|
HC CAPD DAILY TREATMENT
|
Facility
IP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
944000101
|
|
Hospital Revenue Code
|
803
|
| Min. Negotiated Rate |
$257.60 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.20
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
|
|
HC CAPD DAILY TREATMENT
|
Facility
IP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
905400105
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$257.60 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$515.20
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
|
|
HC CAPD DAILY TREATMENT
|
Facility
OP
|
$1,288.00
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
944000101
|
|
Hospital Revenue Code
|
803
|
| Min. Negotiated Rate |
$257.60 |
| Max. Negotiated Rate |
$1,159.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$553.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$475.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$553.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$623.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$760.95
|
| Rate for Payer: BCBS Transplant Transplant |
$772.80
|
| Rate for Payer: Blue Shield of California Commercial |
$810.15
|
| Rate for Payer: Blue Shield of California EPN |
$629.83
|
| Rate for Payer: Caremore Medicare Advantage |
$553.39
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Cash Price |
$579.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,030.40
|
| Rate for Payer: Cigna of CA HMO |
$824.32
|
| Rate for Payer: Cigna of CA PPO |
$953.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$553.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$553.39
|
| Rate for Payer: Galaxy Health WC |
$1,094.80
|
| Rate for Payer: Global Benefits Group Commercial |
$772.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,159.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$966.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$907.56
|
| Rate for Payer: IEHP medi-cal |
$913.09
|
| Rate for Payer: IEHP Medicare Advantage |
$553.39
|
| Rate for Payer: Innovage PACE Commercial |
$830.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$859.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$553.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$257.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$741.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$741.54
|
| Rate for Payer: Multiplan Commercial |
$966.00
|
| Rate for Payer: Networks By Design Commercial |
$837.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,094.80
|
| Rate for Payer: Prime Health Services Medicare |
$586.59
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$772.80
|
| Rate for Payer: Riverside University Health MISP |
$608.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$772.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$772.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$644.00
|
| Rate for Payer: United Healthcare All Other HMO |
$644.00
|
| Rate for Payer: United Healthcare HMO Rider |
$644.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$644.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Vantage Medical Group Senior |
$553.39
|
|
|
HC CAPD RE-TRAINING
|
Facility
IP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000203
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
|
|
HC CAPD RE-TRAINING
|
Facility
OP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000203
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$459.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,868.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,208.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,208.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,064.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,298.58
|
| Rate for Payer: BCBS Transplant Transplant |
$1,318.80
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: Cigna of CA HMO |
$1,406.72
|
| Rate for Payer: Cigna of CA PPO |
$1,626.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,868.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,648.50
|
| Rate for Payer: IEHP medi-cal |
$769.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: Riverside University Health MISP |
$879.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,318.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$524.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,868.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,868.30
|
|
|
HC CAPD RE-TRAINING
|
Facility
IP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000203
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
|
|
HC CAPD RE-TRAINING
|
Facility
OP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000203
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$459.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,868.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,208.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,208.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,064.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,298.58
|
| Rate for Payer: BCBS Transplant Transplant |
$1,318.80
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: Cigna of CA HMO |
$1,406.72
|
| Rate for Payer: Cigna of CA PPO |
$1,626.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,868.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,648.50
|
| Rate for Payer: IEHP medi-cal |
$769.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: Riverside University Health MISP |
$879.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,318.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$524.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,868.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,868.30
|
|
|
HC CAPD TRAINING
|
Facility
OP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000201
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$459.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,868.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,208.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,208.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,064.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,298.58
|
| Rate for Payer: BCBS Transplant Transplant |
$1,318.80
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: Cigna of CA HMO |
$1,406.72
|
| Rate for Payer: Cigna of CA PPO |
