|
HC EMBOLIZATION DEVICE PIPELINE
|
Facility
|
OP
|
$25,000.00
|
|
| Hospital Charge Code |
909020126
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,000.00 |
| Max. Negotiated Rate |
$22,500.00 |
| Rate for Payer: Adventist Health Commercial |
$5,000.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,182.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,750.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,750.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,105.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,542.50
|
| Rate for Payer: Blue Shield of California Commercial |
$15,850.00
|
| Rate for Payer: Blue Shield of California EPN |
$9,975.00
|
| Rate for Payer: Cash Price |
$11,250.00
|
| Rate for Payer: Central Health Plan Commercial |
$20,000.00
|
| Rate for Payer: Cigna of CA HMO |
$16,000.00
|
| Rate for Payer: Cigna of CA PPO |
$18,500.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,250.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,250.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,500.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,000.00
|
| Rate for Payer: Galaxy Health WC |
$21,250.00
|
| Rate for Payer: Global Benefits Group Commercial |
$15,000.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,500.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,875.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,075.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,750.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17,500.00
|
| Rate for Payer: Multiplan Commercial |
$18,750.00
|
| Rate for Payer: Networks By Design Commercial |
$16,250.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,250.00
|
| Rate for Payer: Riverside University Health System MISP |
$10,000.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,500.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,500.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,500.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,500.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,250.00
|
| Rate for Payer: Vantage Medical Group Senior |
$21,250.00
|
|
|
HC EMBOLIZATION, EXTRACRANIAL
|
Facility
|
IP
|
$34,387.00
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
909081338
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,877.40 |
| Max. Negotiated Rate |
$30,948.30 |
| Rate for Payer: Adventist Health Commercial |
$6,877.40
|
| Rate for Payer: Cash Price |
$15,474.15
|
| Rate for Payer: Central Health Plan Commercial |
$27,509.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24,070.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,754.80
|
| Rate for Payer: EPIC Health Plan Senior |
$13,754.80
|
| Rate for Payer: Galaxy Health WC |
$29,228.95
|
| Rate for Payer: Global Benefits Group Commercial |
$20,632.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,948.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21,835.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,288.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,877.40
|
| Rate for Payer: Multiplan Commercial |
$25,790.25
|
| Rate for Payer: Networks By Design Commercial |
$22,351.55
|
| Rate for Payer: Prime Health Services Commercial |
$29,228.95
|
|
|
HC EMBOLIZATION, EXTRACRANIAL
|
Facility
|
OP
|
$34,387.00
|
|
|
Service Code
|
CPT 61626
|
| Hospital Charge Code |
909081338
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.09 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$6,877.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$15,474.15
|
| Rate for Payer: Cash Price |
$15,474.15
|
| Rate for Payer: Cash Price |
$15,474.15
|
| Rate for Payer: Central Health Plan Commercial |
$27,509.60
|
| Rate for Payer: Cigna of CA HMO |
$22,007.68
|
| Rate for Payer: Cigna of CA PPO |
$25,446.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24,070.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$29,228.95
|
| Rate for Payer: Global Benefits Group Commercial |
$20,632.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,948.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21,835.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$257.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,877.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$25,790.25
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$22,351.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Preferred Health Network WC |
$23,427.23
|
| Rate for Payer: Prime Health Services Commercial |
$29,228.95
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,632.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,193.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC EMBOLIZATION FOAM
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
909081259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Blue Shield of California Commercial |
$280.70
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
|
|
HC EMBOLIZATION FOAM
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
909081259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$159.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$191.94
|
| Rate for Payer: Blue Shield of California Commercial |
$280.70
|
| Rate for Payer: Blue Shield of California EPN |
$176.40
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$245.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$222.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$206.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC EMBOLIZATION LCBEADS
|
Facility
|
IP
|
$4,397.50
|
|
| Hospital Charge Code |
909020052
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$879.50 |
| Max. Negotiated Rate |
$3,957.75 |
| Rate for Payer: Adventist Health Commercial |
$879.50
|
| Rate for Payer: Cash Price |
$1,978.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,518.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,078.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,759.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,759.00
|
| Rate for Payer: Galaxy Health WC |
$3,737.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,638.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,957.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,792.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,594.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$879.50
|
| Rate for Payer: Multiplan Commercial |
$3,298.12
|
| Rate for Payer: Networks By Design Commercial |
$2,858.38
|
