|
HC BLLN ANGIOPLASTY, PULM, INIT
|
Facility
|
OP
|
$15,314.00
|
|
|
Service Code
|
CPT 92997
|
| Hospital Charge Code |
906820075
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$22,679.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,767.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$9,188.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Central Health Plan Commercial |
$12,251.20
|
| Rate for Payer: Cigna of CA HMO |
$9,800.96
|
| Rate for Payer: Cigna of CA PPO |
$11,332.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$13,016.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,782.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,485.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,214.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,035.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,062.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
| Rate for Payer: Networks By Design Commercial |
$9,954.10
|
| Rate for Payer: Prime Health Services Commercial |
$13,016.90
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,188.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC BLLN ANGIOPLASTY, PULM, INIT
|
Facility
|
OP
|
$15,314.00
|
|
|
Service Code
|
CPT 92997
|
| Hospital Charge Code |
906812071
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$22,679.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,767.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$9,188.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Central Health Plan Commercial |
$12,251.20
|
| Rate for Payer: Cigna of CA HMO |
$9,800.96
|
| Rate for Payer: Cigna of CA PPO |
$11,332.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$13,016.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,782.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,485.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,214.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,035.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,062.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
| Rate for Payer: Networks By Design Commercial |
$9,954.10
|
| Rate for Payer: Prime Health Services Commercial |
$13,016.90
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,188.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC BLLN ANGIOPLASTY, PULM, INIT
|
Facility
|
IP
|
$15,314.00
|
|
|
Service Code
|
CPT 92997
|
| Hospital Charge Code |
906820075
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,062.80 |
| Max. Negotiated Rate |
$13,782.60 |
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Central Health Plan Commercial |
$12,251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,125.60
|
| Rate for Payer: Galaxy Health WC |
$13,016.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,782.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,214.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,834.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,062.80
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
| Rate for Payer: Networks By Design Commercial |
$9,954.10
|
| Rate for Payer: Prime Health Services Commercial |
$13,016.90
|
|
|
HC BLLN ANGIOPLASTY, PULM, INIT
|
Facility
|
IP
|
$15,314.00
|
|
|
Service Code
|
CPT 92997
|
| Hospital Charge Code |
906812071
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,062.80 |
| Max. Negotiated Rate |
$13,782.60 |
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Central Health Plan Commercial |
$12,251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,125.60
|
| Rate for Payer: Galaxy Health WC |
$13,016.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,782.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,214.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,834.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,062.80
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
| Rate for Payer: Networks By Design Commercial |
$9,954.10
|
| Rate for Payer: Prime Health Services Commercial |
$13,016.90
|
|
|
HC BLLN DILATION URETERAL STRCTR
|
Facility
|
IP
|
$4,886.00
|
|
|
Service Code
|
CPT 50706
|
| Hospital Charge Code |
909050706
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$977.20 |
| Max. Negotiated Rate |
$4,397.40 |
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.40
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,861.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
|
|
HC BLLN DILATION URETERAL STRCTR
|
Facility
|
OP
|
$4,886.00
|
|
|
Service Code
|
CPT 50706
|
| Hospital Charge Code |
909050706
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,153.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,687.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,687.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,931.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Cash Price |
$2,198.70
|
| Rate for Payer: Central Health Plan Commercial |
$3,908.80
|
| Rate for Payer: Cigna of CA PPO |
$3,615.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,153.10
|
| Rate for Payer: Dignity Health Media |
$4,153.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,153.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,954.40
|
| Rate for Payer: Galaxy Health WC |
$4,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,397.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,664.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,710.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,258.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,329.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.20
|
| Rate for Payer: Multiplan Commercial |
$3,664.50
|
| Rate for Payer: Networks By Design Commercial |
$3,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,153.10
|
| Rate for Payer: Riverside University Health System MISP |
$1,954.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,931.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,153.10
|
|
|
HC BLOOD ADMINISTRATION
|
Facility
|
IP
|
$2,564.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
946100364
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$512.80 |
| Max. Negotiated Rate |
$2,307.60 |
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,051.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,025.60
|
| Rate for Payer: Galaxy Health WC |
$2,179.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,538.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,307.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,710.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$976.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.80
|
| Rate for Payer: Multiplan Commercial |
$1,923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,666.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,179.40
|
|
|
HC BLOOD ADMINISTRATION
|
Facility
|
OP
|
$2,564.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
945100364
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$512.80 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$542.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$542.38
|