$1,626.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,868.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,648.50
|
| Rate for Payer: IEHP medi-cal |
$769.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: Riverside University Health MISP |
$879.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,318.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$524.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,868.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,868.30
|
|
|
HC CAPD TRAINING
|
Facility
IP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000201
|
|
Hospital Revenue Code
|
851
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
|
|
HC CAPD TRAINING
|
Facility
IP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000201
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
|
|
HC CAPD TRAINING
|
Facility
OP
|
$2,198.00
|
|
|
Service Code
|
CPT 90993
|
| Hospital Charge Code |
942000201
|
|
Hospital Revenue Code
|
841
|
| Min. Negotiated Rate |
$439.60 |
| Max. Negotiated Rate |
$1,978.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$459.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,868.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,208.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,208.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,064.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,298.58
|
| Rate for Payer: BCBS Transplant Transplant |
$1,318.80
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Cash Price |
$989.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,758.40
|
| Rate for Payer: Cigna of CA HMO |
$1,406.72
|
| Rate for Payer: Cigna of CA PPO |
$1,626.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,868.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$879.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.20
|
| Rate for Payer: Galaxy Health WC |
$1,868.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,318.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,978.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,648.50
|
| Rate for Payer: IEHP medi-cal |
$769.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,466.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.60
|
| Rate for Payer: Multiplan Commercial |
$1,648.50
|
| Rate for Payer: Networks By Design Commercial |
$1,428.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,868.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: Riverside University Health MISP |
$879.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,318.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,318.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$524.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$479.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,868.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,868.30
|
|
|
HC CAP HEAD POST TORTLE 24-27CM
|
Facility
IP
|
$419.63
|
|
| Hospital Charge Code |
901698211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$377.67 |
| Rate for Payer: Cash Price |
$188.83
|
| Rate for Payer: Central Health Plan Commercial |
$335.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.85
|
| Rate for Payer: Galaxy Health WC |
$356.69
|
| Rate for Payer: Global Benefits Group Commercial |
$251.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$377.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$279.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.93
|
| Rate for Payer: Multiplan Commercial |
$314.72
|
| Rate for Payer: Networks By Design Commercial |
$272.76
|
| Rate for Payer: Prime Health Services Commercial |
$356.69
|
|
|
HC CAP HEAD POST TORTLE 24-27CM
|
Facility
OP
|
$419.63
|
|
| Hospital Charge Code |
901698211
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$377.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$254.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$356.69
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$230.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$230.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$203.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$247.92
|
| Rate for Payer: BCBS Transplant Transplant |
$251.78
|
| Rate for Payer: Blue Shield of California Commercial |
$263.95
|
| Rate for Payer: Blue Shield of California EPN |
$205.20
|
| Rate for Payer: Cash Price |
$188.83
|
| Rate for Payer: Central Health Plan Commercial |
$335.70
|
| Rate for Payer: Cigna of CA HMO |
$268.56
|
| Rate for Payer: Cigna of CA PPO |
$310.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$356.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$167.85
|
| Rate for Payer: Galaxy Health WC |
$356.69
|
| Rate for Payer: Global Benefits Group Commercial |
$251.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$377.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$314.72
|
| Rate for Payer: IEHP medi-cal |
$146.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$279.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.93
|
| Rate for Payer: Multiplan Commercial |
$314.72
|
| Rate for Payer: Networks By Design Commercial |
$272.76
|
| Rate for Payer: Prime Health Services Commercial |
$356.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$251.78
|
| Rate for Payer: Riverside University Health MISP |
$167.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$251.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$251.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$209.82
|
| Rate for Payer: United Healthcare All Other HMO |
$209.82
|
| Rate for Payer: United Healthcare HMO Rider |
$209.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$209.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.69
|
| Rate for Payer: Vantage Medical Group Senior |
$356.69
|
|
|
HC CAP HEAD POST TORTLE 27-31CM
|
Facility
IP
|
$419.63
|
|
| Hospital Charge Code |
901698212
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$377.67 |
| Rate for Payer: Cash Price |
$188.83
|
| Rate for Payer: Central Health Plan Commercial |
$335.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.85
|
| Rate for Payer: Galaxy Health WC |
$356.69
|
| Rate for Payer: Global Benefits Group Commercial |
$251.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$377.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$279.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.93
|
| Rate for Payer: Multiplan Commercial |
$314.72
|
| Rate for Payer: Networks By Design Commercial |