| Rate for Payer: Prime Health Services Commercial |
$3,737.88
|
|
|
HC EMBOLIZATION LCBEADS
|
Facility
|
OP
|
$4,397.50
|
|
| Hospital Charge Code |
909020052
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$879.50 |
| Max. Negotiated Rate |
$3,957.75 |
| Rate for Payer: Adventist Health Commercial |
$879.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,670.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,737.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,418.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,298.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,129.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,558.03
|
| Rate for Payer: Blue Shield of California Commercial |
$2,788.01
|
| Rate for Payer: Blue Shield of California EPN |
$1,754.60
|
| Rate for Payer: Cash Price |
$1,978.88
|
| Rate for Payer: Central Health Plan Commercial |
$3,518.00
|
| Rate for Payer: Cigna of CA HMO |
$2,814.40
|
| Rate for Payer: Cigna of CA PPO |
$3,254.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,737.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,737.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,737.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,078.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,759.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,759.00
|
| Rate for Payer: Galaxy Health WC |
$3,737.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,638.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,957.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,792.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,596.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,594.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$879.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,078.25
|
| Rate for Payer: Multiplan Commercial |
$3,298.12
|
| Rate for Payer: Networks By Design Commercial |
$2,858.38
|
| Rate for Payer: Prime Health Services Commercial |
$3,737.88
|
| Rate for Payer: Riverside University Health System MISP |
$1,759.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,638.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,638.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,198.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,198.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,198.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,198.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,737.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,737.88
|
| Rate for Payer: Vantage Medical Group Senior |
$3,737.88
|
|
|
HC EMBOLIZATION PARTICLE
|
Facility
|
IP
|
$1,122.40
|
|
| Hospital Charge Code |
909081256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.48 |
| Max. Negotiated Rate |
$1,010.16 |
| Rate for Payer: Adventist Health Commercial |
$224.48
|
| Rate for Payer: Blue Shield of California Commercial |
$900.16
|
| Rate for Payer: Blue Shield of California EPN |
$565.69
|
| Rate for Payer: Cash Price |
$505.08
|
| Rate for Payer: Central Health Plan Commercial |
$897.92
|
| Rate for Payer: Cigna of CA HMO |
$785.68
|
| Rate for Payer: Cigna of CA PPO |
$785.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$785.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$448.96
|
| Rate for Payer: EPIC Health Plan Senior |
$448.96
|
| Rate for Payer: Galaxy Health WC |
$954.04
|
| Rate for Payer: Global Benefits Group Commercial |
$673.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,010.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$712.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$662.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.48
|
| Rate for Payer: Multiplan Commercial |
$841.80
|
| Rate for Payer: Networks By Design Commercial |
$561.20
|
| Rate for Payer: Prime Health Services Commercial |
$954.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$421.24
|
| Rate for Payer: United Healthcare All Other HMO |
$410.01
|
| Rate for Payer: United Healthcare HMO Rider |
$401.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$367.59
|
|
|
HC EMBOLIZATION PARTICLE
|
Facility
|
OP
|
$1,122.40
|
|
| Hospital Charge Code |
909081256
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$224.48 |
| Max. Negotiated Rate |
$1,010.16 |
| Rate for Payer: Adventist Health Commercial |
$224.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$954.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$617.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$841.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$512.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$615.52
|
| Rate for Payer: Blue Shield of California Commercial |
$900.16
|
| Rate for Payer: Blue Shield of California EPN |
$565.69
|
| Rate for Payer: Cash Price |
$505.08
|
| Rate for Payer: Central Health Plan Commercial |
$897.92
|
| Rate for Payer: Cigna of CA HMO |
$785.68
|
| Rate for Payer: Cigna of CA PPO |
$785.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$954.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$954.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$954.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$785.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$448.96
|
| Rate for Payer: EPIC Health Plan Senior |
$448.96
|
| Rate for Payer: Galaxy Health WC |
$954.04
|
| Rate for Payer: Global Benefits Group Commercial |
$673.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,010.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$712.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$407.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$662.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$785.68
|
| Rate for Payer: Multiplan Commercial |
$841.80
|
| Rate for Payer: Networks By Design Commercial |
$561.20
|
| Rate for Payer: Prime Health Services Commercial |
$954.04
|
| Rate for Payer: Riverside University Health System MISP |
$448.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$673.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$673.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$421.24
|
| Rate for Payer: United Healthcare All Other HMO |
$410.01
|
| Rate for Payer: United Healthcare HMO Rider |
$401.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$367.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$954.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$954.04
|
| Rate for Payer: Vantage Medical Group Senior |
$954.04
|
|
|
HC EMBOLIZ, INTRACRAN/SP.CRD.
