|
HC DRAINAGE/ SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$6,688.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
900501614
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,337.60 |
| Max. Negotiated Rate |
$6,019.20 |
| Rate for Payer: Adventist Health Commercial |
$1,337.60
|
| Rate for Payer: Cash Price |
$3,009.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,350.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,681.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,675.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,675.20
|
| Rate for Payer: Galaxy Health WC |
$5,684.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,012.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,019.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,246.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,945.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,337.60
|
| Rate for Payer: Multiplan Commercial |
$5,016.00
|
| Rate for Payer: Networks By Design Commercial |
$4,347.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,684.80
|
|
|
HC DRAINAGE/ SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$6,688.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
900501614
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$370.67 |
| Max. Negotiated Rate |
$6,019.20 |
| Rate for Payer: Adventist Health Commercial |
$1,337.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$3,009.60
|
| Rate for Payer: Cash Price |
$3,009.60
|
| Rate for Payer: Cash Price |
$3,009.60
|
| Rate for Payer: Cash Price |
$3,009.60
|
| Rate for Payer: Central Health Plan Commercial |
$5,350.40
|
| Rate for Payer: Cigna of CA HMO |
$4,280.32
|
| Rate for Payer: Cigna of CA PPO |
$4,949.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,681.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$5,684.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,012.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,019.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,246.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$370.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,337.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$5,016.00
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$4,347.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,684.80
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,012.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,344.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,344.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,344.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,344.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC DRAIN CATH PLCMT HEMATOMA/SEROMA/CYST
|
Facility
|
OP
|
$3,850.00
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
909020024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.24 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$770.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$910.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,732.50
|
| Rate for Payer: Cash Price |
$1,732.50
|
| Rate for Payer: Cash Price |
$1,732.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,080.00
|
| Rate for Payer: Cigna of CA HMO |
$2,464.00
|
| Rate for Payer: Cigna of CA PPO |
$2,849.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,695.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$3,272.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,310.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,465.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$229.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,444.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$253.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$770.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,887.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,502.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,272.50
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,310.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,925.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC DRAIN CATH PLCMT HEMATOMA/SEROMA/CYST
|
Facility
|
IP
|
$3,850.00
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
909020024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$770.00 |
| Max. Negotiated Rate |
$3,465.00 |
| Rate for Payer: Adventist Health Commercial |
$770.00
|
| Rate for Payer: Cash Price |
$1,732.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,080.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,695.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,540.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,540.00
|
| Rate for Payer: Galaxy Health WC |
$3,272.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,310.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,465.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,444.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,271.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$770.00
|
| Rate for Payer: Multiplan Commercial |
$2,887.50
|
| Rate for Payer: Networks By Design Commercial |
$2,502.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,272.50
|
|
|
HC DRAIN CHEST ATRIUM
|
Facility
|
IP
|
$287.28
|
|
| Hospital Charge Code |
901600595
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.46 |
| Max. Negotiated Rate |
$258.55 |
| Rate for Payer: Adventist Health Commercial |
$57.46
|
| Rate for Payer: Cash Price |
$129.28
|
| Rate for Payer: Central Health Plan Commercial |
$229.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.91
|
| Rate for Payer: EPIC Health Plan Senior |
$114.91
|
| Rate for Payer: Galaxy Health WC |
$244.19
|
| Rate for Payer: Global Benefits Group Commercial |
$172.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$258.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.46
|
| Rate for Payer: Multiplan Commercial |
$215.46
|
| Rate for Payer: Networks By Design Commercial |
$186.73
|
| Rate for Payer: Prime Health Services Commercial |
$244.19
|
|
|
HC DRAIN CHEST ATRIUM
|
Facility
|
OP
|
$287.28
|
|
| Hospital Charge Code |
901600595
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.46 |
| Max. Negotiated Rate |
$258.55 |
| Rate for Payer: Adventist Health Commercial |