$272.76
|
| Rate for Payer: Prime Health Services Commercial |
$356.69
|
|
|
HC CAP HEAD POST TORTLE 27-31CM
|
Facility
OP
|
$419.63
|
|
| Hospital Charge Code |
901698212
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$377.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$254.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$356.69
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$230.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$230.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$203.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$247.92
|
| Rate for Payer: BCBS Transplant Transplant |
$251.78
|
| Rate for Payer: Blue Shield of California Commercial |
$263.95
|
| Rate for Payer: Blue Shield of California EPN |
$205.20
|
| Rate for Payer: Cash Price |
$188.83
|
| Rate for Payer: Central Health Plan Commercial |
$335.70
|
| Rate for Payer: Cigna of CA HMO |
$268.56
|
| Rate for Payer: Cigna of CA PPO |
$310.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$356.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$167.85
|
| Rate for Payer: Galaxy Health WC |
$356.69
|
| Rate for Payer: Global Benefits Group Commercial |
$251.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$377.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$314.72
|
| Rate for Payer: IEHP medi-cal |
$146.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$279.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.93
|
| Rate for Payer: Multiplan Commercial |
$314.72
|
| Rate for Payer: Networks By Design Commercial |
$272.76
|
| Rate for Payer: Prime Health Services Commercial |
$356.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$251.78
|
| Rate for Payer: Riverside University Health MISP |
$167.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$251.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$251.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$209.82
|
| Rate for Payer: United Healthcare All Other HMO |
$209.82
|
| Rate for Payer: United Healthcare HMO Rider |
$209.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$209.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.69
|
| Rate for Payer: Vantage Medical Group Senior |
$356.69
|
|
|
HC CAP HEAD POST TORTLE 32-37CM
|
Facility
OP
|
$419.63
|
|
| Hospital Charge Code |
901698213
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$377.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$254.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$356.69
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$230.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$230.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$203.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$247.92
|
| Rate for Payer: BCBS Transplant Transplant |
$251.78
|
| Rate for Payer: Blue Shield of California Commercial |
$263.95
|
| Rate for Payer: Blue Shield of California EPN |
$205.20
|
| Rate for Payer: Cash Price |
$188.83
|
| Rate for Payer: Central Health Plan Commercial |
$335.70
|
| Rate for Payer: Cigna of CA HMO |
$268.56
|
| Rate for Payer: Cigna of CA PPO |
$310.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$356.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$167.85
|
| Rate for Payer: Galaxy Health WC |
$356.69
|
| Rate for Payer: Global Benefits Group Commercial |
$251.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$377.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$314.72
|
| Rate for Payer: IEHP medi-cal |
$146.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$279.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.93
|
| Rate for Payer: Multiplan Commercial |
$314.72
|
| Rate for Payer: Networks By Design Commercial |
$272.76
|
| Rate for Payer: Prime Health Services Commercial |
$356.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$251.78
|
| Rate for Payer: Riverside University Health MISP |
$167.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$251.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$251.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$209.82
|
| Rate for Payer: United Healthcare All Other HMO |
$209.82
|
| Rate for Payer: United Healthcare HMO Rider |
$209.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$209.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$356.69
|
| Rate for Payer: Vantage Medical Group Senior |
$356.69
|
|
|
HC CAP HEAD POST TORTLE 32-37CM
|
Facility
IP
|
$419.63
|
|
| Hospital Charge Code |
901698213
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$83.93 |
| Max. Negotiated Rate |
$377.67 |
| Rate for Payer: Cash Price |
$188.83
|
| Rate for Payer: Central Health Plan Commercial |
$335.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$167.85
|
| Rate for Payer: Galaxy Health WC |
$356.69
|
| Rate for Payer: Global Benefits Group Commercial |
$251.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$377.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$279.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$83.93
|
| Rate for Payer: Multiplan Commercial |
$314.72
|
| Rate for Payer: Networks By Design Commercial |
$272.76
|
| Rate for Payer: Prime Health Services Commercial |
$356.69
|
|
|
HC CAPILLARY BLOOD DRAW HEEL FNGR EAR
|
Facility
IP
|
$64.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
900802002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC CAPILLARY BLOOD DRAW HEEL FNGR EAR
|
Facility
IP
|
$64.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
902400137
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC CAPILLARY BLOOD DRAW HEEL FNGR EAR
|
Facility
OP
|
$64.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
902400137
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$35.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$38.40
|
| Rate for Payer: Blue Shield of California Commercial |
$39.55
|
| Rate for Payer: Blue Shield of California EPN |
$31.10
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$48.00
|
| Rate for Payer: IEHP medi-cal |
$22.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: Riverside University Health MISP |
$25.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.52
|
| Rate for Payer: United Healthcare All Other HMO |
$2.52
|
| Rate for Payer: United Healthcare HMO Rider |
$2.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54.40
|
|
|
HC CAPILLARY BLOOD DRAW HEEL FNGR EAR
|
Facility
OP
|