|
Facility
|
IP
|
$13,709.00
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
909081337
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,741.80 |
| Max. Negotiated Rate |
$12,338.10 |
| Rate for Payer: Adventist Health Commercial |
$2,741.80
|
| Rate for Payer: Cash Price |
$6,169.05
|
| Rate for Payer: Central Health Plan Commercial |
$10,967.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,596.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,483.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,483.60
|
| Rate for Payer: Galaxy Health WC |
$11,652.65
|
| Rate for Payer: Global Benefits Group Commercial |
$8,225.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,338.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,705.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,088.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,741.80
|
| Rate for Payer: Multiplan Commercial |
$10,281.75
|
| Rate for Payer: Networks By Design Commercial |
$8,910.85
|
| Rate for Payer: Prime Health Services Commercial |
$11,652.65
|
|
|
HC EMBOLIZ, INTRACRAN/SP.CRD.
|
Facility
|
OP
|
$13,709.00
|
|
|
Service Code
|
CPT 61624
|
| Hospital Charge Code |
909081337
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,435.68 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$2,741.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$23,577.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$6,169.05
|
| Rate for Payer: Cash Price |
$6,169.05
|
| Rate for Payer: Cash Price |
$6,169.05
|
| Rate for Payer: Central Health Plan Commercial |
$10,967.20
|
| Rate for Payer: Cigna of CA HMO |
$8,773.76
|
| Rate for Payer: Cigna of CA PPO |
$10,144.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,596.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,902.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25,935.31
|
| Rate for Payer: Galaxy Health WC |
$11,652.65
|
| Rate for Payer: Global Benefits Group Commercial |
$8,225.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,338.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,667.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,435.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,705.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,585.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,741.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$10,281.75
|
| Rate for Payer: Networks By Design Commercial |
$8,910.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Prime Health Services Commercial |
$11,652.65
|
| Rate for Payer: Prime Health Services Medicare |
$24,992.20
|
| Rate for Payer: Riverside University Health System MISP |
$25,935.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,225.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,854.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$23,577.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC EM EMBED ONLY
|
Facility
|
IP
|
$597.00
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
903800053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$537.30 |
| Rate for Payer: Adventist Health Commercial |
$119.40
|
| Rate for Payer: Cash Price |
$268.65
|
| Rate for Payer: Central Health Plan Commercial |
$477.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$417.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.80
|
| Rate for Payer: EPIC Health Plan Senior |
$238.80
|
| Rate for Payer: Galaxy Health WC |
$507.45
|
| Rate for Payer: Global Benefits Group Commercial |
$358.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$537.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$379.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$352.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.40
|
| Rate for Payer: Multiplan Commercial |
$447.75
|
| Rate for Payer: Networks By Design Commercial |
$388.05
|
| Rate for Payer: Prime Health Services Commercial |
$507.45
|
|
|
HC EM EMBED ONLY
|
Facility
|
OP
|
$597.00
|
|
|
Service Code
|
CPT 88399
|
| Hospital Charge Code |
903800053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.11 |
| Max. Negotiated Rate |
$537.30 |
| Rate for Payer: Adventist Health Commercial |
$119.40
|
| Rate for Payer: Adventist Health Commercial |
$65.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$67.02
|
| Rate for Payer: Adventist Health Medi-Cal |
$67.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$362.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$199.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$158.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$289.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.27
|
| Rate for Payer: Blue Shield of California Commercial |
$206.64
|
| Rate for Payer: Blue Shield of California Commercial |
$376.11
|
| Rate for Payer: Blue Shield of California EPN |
$237.01
|
| Rate for Payer: Blue Shield of California EPN |
$130.22
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Cash Price |
$268.65
|
| Rate for Payer: Cash Price |
$268.65
|
| Rate for Payer: Cash Price |
$147.60
|
| Rate for Payer: Central Health Plan Commercial |
$262.40
|
| Rate for Payer: Central Health Plan Commercial |
$477.60
|
| Rate for Payer: Cigna of CA HMO |
$209.92
|
| Rate for Payer: Cigna of CA HMO |
$382.08
|
| Rate for Payer: Cigna of CA PPO |
$441.78
|
| Rate for Payer: Cigna of CA PPO |
$242.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$417.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$229.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.58
|
| Rate for Payer: EPIC Health Plan Senior |
$73.72
|
| Rate for Payer: EPIC Health Plan Senior |
$73.72
|
| Rate for Payer: Galaxy Health WC |
$507.45
|
| Rate for Payer: Galaxy Health WC |
$278.80
|
| Rate for Payer: Global Benefits Group Commercial |
$358.20
|
| Rate for Payer: Global Benefits Group Commercial |
$196.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$537.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$295.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$109.91