| 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 |
$1,538.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,612.76
|
| Rate for Payer: Blue Shield of California EPN |
$1,253.80
|
| Rate for Payer: Caremore Medicare Advantage |
$542.38
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,051.20
|
| Rate for Payer: Cigna of CA HMO |
$1,640.96
|
| Rate for Payer: Cigna of CA PPO |
$1,897.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.57
|
| Rate for Payer: Dignity Health Media |
$542.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$542.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$542.38
|
| Rate for Payer: Galaxy Health WC |
$2,179.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,538.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,307.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,923.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$889.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$894.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$542.38
|
| Rate for Payer: InnovAge PACE Commercial |
$813.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,710.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$976.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$726.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$726.79
|
| Rate for Payer: Multiplan Commercial |
$1,923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,666.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,179.40
|
| Rate for Payer: Prime Health Services Medicare |
$574.92
|
| Rate for Payer: Riverside University Health System MISP |
$596.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,538.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,538.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Vantage Medical Group Senior |
$542.38
|
|
|
HC BLOOD ADMINISTRATION
|
Facility
|
OP
|
$2,564.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
941100364
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$512.80 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$542.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$542.38
|
| 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 |
$1,538.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,612.76
|
| Rate for Payer: Blue Shield of California EPN |
$1,253.80
|
| Rate for Payer: Caremore Medicare Advantage |
$542.38
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,051.20
|
| Rate for Payer: Cigna of CA HMO |
$1,640.96
|
| Rate for Payer: Cigna of CA PPO |
$1,897.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.57
|
| Rate for Payer: Dignity Health Media |
$542.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$542.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$542.38
|
| Rate for Payer: Galaxy Health WC |
$2,179.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,538.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,307.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,923.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$889.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$894.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$542.38
|
| Rate for Payer: InnovAge PACE Commercial |
$813.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,710.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$976.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$726.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$726.79
|
| Rate for Payer: Multiplan Commercial |
$1,923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,666.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,179.40
|
| Rate for Payer: Prime Health Services Medicare |
$574.92
|
| Rate for Payer: Riverside University Health System MISP |
$596.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,538.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,538.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Vantage Medical Group Senior |
$542.38
|
|
|
HC BLOOD ADMINISTRATION
|
Facility
|
IP
|
$2,564.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
945100364
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$512.80 |
| Max. Negotiated Rate |
$2,307.60 |
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,051.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,025.60
|
| Rate for Payer: Galaxy Health WC |
$2,179.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,538.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,307.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,710.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$976.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.80
|
| Rate for Payer: Multiplan Commercial |
$1,923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,666.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,179.40
|
|
|
HC BLOOD ADMINISTRATION
|
Facility
|
OP
|
$2,564.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
946100364
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$512.80 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$542.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$542.38
|
| 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 |
$1,538.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,612.76
|
| Rate for Payer: Blue Shield of California EPN |
$1,253.80
|
| Rate for Payer: Caremore Medicare Advantage |
$542.38
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,051.20
|
| Rate for Payer: Cigna of CA HMO |
$1,640.96
|
| Rate for Payer: Cigna of CA PPO |
$1,897.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.57
|
| Rate for Payer: Dignity Health Media |
$542.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$596.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$542.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$542.38
|
| Rate for Payer: Galaxy Health WC |
$2,179.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,538.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,307.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,923.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$889.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$894.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$542.38
|
| Rate for Payer: InnovAge PACE Commercial |
$813.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,710.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$976.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$726.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$726.79
|
| Rate for Payer: Multiplan Commercial |
$1,923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,666.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,179.40
|
| Rate for Payer: Prime Health Services Medicare |
$574.92
|
| Rate for Payer: Riverside University Health System MISP |
$596.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,538.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,538.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Vantage Medical Group Senior |
$542.38
|
|
|
HC BLOOD ADMINISTRATION
|
Facility
|
IP
|
$2,564.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
941100364
