.00
|
|
| Hospital Charge Code |
901698177
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$381.80 |
| Max. Negotiated Rate |
$1,718.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,159.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,622.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,049.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,049.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$924.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,127.84
|
| Rate for Payer: Blue Distinction Transplant |
$1,145.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,200.76
|
| Rate for Payer: Blue Shield of California EPN |
$933.50
|
| Rate for Payer: Cash Price |
$859.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,527.20
|
| Rate for Payer: Cigna of CA HMO |
$1,221.76
|
| Rate for Payer: Cigna of CA PPO |
$1,412.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,622.65
|
| Rate for Payer: Dignity Health Media |
$1,622.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,622.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$763.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$763.60
|
| Rate for Payer: Galaxy Health WC |
$1,622.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,145.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,718.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,431.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$668.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,273.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$727.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$381.80
|
| Rate for Payer: Multiplan Commercial |
$1,431.75
|
| Rate for Payer: Networks By Design Commercial |
$1,240.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,622.65
|
| Rate for Payer: Riverside University Health System MISP |
$763.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,145.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,145.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$954.50
|
| Rate for Payer: United Healthcare All Other HMO |
$954.50
|
| Rate for Payer: United Healthcare HMO Rider |
$954.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$954.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,622.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,622.65
|
|
|
HC BIOFEEDBACK TRAIN ANY METHOD
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
905601818
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$447.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$447.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$45.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: Cigna of CA HMO |
$48.64
|
| Rate for Payer: Cigna of CA PPO |
$56.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.60
|
| Rate for Payer: Dignity Health Media |
$64.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$57.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.16
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
| Rate for Payer: Riverside University Health System MISP |
$30.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.60
|
| Rate for Payer: Vantage Medical Group Senior |
$64.60
|
|
|
HC BIOFEEDBACK TRAIN ANY METHOD
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
905601818
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.20
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
|
|
HC BIOFEEDBACK TRAIN ANY METHOD OT
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
903208880
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.20
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
|
|
HC BIOFEEDBACK TRAIN ANY METHOD OT
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
903208880
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$447.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$447.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$45.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: Cigna of CA HMO |
$48.64
|
| Rate for Payer: Cigna of CA PPO |
$56.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.60
|
| Rate for Payer: Dignity Health Media |
$64.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$57.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.16
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
| Rate for Payer: Riverside University Health System MISP |
$30.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.60
|
| Rate for Payer: Vantage Medical Group Senior |
$64.60
|
|
|
HC BIOFEEDBACK TRAIN ANY METHOD PT
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
903200262
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$447.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$447.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$45.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: Cigna of CA HMO |
$48.64
|
| Rate for Payer: Cigna of CA PPO |
$56.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.60
|
| Rate for Payer: Dignity Health Media |
$64.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$57.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.16
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
| Rate for Payer: Riverside University Health System MISP |
$30.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.60
|
| Rate for Payer: Vantage Medical Group Senior |
$64.60
|
|
|
HC BIOFEEDBACK TRAIN ANY METHOD PT
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 90901
|
| Hospital Charge Code |
903200262
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Cash Price |
$34.20
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.20
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
|
|
HC BIOFEEDBACK TRNG 1ST 15 MIN
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
CPT 90912
|
| Hospital Charge Code |
906790912
|
|
Hospital Revenue Code
|
917
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$1,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$265.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$129.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$114.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$139.43
|
| Rate for Payer: Blue Distinction Transplant |
$141.60
|
| Rate for Payer: Blue Shield of California Commercial |
$148.44
|
| Rate for Payer: Blue Shield of California EPN |
$115.40
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Cigna of CA HMO |
$151.04
|
| Rate for Payer: Cigna of CA PPO |
$174.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$200.60
|
| Rate for Payer: Dignity Health Media |
$200.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$200.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$177.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$82.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$157.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
| Rate for Payer: Riverside University Health System MISP |
$94.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,510.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,425.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$984.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$200.60
|
| Rate for Payer: Vantage Medical Group Senior |