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$109.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$208.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$379.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$93.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$119.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.81
|
| Rate for Payer: Multiplan Commercial |
$246.00
|
| Rate for Payer: Multiplan Commercial |
$447.75
|
| Rate for Payer: Networks By Design Commercial |
$213.20
|
| Rate for Payer: Networks By Design Commercial |
$388.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$67.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$67.02
|
| Rate for Payer: Prime Health Services Commercial |
$278.80
|
| Rate for Payer: Prime Health Services Commercial |
$507.45
|
| Rate for Payer: Prime Health Services Medicare |
$71.04
|
| Rate for Payer: Prime Health Services Medicare |
$71.04
|
| Rate for Payer: Riverside University Health System MISP |
$73.72
|
| Rate for Payer: Riverside University Health System MISP |
$73.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$196.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$67.02
|
| Rate for Payer: Upland Medical Group Pediatric |
$67.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
|
|
HC END ABL THY INC VEIN 1ST VEIN
|
Facility
|
OP
|
$22,694.00
|
|
|
Service Code
|
CPT 36482
|
| Hospital Charge Code |
909026482
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,386.20 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,538.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,156.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Central Health Plan Commercial |
$18,155.20
|
| Rate for Payer: Cigna of CA HMO |
$14,524.16
|
| Rate for Payer: Cigna of CA PPO |
$16,793.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,885.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$19,289.90
|
| Rate for Payer: Global Benefits Group Commercial |
$13,616.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,424.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,386.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,410.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,740.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,538.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$17,020.50
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$14,751.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$19,289.90
|
| Rate for Payer: Prime Health Services Medicare |
$7,586.27
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,872.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,616.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,347.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC END ABL THY INC VEIN 1ST VEIN
|
Facility
|
IP
|
$22,694.00
|
|
|
Service Code
|
CPT 36482
|
| Hospital Charge Code |
909026482
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,538.80 |
| Max. Negotiated Rate |
$20,424.60 |
| Rate for Payer: Adventist Health Commercial |
$4,538.80
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Central Health Plan Commercial |
$18,155.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,885.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,077.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,077.60
|
| Rate for Payer: Galaxy Health WC |
$19,289.90
|
| Rate for Payer: Global Benefits Group Commercial |
$13,616.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,424.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,410.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,389.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,538.80
|
| Rate for Payer: Multiplan Commercial |
$17,020.50
|
| Rate for Payer: Networks By Design Commercial |
$14,751.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,289.90
|
|
|
HC END ABL THY INC VEIN SUB VEIN
|
Facility
|
IP
|
$11,347.00
|
|
|
Service Code
|
CPT 36483
|
| Hospital Charge Code |
909026483
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,269.40 |
| Max. Negotiated Rate |
$10,212.30 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,942.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,538.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,538.80
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,205.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,694.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
|
|
HC END ABL THY INC VEIN SUB VEIN
|
Facility
|
OP
|
$11,347.00
|
|
|
Service Code
|
CPT 36483
|
| Hospital Charge Code |
909026483
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$213.25 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,269.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,644.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,240.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,510.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Cash Price |
$5,106.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,077.60
|
| Rate for Payer: Cigna of CA HMO |
$7,262.08
|
| Rate for Payer: Cigna of CA PPO |
$8,396.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,644.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,644.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,644.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,942.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,538.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,538.80
|
| Rate for Payer: Galaxy Health WC |
$9,644.95
|
| Rate for Payer: Global Benefits Group Commercial |
$6,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,212.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$213.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,205.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$235.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,694.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,269.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,942.90
|
| Rate for Payer: Multiplan Commercial |
$8,510.25
|
| Rate for Payer: Networks By Design Commercial |