$57.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$174.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$215.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.11
|
| Rate for Payer: Blue Shield of California Commercial |
$182.14
|
| Rate for Payer: Blue Shield of California EPN |
$114.62
|
| Rate for Payer: Cash Price |
$129.28
|
| Rate for Payer: Central Health Plan Commercial |
$229.82
|
| Rate for Payer: Cigna of CA HMO |
$183.86
|
| Rate for Payer: Cigna of CA PPO |
$212.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.91
|
| Rate for Payer: EPIC Health Plan Senior |
$114.91
|
| Rate for Payer: Galaxy Health WC |
$244.19
|
| Rate for Payer: Global Benefits Group Commercial |
$172.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$258.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$215.46
|
| Rate for Payer: Networks By Design Commercial |
$186.73
|
| Rate for Payer: Prime Health Services Commercial |
$244.19
|
| Rate for Payer: Riverside University Health System MISP |
$114.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.64
|
| Rate for Payer: United Healthcare All Other HMO |
$143.64
|
| Rate for Payer: United Healthcare HMO Rider |
$143.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.19
|
| Rate for Payer: Vantage Medical Group Senior |
$244.19
|
|
|
HC DRAINE SKENES GLAND ABSCESS
|
Facility
|
OP
|
$8,747.00
|
|
|
Service Code
|
CPT 53060
|
| Hospital Charge Code |
950442317
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.54 |
| Max. Negotiated Rate |
$7,872.30 |
| Rate for Payer: Cigna of CA HMO |
$5,598.08
|
| Rate for Payer: Cigna of CA PPO |
$6,472.78
|
| Rate for Payer: Adventist Health Commercial |
$1,749.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,688.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,147.14
|
| Rate for Payer: Cash Price |
$3,936.15
|
| Rate for Payer: Cash Price |
$3,936.15
|
| Rate for Payer: Cash Price |
$3,936.15
|
| Rate for Payer: Cash Price |
$3,936.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,997.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,957.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,688.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,122.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,436.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2,957.44
|
| Rate for Payer: Galaxy Health WC |
$7,434.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,248.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,872.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,409.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,688.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,554.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,890.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,749.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,602.70
|
| Rate for Payer: Multiplan Commercial |
$6,560.25
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$5,685.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,688.58
|
| Rate for Payer: Preferred Health Network WC |
$4,231.78
|
| Rate for Payer: Prime Health Services Commercial |
$7,434.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,849.89
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Riverside University Health System MISP |
$2,957.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,248.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,373.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,373.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,373.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,373.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,688.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,032.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,957.44
|
| Rate for Payer: Vantage Medical Group Senior |
$2,688.58
|
|
|
HC DRAINE SKENES GLAND ABSCESS
|
Facility
|
IP
|
$8,747.00
|
|
|
Service Code
|
CPT 53060
|
| Hospital Charge Code |
950442317
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,749.40 |
| Max. Negotiated Rate |
$7,872.30 |
| Rate for Payer: Adventist Health Commercial |
$1,749.40
|
| Rate for Payer: Cash Price |
$3,936.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,997.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,122.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,498.80
|
| Rate for Payer: Galaxy Health WC |
$7,434.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,248.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,872.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,554.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,160.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,749.40
|
| Rate for Payer: Multiplan Commercial |
$6,560.25
|
| Rate for Payer: Networks By Design Commercial |
$5,685.55
|
| Rate for Payer: Prime Health Services Commercial |
$7,434.95
|
|
|
HC DRAIN EXT EAR ABSC SIMPLE
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
900501184
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$236.00 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Adventist Health Commercial |
$236.00
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Central Health Plan Commercial |
$944.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$826.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$472.00
|
| Rate for Payer: EPIC Health Plan Senior |
$472.00
|
| Rate for Payer: Galaxy Health WC |
$1,003.00
|
| Rate for Payer: Global Benefits Group Commercial |
$708.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,062.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$749.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$696.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.00
|
| Rate for Payer: Multiplan Commercial |
$885.00
|
| Rate for Payer: Networks By Design Commercial |
$767.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,003.00
|
|
|
HC DRAIN EXT EAR ABSC SIMPLE
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
900501184
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.52 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$236.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Central Health Plan Commercial |
$944.00
|
| Rate for Payer: Cigna of CA HMO |
$755.20
|
| Rate for Payer: Cigna of CA PPO |
$873.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$826.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$1,003.00