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$512.80 |
| Max. Negotiated Rate |
$2,307.60 |
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,051.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,025.60
|
| Rate for Payer: Galaxy Health WC |
$2,179.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,538.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,307.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,710.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$976.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.80
|
| Rate for Payer: Multiplan Commercial |
$1,923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,666.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,179.40
|
|
|
HC BLOOD DRAW FOR VAD
|
Facility
|
OP
|
$345.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
901200031
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$155.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$189.97
|
| Rate for Payer: Blue Distinction Transplant |
$207.00
|
| Rate for Payer: Blue Shield of California Commercial |
$213.21
|
| Rate for Payer: Blue Shield of California EPN |
$167.67
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: Cigna of CA HMO |
$220.80
|
| Rate for Payer: Cigna of CA PPO |
$255.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$258.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$207.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$207.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.50
|
| Rate for Payer: United Healthcare All Other HMO |
$172.50
|
| Rate for Payer: United Healthcare HMO Rider |
$172.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$172.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC BLOOD DRAW FOR VAD
|
Facility
|
OP
|
$345.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
910100007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$155.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$189.97
|
| Rate for Payer: Blue Distinction Transplant |
$207.00
|
| Rate for Payer: Blue Shield of California Commercial |
$213.21
|
| Rate for Payer: Blue Shield of California EPN |
$167.67
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: Cigna of CA HMO |
$220.80
|
| Rate for Payer: Cigna of CA PPO |
$255.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$258.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$207.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$207.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.50
|
| Rate for Payer: United Healthcare All Other HMO |
$172.50
|
| Rate for Payer: United Healthcare HMO Rider |
$172.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$172.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC BLOOD DRAW FOR VAD
|
Facility
|
IP
|
$345.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
910100007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$138.00
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
|
|
HC BLOOD DRAW FOR VAD
|
Facility
|
IP
|
$345.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
901200031
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$138.00
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
|
|
HC BLOOD DRAW LT 3YRS FEM/JUGULAR
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
CPT 36400
|
| Hospital Charge Code |
900501687
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$118.80 |
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$105.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Multiplan Commercial |
$99.00
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
|
|
HC BLOOD DRAW LT 3YRS FEM/JUGULAR
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
CPT 36400
|
| Hospital Charge Code |
900501687
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$91.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$112.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$79.20
|
| Rate for Payer: Blue Shield of California Commercial |
$83.03
|
| Rate for Payer: Blue Shield of California EPN |
$64.55
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$105.60
|
| Rate for Payer: Cigna of CA HMO |
$84.48
|
| Rate for Payer: Cigna of CA PPO |
$97.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.20
|
| Rate for Payer: Dignity Health Media |
$112.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$112.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$99.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$46.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Multiplan Commercial |
$99.00
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: Riverside University Health System MISP |
$52.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$66.00
|
| Rate for Payer: United Healthcare All Other HMO |
$66.00
|
| Rate for Payer: United Healthcare HMO Rider |
$66.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.20
|
| Rate for Payer: Vantage Medical Group Senior |
$112.20
|
|
|
HC BLOOD DRAW LT 3YRS FEM/JUGULAR
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
CPT 36400
|
| Hospital Charge Code |
900501687
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$118.80 |
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$105.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Multiplan Commercial |
$99.00
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
|
|
HC BLOOD DRAW LT 3YRS FEM/JUGULAR
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
CPT 36400
|
| Hospital Charge Code |
900501687
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$2,696.00 |
| 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 |
$112.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$79.20
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$105.60
|
| Rate for Payer: Cigna of CA PPO |
$97.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.20
|
| Rate for Payer: Dignity Health Media |
$112.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$112.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$52.80
|
| Rate for Payer: Galaxy Health WC |
$112.20
|
| Rate for Payer: Global Benefits Group Commercial |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$118.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$99.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.40
|
| Rate for Payer: Multiplan Commercial |
$99.00
|
| Rate for Payer: Networks By Design Commercial |
$85.80
|
| Rate for Payer: Prime Health Services Commercial |
$112.20
|
| Rate for Payer: Riverside University Health System MISP |
$52.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$66.00
|
| Rate for Payer: United Healthcare All Other HMO |
$66.00
|
| Rate for Payer: United Healthcare HMO Rider |
$66.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$66.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.20
|
| Rate for Payer: Vantage Medical Group Senior |
$112.20
|
|
|
HC BLOOD GAS
|
Facility
|
OP
|
$974.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
900801107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.11 |
| Max. Negotiated Rate |