$7,375.55
|
| Rate for Payer: Prime Health Services Commercial |
$9,644.95
|
| Rate for Payer: Riverside University Health System MISP |
$4,538.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,808.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,673.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,644.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,644.95
|
| Rate for Payer: Vantage Medical Group Senior |
$9,644.95
|
|
|
HC ENDLMNL BX RNL PLVS AND OR URE
|
Facility
|
OP
|
$6,462.00
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
909050606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$826.70 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,292.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,492.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,554.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,846.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,907.90
|
| Rate for Payer: Cash Price |
$2,907.90
|
| Rate for Payer: Cash Price |
$2,907.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,169.60
|
| Rate for Payer: Cigna of CA HMO |
$4,135.68
|
| Rate for Payer: Cigna of CA PPO |
$4,781.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,492.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,492.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,492.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,523.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,584.80
|
| Rate for Payer: Galaxy Health WC |
$5,492.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,815.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$826.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,103.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$913.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,812.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,292.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,523.40
|
| Rate for Payer: Multiplan Commercial |
$4,846.50
|
| Rate for Payer: Networks By Design Commercial |
$4,200.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,492.70
|
| Rate for Payer: Riverside University Health System MISP |
$2,584.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,877.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,231.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,492.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,492.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5,492.70
|
|
|
HC ENDLMNL BX RNL PLVS AND OR URE
|
Facility
|
IP
|
$6,462.00
|
|
|
Service Code
|
CPT 50606
|
| Hospital Charge Code |
909050606
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,292.40 |
| Max. Negotiated Rate |
$5,815.80 |
| Rate for Payer: Adventist Health Commercial |
$1,292.40
|
| Rate for Payer: Cash Price |
$2,907.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,169.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,523.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,584.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,584.80
|
| Rate for Payer: Galaxy Health WC |
$5,492.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,877.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,815.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,103.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,812.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,292.40
|
| Rate for Payer: Multiplan Commercial |
$4,846.50
|
| Rate for Payer: Networks By Design Commercial |
$4,200.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,492.70
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$3,291.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$658.20 |
| Max. Negotiated Rate |
$2,961.90 |
| Rate for Payer: Adventist Health Commercial |
$658.20
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,632.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,303.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,316.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,316.40
|
| Rate for Payer: Galaxy Health WC |
$2,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,961.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,089.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,941.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$658.20
|
| Rate for Payer: Multiplan Commercial |
$2,468.25
|
| Rate for Payer: Networks By Design Commercial |
$2,139.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,797.35
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$3,291.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$658.20 |
| Max. Negotiated Rate |
$2,961.90 |
| Rate for Payer: Adventist Health Commercial |
$658.20
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,632.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,303.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,316.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,316.40
|
| Rate for Payer: Galaxy Health WC |
$2,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,961.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,089.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,941.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$658.20
|
| Rate for Payer: Multiplan Commercial |
$2,468.25
|
| Rate for Payer: Networks By Design Commercial |
$2,139.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,797.35
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$3,291.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$249.73 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$658.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,184.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$579.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,086.49
|
| Rate for Payer: Blue Shield of California EPN |
$1,313.11
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,632.80
|
| Rate for Payer: Cigna of CA HMO |
$2,106.24
|
| Rate for Payer: Cigna of CA PPO |
$2,435.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,303.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Galaxy Health WC |