$64.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
900802002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$54.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$35.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$35.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$38.40
|
| Rate for Payer: Blue Shield of California Commercial |
$39.55
|
| Rate for Payer: Blue Shield of California EPN |
$31.10
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$48.00
|
| Rate for Payer: IEHP medi-cal |
$22.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: Riverside University Health MISP |
$25.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.52
|
| Rate for Payer: United Healthcare All Other HMO |
$2.52
|
| Rate for Payer: United Healthcare HMO Rider |
$2.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54.40
|
|
|
HC CAPILLARY HA1C
|
Facility
OP
|
$302.00
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
902501902
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$271.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$9.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$70.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.15
|
| Rate for Payer: BCBS Transplant Transplant |
$181.20
|
| Rate for Payer: Blue Shield of California Commercial |
$186.64
|
| Rate for Payer: Blue Shield of California EPN |
$146.77
|
| Rate for Payer: Caremore Medicare Advantage |
$9.71
|
| Rate for Payer: Cash Price |
$135.90
|
| Rate for Payer: Cash Price |
$135.90
|
| Rate for Payer: Central Health Plan Commercial |
$241.60
|
| Rate for Payer: Cigna of CA HMO |
$193.28
|
| Rate for Payer: Cigna of CA PPO |
$223.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.71
|
| Rate for Payer: Galaxy Health WC |
$256.70
|
| Rate for Payer: Global Benefits Group Commercial |
$181.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$226.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.92
|
| Rate for Payer: IEHP medi-cal |
$16.02
|
| Rate for Payer: IEHP Medicare Advantage |
$9.71
|
| Rate for Payer: Innovage PACE Commercial |
$14.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.01
|
| Rate for Payer: Multiplan Commercial |
$226.50
|
| Rate for Payer: Networks By Design Commercial |
$196.30
|
| Rate for Payer: Prime Health Services Commercial |
$256.70
|
| Rate for Payer: Prime Health Services Medicare |
$10.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$181.20
|
| Rate for Payer: Riverside University Health MISP |
$10.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$181.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$181.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.87
|
| Rate for Payer: United Healthcare All Other HMO |
$7.87
|
| Rate for Payer: United Healthcare HMO Rider |
$7.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.68
|
| Rate for Payer: Vantage Medical Group Senior |
$9.71
|
|
|
HC CAPILLARY HA1C
|
Facility
IP
|
$302.00
|
|
|
Service Code
|
CPT 83036
|
| Hospital Charge Code |
902501902
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$60.40 |
| Max. Negotiated Rate |
$271.80 |
| Rate for Payer: Cash Price |
$135.90
|
| Rate for Payer: Central Health Plan Commercial |
$241.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.80
|
| Rate for Payer: Galaxy Health WC |
$256.70
|
| Rate for Payer: Global Benefits Group Commercial |
$181.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$271.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.40
|
| Rate for Payer: Multiplan Commercial |
$226.50
|
| Rate for Payer: Networks By Design Commercial |
$196.30
|
| Rate for Payer: Prime Health Services Commercial |
$256.70
|
|
|
HC CAP NEWBORN LRG 16IN PINK
|
Facility
IP
|
$481.40
|
|
| Hospital Charge Code |
901608014
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$433.26 |
| Rate for Payer: Cash Price |
$216.63
|
| Rate for Payer: Central Health Plan Commercial |
$385.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.56
|
| Rate for Payer: Galaxy Health WC |
$409.19
|
| Rate for Payer: Global Benefits Group Commercial |
$288.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.28
|
| Rate for Payer: Multiplan Commercial |
$361.05
|
| Rate for Payer: Networks By Design Commercial |
$312.91
|
| Rate for Payer: Prime Health Services Commercial |
$409.19
|
|
|
HC CAP NEWBORN LRG 16IN PINK
|
Facility
OP
|
$481.40
|
|
| Hospital Charge Code |
901608014
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$96.28 |
| Max. Negotiated Rate |
$433.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$292.35
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$409.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$264.77
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$264.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$233.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.41
|
| Rate for Payer: BCBS Transplant Transplant |
$288.84
|
| Rate for Payer: Blue Shield of California Commercial |
$302.80
|
| Rate for Payer: Blue Shield of California EPN |
$235.40
|
| Rate for Payer: Cash Price |
$216.63
|
| Rate for Payer: Central Health Plan Commercial |
$385.12
|
| Rate for Payer: Cigna of CA HMO |
$308.10
|
| Rate for Payer: Cigna of CA PPO |
$356.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$409.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$192.56
|
| Rate for Payer: Galaxy Health WC |
$409.19
|
| Rate for Payer: Global Benefits Group Commercial |
$288.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$433.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$361.05
|
| Rate for Payer: IEHP medi-cal |
$168.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$321.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.28
|
| Rate for Payer: Multiplan Commercial |
$361.05
|
| Rate for Payer: Networks By Design Commercial |
$312.91
|
| Rate for Payer: Prime Health Services Commercial |
$409.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$288.84
|
| Rate for Payer: Riverside University Health MISP |
$192.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$288.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$288.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.70
|
| Rate for Payer: United Healthcare All Other HMO |
$240.70
|
| Rate for Payer: United Healthcare HMO Rider |
$240.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$409.19
|
| Rate for Payer: Vantage Medical Group Senior |
$409.19
|
|