|
| Rate for Payer: Global Benefits Group Commercial |
$708.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,062.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$749.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$885.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$767.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,003.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$708.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$590.00
|
| Rate for Payer: United Healthcare All Other HMO |
$590.00
|
| Rate for Payer: United Healthcare HMO Rider |
$590.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$590.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC DRAIN EXT EAR ABSC SIMPLE
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
900501184
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$107.52 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$483.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$678.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Central Health Plan Commercial |
$944.00
|
| Rate for Payer: Cigna of CA HMO |
$755.20
|
| Rate for Payer: Cigna of CA PPO |
$873.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$826.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$1,003.00
|
| Rate for Payer: Global Benefits Group Commercial |
$708.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,062.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$749.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$107.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$885.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$767.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,003.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$708.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$708.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC DRAIN EXT EAR ABSC SIMPLE
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
CPT 69000
|
| Hospital Charge Code |
900501184
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$236.00 |
| Max. Negotiated Rate |
$1,062.00 |
| Rate for Payer: Adventist Health Commercial |
$236.00
|
| Rate for Payer: Cash Price |
$531.00
|
| Rate for Payer: Central Health Plan Commercial |
$944.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$826.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$472.00
|
| Rate for Payer: EPIC Health Plan Senior |
$472.00
|
| Rate for Payer: Galaxy Health WC |
$1,003.00
|
| Rate for Payer: Global Benefits Group Commercial |
$708.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,062.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$749.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$696.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.00
|
| Rate for Payer: Multiplan Commercial |
$885.00
|
| Rate for Payer: Networks By Design Commercial |
$767.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,003.00
|
|
|
HC DRAIN EXTERNAL PEDS BAXTER
|
Facility
|
IP
|
$1,274.20
|
|
| Hospital Charge Code |
901603691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.84 |
| Max. Negotiated Rate |
$1,146.78 |
| Rate for Payer: Adventist Health Commercial |
$254.84
|
| Rate for Payer: Cash Price |
$573.39
|
| Rate for Payer: Central Health Plan Commercial |
$1,019.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$891.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$509.68
|
| Rate for Payer: EPIC Health Plan Senior |
$509.68
|
| Rate for Payer: Galaxy Health WC |
$1,083.07
|
| Rate for Payer: Global Benefits Group Commercial |
$764.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,146.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$809.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$751.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.84
|
| Rate for Payer: Multiplan Commercial |
$955.65
|
| Rate for Payer: Networks By Design Commercial |
$828.23
|
| Rate for Payer: Prime Health Services Commercial |
$1,083.07
|
|
|
HC DRAIN EXTERNAL PEDS BAXTER
|
Facility
|
OP
|
$1,274.20
|
|
| Hospital Charge Code |
901603691
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$254.84 |
| Max. Negotiated Rate |
$1,146.78 |
| Rate for Payer: Adventist Health Commercial |
$254.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$773.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,083.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$700.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$955.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$616.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$741.20
|
| Rate for Payer: Blue Shield of California Commercial |
$807.84
|
| Rate for Payer: Blue Shield of California EPN |
$508.41
|
| Rate for Payer: Cash Price |
$573.39
|
| Rate for Payer: Central Health Plan Commercial |
$1,019.36
|
| Rate for Payer: Cigna of CA HMO |
$815.49
|
| Rate for Payer: Cigna of CA PPO |
$942.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,083.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,083.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,083.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$891.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$509.68
|
| Rate for Payer: EPIC Health Plan Senior |
$509.68
|
| Rate for Payer: Galaxy Health WC |
$1,083.07
|
| Rate for Payer: Global Benefits Group Commercial |
$764.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,146.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$809.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$462.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$751.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$891.94
|
| Rate for Payer: Multiplan Commercial |
$955.65
|
| Rate for Payer: Networks By Design Commercial |
$828.23
|
| Rate for Payer: Prime Health Services Commercial |
$1,083.07
|
| Rate for Payer: Riverside University Health System MISP |
$509.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$764.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$764.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$637.10
|
| Rate for Payer: United Healthcare All Other HMO |
$637.10
|
| Rate for Payer: United Healthcare HMO Rider |
$637.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$637.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,083.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,083.07