$200.60
|
|
|
HC BIOFEEDBACK TRNG 1ST 15 MIN
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 90912
|
| Hospital Charge Code |
906790912
|
|
Hospital Revenue Code
|
917
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$212.40 |
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$157.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC BIOFEEDBACK TRNG EA ADD 15 MIN
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
CPT 90913
|
| Hospital Charge Code |
906790913
|
|
Hospital Revenue Code
|
917
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.00
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
|
|
HC BIOFEEDBACK TRNG EA ADD 15 MIN
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
CPT 90913
|
| Hospital Charge Code |
906790913
|
|
Hospital Revenue Code
|
917
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$1,510.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$147.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$80.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.13
|
| Rate for Payer: Blue Distinction Transplant |
$57.00
|
| Rate for Payer: Blue Shield of California Commercial |
$59.76
|
| Rate for Payer: Blue Shield of California EPN |
$46.46
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: Cigna of CA HMO |
$60.80
|
| Rate for Payer: Cigna of CA PPO |
$70.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.75
|
| Rate for Payer: Dignity Health Media |
$80.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$80.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.00
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$71.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
| Rate for Payer: Riverside University Health System MISP |
$38.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,510.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,425.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$984.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.75
|
| Rate for Payer: Vantage Medical Group Senior |
$80.75
|
|
|
HC BIOPSY ANORECTAL WALL
|
Facility
|
IP
|
$10,450.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
906745100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,090.00 |
| Max. Negotiated Rate |
$9,405.00 |
| Rate for Payer: Cash Price |
$4,702.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,360.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,180.00
|
| Rate for Payer: Galaxy Health WC |
$8,882.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,405.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,970.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,981.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,090.00
|
| Rate for Payer: Multiplan Commercial |
$7,837.50
|
| Rate for Payer: Networks By Design Commercial |
$6,792.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,882.50
|
|
|
HC BIOPSY ANORECTAL WALL
|
Facility
|
OP
|
$5,770.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
906745100
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$320.44 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,508.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,508.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,462.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$3,508.15
|
| Rate for Payer: Cash Price |
$2,596.50
|
| Rate for Payer: Cash Price |
$2,596.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,616.00
|
| Rate for Payer: Cigna of CA PPO |
$4,269.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Dignity Health Media |
$3,508.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,858.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,736.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,508.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,508.15
|
| Rate for Payer: Galaxy Health WC |
$4,904.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,462.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,193.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,327.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,753.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,788.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,508.15
|
| Rate for Payer: InnovAge PACE Commercial |
$5,262.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,848.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,508.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,154.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,700.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,700.92
|
| Rate for Payer: Multiplan Commercial |
$4,327.50
|
| Rate for Payer: Networks By Design Commercial |
$3,750.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,904.50
|
| Rate for Payer: Prime Health Services Medicare |
$3,718.64
|
| Rate for Payer: Riverside University Health System MISP |
$3,858.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,462.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,209.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,508.15
|
|
|
HC BIOPSY ANORECTAL WALL
|
Facility
|
OP
|
$5,770.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
906745100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$320.44 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,508.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,508.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,462.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$3,508.15
|
| Rate for Payer: Cash Price |
$2,596.50
|
| Rate for Payer: Cash Price |
$2,596.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,616.00
|
| Rate for Payer: Cigna of CA PPO |
$4,269.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Dignity Health Media |
$3,508.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,858.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,736.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,508.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,508.15
|
| Rate for Payer: Galaxy Health WC |
$4,904.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,462.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,193.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,327.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,753.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,788.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,508.15
|
| Rate for Payer: InnovAge PACE Commercial |
$5,262.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,848.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,508.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,154.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,700.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,700.92
|
| Rate for Payer: Multiplan Commercial |
$4,327.50
|
| Rate for Payer: Networks By Design Commercial |
$3,750.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,904.50
|
| Rate for Payer: Prime Health Services Medicare |
$3,718.64
|
| Rate for Payer: Riverside University Health System MISP |
$3,858.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,462.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,508.15
|
|