$876.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$26.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$141.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$171.69
|
| Rate for Payer: Blue Distinction Transplant |
$584.40
|
| Rate for Payer: Blue Shield of California Commercial |
$601.93
|
| Rate for Payer: Blue Shield of California EPN |
$473.36
|
| Rate for Payer: Caremore Medicare Advantage |
$26.07
|
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Central Health Plan Commercial |
$779.20
|
| Rate for Payer: Cigna of CA HMO |
$623.36
|
| Rate for Payer: Cigna of CA PPO |
$720.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.10
|
| Rate for Payer: Dignity Health Media |
$26.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$26.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$26.07
|
| Rate for Payer: Galaxy Health WC |
$827.90
|
| Rate for Payer: Global Benefits Group Commercial |
$584.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$876.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$730.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$43.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.07
|
| Rate for Payer: InnovAge PACE Commercial |
$39.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$649.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$194.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.93
|
| Rate for Payer: Multiplan Commercial |
$730.50
|
| Rate for Payer: Networks By Design Commercial |
$633.10
|
| Rate for Payer: Prime Health Services Commercial |
$827.90
|
| Rate for Payer: Prime Health Services Medicare |
$27.63
|
| Rate for Payer: Riverside University Health System MISP |
$28.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$584.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$584.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.11
|
| Rate for Payer: United Healthcare All Other HMO |
$21.11
|
| Rate for Payer: United Healthcare HMO Rider |
$21.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Vantage Medical Group Senior |
$26.07
|
|
|
HC BLOOD GAS
|
Facility
|
IP
|
$974.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
900801107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$194.80 |
| Max. Negotiated Rate |
$876.60 |
| Rate for Payer: Cash Price |
$438.30
|
| Rate for Payer: Central Health Plan Commercial |
$779.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$389.60
|
| Rate for Payer: Galaxy Health WC |
$827.90
|
| Rate for Payer: Global Benefits Group Commercial |
$584.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$876.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$649.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$371.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$194.80
|
| Rate for Payer: Multiplan Commercial |
$730.50
|
| Rate for Payer: Networks By Design Commercial |
$633.10
|
| Rate for Payer: Prime Health Services Commercial |
$827.90
|
|
|
HC BLOOD GAS AND COOXIMETRY
|
Facility
|
IP
|
$1,420.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
900801109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$284.00 |
| Max. Negotiated Rate |
$1,278.00 |
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.00
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$947.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$541.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
|
|
HC BLOOD GAS AND COOXIMETRY
|
Facility
|
OP
|
$1,420.00
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
900801109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.17 |
| Max. Negotiated Rate |
$1,278.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$78.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$208.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$86.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$204.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$249.47
|
| Rate for Payer: Blue Distinction Transplant |
$852.00
|
| Rate for Payer: Blue Shield of California Commercial |
$877.56
|
| Rate for Payer: Blue Shield of California EPN |
$690.12
|
| Rate for Payer: Caremore Medicare Advantage |
$78.77
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: Cigna of CA HMO |
$908.80
|
| Rate for Payer: Cigna of CA PPO |
$1,050.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.16
|
| Rate for Payer: Dignity Health Media |
$78.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$78.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$78.77
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,065.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$129.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$129.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$78.77
|
| Rate for Payer: InnovAge PACE Commercial |
$118.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$947.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$105.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$105.55
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
| Rate for Payer: Prime Health Services Medicare |
$83.50
|
| Rate for Payer: Riverside University Health System MISP |
$86.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$852.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$852.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.80
|
| Rate for Payer: United Healthcare All Other HMO |
$63.80
|
| Rate for Payer: United Healthcare HMO Rider |
$63.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$118.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.65
|
| Rate for Payer: Vantage Medical Group Senior |
$78.77
|
|
|
HC BLOOD GAS CHLORIDE
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
900801121
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$33.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.16
|
| Rate for Payer: Blue Distinction Transplant |
$66.00
|
| Rate for Payer: Blue Shield of California Commercial |
$67.98
|
| Rate for Payer: Blue Shield of California EPN |
$53.46
|
| Rate for Payer: Caremore Medicare Advantage |
$4.60
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Cash Price |
$49.50
|
| Rate for Payer: Central Health Plan Commercial |
$88.00
|
| Rate for Payer: Cigna of CA HMO |
$70.40
|
| Rate for Payer: Cigna of CA PPO |
$81.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.90
|
| Rate for Payer: Dignity Health Media |
$4.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.60
|
| Rate for Payer: Galaxy Health WC |
$93.50
|
| Rate for Payer: Global Benefits Group Commercial |
$66.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$82.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: Networks By Design Commercial |
$71.50
|
| Rate for Payer: Prime Health Services Commercial |
$93.50
|
| Rate for Payer: Prime Health Services Medicare |
$4.88
|
| Rate for Payer: Riverside University Health System MISP |
$5.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.73
|
| Rate for Payer: United Healthcare All Other HMO |
$3.73
|
| Rate for Payer: United Healthcare HMO Rider |
$3.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.06
|
| Rate for Payer: Vantage Medical Group Senior |
$4.60
|
|