|
| Rate for Payer: Vantage Medical Group Senior |
$1,083.07
|
|
|
HC DRAIN FINGER ABSCESS COMPL
|
Facility
|
OP
|
$5,695.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
900501073
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$269.51 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$2,334.95
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,043.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,556.00
|
| Rate for Payer: Cigna of CA HMO |
$3,644.80
|
| Rate for Payer: Cigna of CA PPO |
$4,214.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,986.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$4,840.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,417.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,125.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,616.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$269.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,139.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$4,271.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,701.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,840.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,417.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,417.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC DRAIN FINGER ABSCESS COMPL
|
Facility
|
IP
|
$5,695.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
900501073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,139.00 |
| Max. Negotiated Rate |
$5,125.50 |
| Rate for Payer: Adventist Health Commercial |
$1,139.00
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,556.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,986.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,278.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,278.00
|
| Rate for Payer: Galaxy Health WC |
$4,840.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,417.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,125.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,616.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,360.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,139.00
|
| Rate for Payer: Multiplan Commercial |
$4,271.25
|
| Rate for Payer: Networks By Design Commercial |
$3,701.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,840.75
|
|
|
HC DRAIN FINGER ABSCESS COMPL
|
Facility
|
IP
|
$5,695.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
900501073
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,139.00 |
| Max. Negotiated Rate |
$5,125.50 |
| Rate for Payer: Adventist Health Commercial |
$1,139.00
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,556.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,986.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,278.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,278.00
|
| Rate for Payer: Galaxy Health WC |
$4,840.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,417.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,125.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,616.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,360.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,139.00
|
| Rate for Payer: Multiplan Commercial |
$4,271.25
|
| Rate for Payer: Networks By Design Commercial |
$3,701.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,840.75
|
|
|
HC DRAIN FINGER ABSCESS COMPL
|
Facility
|
OP
|
$5,695.00
|
|
|
Service Code
|
CPT 26011
|
| Hospital Charge Code |
900501073
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$269.51 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,139.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Cash Price |
$2,562.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,556.00
|
| Rate for Payer: Cigna of CA HMO |
$3,644.80
|
| Rate for Payer: Cigna of CA PPO |
$4,214.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,986.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$4,840.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,417.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,125.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,616.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$269.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,139.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$4,271.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,701.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,840.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,417.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,847.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,847.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,847.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,847.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC DRAIN FINGER ABSCESS, SIMPLE
|
Facility
|
IP
|
$1,331.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
900501461
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$266.20 |
| Max. Negotiated Rate |
$1,197.90 |
| Rate for Payer: Adventist Health Commercial |
$266.20
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,064.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$931.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$532.40
|
| Rate for Payer: EPIC Health Plan Senior |
$532.40
|
| Rate for Payer: Galaxy Health WC |
$1,131.35
|
| Rate for Payer: Global Benefits Group Commercial |
$798.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,197.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$845.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$785.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.20
|
| Rate for Payer: Multiplan Commercial |
$998.25
|
| Rate for Payer: Networks By Design Commercial |
$865.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,131.35
|
|
|
HC DRAIN FINGER ABSCESS, SIMPLE
|
Facility
|
IP
|
$1,331.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
900501461
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$266.20 |
| Max. Negotiated Rate |
$1,197.90 |
| Rate for Payer: Adventist Health Commercial |
$266.20
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,064.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$931.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$532.40
|
| Rate for Payer: EPIC Health Plan Senior |