$2,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,961.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$249.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,089.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$275.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,658.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$658.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan Commercial |
$2,468.25
|
| Rate for Payer: Networks By Design Commercial |
$2,139.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Prime Health Services Commercial |
$2,797.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,974.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,974.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,645.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,645.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,645.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,645.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$3,291.00
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
900501170
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$275.86 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$658.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Cash Price |
$1,480.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,632.80
|
| Rate for Payer: Cigna of CA HMO |
$2,106.24
|
| Rate for Payer: Cigna of CA PPO |
$2,435.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,303.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Galaxy Health WC |
$2,797.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,974.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,961.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,089.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$275.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,273.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$658.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan Commercial |
$2,468.25
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: Networks By Design Commercial |
$2,139.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Commercial |
$2,797.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,974.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,645.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,645.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,645.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,645.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
HC ENDO EVAL SM INTESTINE W BX
|
Facility
|
IP
|
$6,477.00
|
|
|
Service Code
|
CPT 44386
|
| Hospital Charge Code |
906744386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,295.40 |
| Max. Negotiated Rate |
$5,829.30 |
| Rate for Payer: Adventist Health Commercial |
$1,295.40
|
| Rate for Payer: Cash Price |
$2,914.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,181.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,533.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,590.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,590.80
|
| Rate for Payer: Galaxy Health WC |
$5,505.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,886.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,829.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,112.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,821.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.40
|
| Rate for Payer: Multiplan Commercial |
$4,857.75
|
| Rate for Payer: Networks By Design Commercial |
$4,210.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,505.45
|
|
|
HC ENDO EVAL SM INTESTINE W BX
|
Facility
|
OP
|
$6,477.00
|
|
|
Service Code
|
CPT 44386
|
| Hospital Charge Code |
906744386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$209.39 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,295.40
|
| Rate for Payer: Adventist Health Commercial |
$571.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,914.65
|
| Rate for Payer: Cash Price |
$2,914.65
|
| Rate for Payer: Cash Price |
$1,286.55
|
| Rate for Payer: Cash Price |
$2,914.65
|
| Rate for Payer: Cash Price |
$1,286.55
|
| Rate for Payer: Cash Price |
$1,286.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,287.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,181.60
|
| Rate for Payer: Cigna of CA HMO |
$1,829.76
|
| Rate for Payer: Cigna of CA HMO |
$4,145.28
|
| Rate for Payer: Cigna of CA PPO |
$4,792.98
|
| Rate for Payer: Cigna of CA PPO |
$2,115.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,001.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,533.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$5,505.45
|
| Rate for Payer: Galaxy Health WC |
$2,430.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,715.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,886.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,573.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,829.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$209.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$209.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,815.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,112.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$231.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$231.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,295.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$571.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$4,857.75
|
| Rate for Payer: Multiplan Commercial |
$2,144.25
|
| Rate for Payer: Networks By Design Commercial |
$4,210.05
|
| Rate for Payer: Networks By Design Commercial |
$1,858.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,430.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,505.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,715.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,886.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,238.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,429.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