$532.40
|
| Rate for Payer: Galaxy Health WC |
$1,131.35
|
| Rate for Payer: Global Benefits Group Commercial |
$798.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,197.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$845.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$785.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.20
|
| Rate for Payer: Multiplan Commercial |
$998.25
|
| Rate for Payer: Networks By Design Commercial |
$865.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,131.35
|
|
|
HC DRAIN FINGER ABSCESS, SIMPLE
|
Facility
|
OP
|
$1,331.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
900501461
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.78 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$266.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,064.80
|
| Rate for Payer: Cigna of CA HMO |
$851.84
|
| Rate for Payer: Cigna of CA PPO |
$984.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$931.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$1,131.35
|
| Rate for Payer: Global Benefits Group Commercial |
$798.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,197.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$845.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$998.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$865.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$258.05
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,131.35
|
| Rate for Payer: Prime Health Services Medicare |
$273.53
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$283.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$798.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$665.50
|
| Rate for Payer: United Healthcare All Other HMO |
$665.50
|
| Rate for Payer: United Healthcare HMO Rider |
$665.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$665.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC DRAIN FINGER ABSCESS, SIMPLE
|
Facility
|
OP
|
$1,331.00
|
|
|
Service Code
|
CPT 26010
|
| Hospital Charge Code |
900501461
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$198.78 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$545.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$766.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Cash Price |
$598.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,064.80
|
| Rate for Payer: Cigna of CA HMO |
$851.84
|
| Rate for Payer: Cigna of CA PPO |
$984.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$931.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$1,131.35
|
| Rate for Payer: Global Benefits Group Commercial |
$798.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,197.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$845.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$998.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$865.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$258.05
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,131.35
|
| Rate for Payer: Prime Health Services Medicare |
$273.53
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$283.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$798.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$798.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC DRAIN FLAT 10FR W/TROCAR
|
Facility
|
IP
|
$196.14
|
|
| Hospital Charge Code |
901603860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.23 |
| Max. Negotiated Rate |
$176.53 |
| Rate for Payer: Adventist Health Commercial |
$39.23
|
| Rate for Payer: Cash Price |
$88.26
|
| Rate for Payer: Central Health Plan Commercial |
$156.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.46
|
| Rate for Payer: EPIC Health Plan Senior |
$78.46
|
| Rate for Payer: Galaxy Health WC |
$166.72
|
| Rate for Payer: Global Benefits Group Commercial |
$117.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.23
|
| Rate for Payer: Multiplan Commercial |
$147.10
|
| Rate for Payer: Networks By Design Commercial |
$127.49
|
| Rate for Payer: Prime Health Services Commercial |
$166.72
|
|
|
HC DRAIN FLAT 10FR W/TROCAR
|
Facility
|
OP
|
$196.14
|
|
| Hospital Charge Code |
901603860
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.23 |
| Max. Negotiated Rate |
$176.53 |
| Rate for Payer: Adventist Health Commercial |
$39.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$94.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.09
|
| Rate for Payer: Blue Shield of California Commercial |
$124.35
|
| Rate for Payer: Blue Shield of California EPN |
$78.26
|
| Rate for Payer: Cash Price |
$88.26
|
| Rate for Payer: Central Health Plan Commercial |
$156.91
|
| Rate for Payer: Cigna of CA HMO |
$125.53
|
| Rate for Payer: Cigna of CA PPO |
$145.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.46
|
| Rate for Payer: EPIC Health Plan Senior |
$78.46
|
| Rate for Payer: Galaxy Health WC |
$166.72
|
| Rate for Payer: Global Benefits Group Commercial |
$117.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$71.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$137.30
|
| Rate for Payer: Multiplan Commercial |
$147.10
|
| Rate for Payer: Networks By Design Commercial |
$127.49
|
| Rate for Payer: Prime Health Services Commercial |
$166.72
|
| Rate for Payer: Riverside University Health System MISP |
$78.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.07
|
| Rate for Payer: United Healthcare All Other HMO |
$98.07
|
| Rate for Payer: United Healthcare HMO Rider |
$98.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.72
|
| Rate for Payer: Vantage Medical Group Senior |
$166.72
|
|
|
HC DRAIN HEMOVAC 1/8" CLSD SCTN
|
Facility
|
IP
|
$23.70
|
|
| Hospital Charge Code |
901605639
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.74 |
| Max. Negotiated Rate |
$21.33 |
| Rate for Payer: Adventist Health Commercial |
$4.74
|
| Rate for Payer: Cash Price |
$10.66
|
| Rate for Payer: Central Health Plan Commercial |
$18.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.48
|
| Rate for Payer: EPIC Health Plan Senior |
$9.48
|
| Rate for Payer: Galaxy Health WC |
$20.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.74
|
| Rate for Payer: Multiplan Commercial |
$17.77
|
| Rate for Payer: Networks By Design Commercial |
$15.40
|
| Rate for Payer: Prime Health Services Commercial |
$20.14
|
|
