|
HC EO ELASTIC PREFAB (NEOPRENE)
|
Facility
|
OP
|
$36.00
|
|
| Hospital Charge Code |
905353701
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.94
|
| Rate for Payer: Blue Shield of California Commercial |
$22.82
|
| Rate for Payer: Blue Shield of California EPN |
$14.36
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Central Health Plan Commercial |
$28.80
|
| Rate for Payer: Cigna of CA HMO |
$23.04
|
| Rate for Payer: Cigna of CA PPO |
$26.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.20
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Riverside University Health System MISP |
$14.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.60
|
| Rate for Payer: Vantage Medical Group Senior |
$30.60
|
|
|
HC EO ELASTIC PREFAB (NEOPRENE)
|
Facility
|
IP
|
$36.00
|
|
| Hospital Charge Code |
905353701
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Central Health Plan Commercial |
$28.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: Networks By Design Commercial |
$23.40
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
|
|
HC EO ELASTIC WITH JOINTS
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT L3710
|
| Hospital Charge Code |
905353710
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$50.00
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$126.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$175.00
|
| Rate for Payer: Cigna of CA PPO |
$175.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.83
|
| Rate for Payer: United Healthcare All Other HMO |
$91.33
|
| Rate for Payer: United Healthcare HMO Rider |
$89.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.88
|
|
|
HC EO ELASTIC WITH JOINTS
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT L3710
|
| Hospital Charge Code |
905353710
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$81.88 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$102.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$212.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$137.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$187.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.43
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$126.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$175.00
|
| Rate for Payer: Cigna of CA PPO |
$175.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$212.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$212.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$212.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$102.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$125.00
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: Riverside University Health System MISP |
$100.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.83
|
| Rate for Payer: United Healthcare All Other HMO |
$91.33
|
| Rate for Payer: United Healthcare HMO Rider |
$89.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$212.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$212.50
|
| Rate for Payer: Vantage Medical Group Senior |
$212.50
|
|
|
HC EO ELASTIC WITH JOINTS
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT L3710
|
| Hospital Charge Code |
915353710
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$50.00
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$126.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$175.00
|
| Rate for Payer: Cigna of CA PPO |
$175.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.83
|
| Rate for Payer: United Healthcare All Other HMO |
$91.33
|
| Rate for Payer: United Healthcare HMO Rider |
$89.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.88
|
|
|
HC EO ELASTIC WITH JOINTS
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT L3710
|
| Hospital Charge Code |
915353710
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$81.88 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$102.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$212.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$137.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$187.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.43
|
| Rate for Payer: Blue Shield of California Commercial |
$200.50
|
| Rate for Payer: Blue Shield of California EPN |
$126.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$175.00
|
| Rate for Payer: Cigna of CA PPO |
$175.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$212.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$212.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$212.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$102.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$125.00
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: Riverside University Health System MISP |
$100.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$93.83
|
| Rate for Payer: United Healthcare All Other HMO |
$91.33
|
| Rate for Payer: United Healthcare HMO Rider |
$89.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$81.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$212.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$212.50
|
| Rate for Payer: Vantage Medical Group Senior |
$212.50
|
|
|
HC EO ELASTIC WITH STAYS
|
Facility
|
IP
|
$194.00
|
|
| Hospital Charge Code |
905353700
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Adventist Health Commercial |
$38.80
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Central Health Plan Commercial |
$155.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$135.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: EPIC Health Plan Senior |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$174.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$123.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$114.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.80
|
| Rate for Payer: Multiplan Commercial |
$145.50
|
| Rate for Payer: Networks By Design Commercial |
$126.10
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
|
|
HC EO ELASTIC WITH STAYS
|
Facility
|
OP
|
$194.00
|
|
| Hospital Charge Code |
905353700
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Adventist Health Commercial |
$38.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$164.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$106.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$145.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.85
|
| Rate for Payer: Blue Shield of California Commercial |
$123.00
|
| Rate for Payer: Blue Shield of California EPN |
$77.41
|
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Central Health Plan Commercial |
$155.20
|
| Rate for Payer: Cigna of CA HMO |
$124.16
|
| Rate for Payer: Cigna of CA PPO |
$143.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$164.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$164.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$164.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$135.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: EPIC Health Plan Senior |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$174.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$123.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$114.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$135.80
|
| Rate for Payer: Multiplan Commercial |
$145.50
|
| Rate for Payer: Networks By Design Commercial |
$126.10
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
| Rate for Payer: Riverside University Health System MISP |
$77.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$116.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$116.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$97.00
|
| Rate for Payer: United Healthcare All Other HMO |
$97.00
|
| Rate for Payer: United Healthcare HMO Rider |
$97.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$97.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$164.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$164.90
|
| Rate for Payer: Vantage Medical Group Senior |
$164.90
|
|
|
HC EO RIGID W/O JNTS SFT INTERFAC
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT L3762
|
| Hospital Charge Code |
905353762
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$44.20 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Adventist Health Commercial |
$44.20
|
| Rate for Payer: Blue Shield of California Commercial |
$177.24
|
| Rate for Payer: Blue Shield of California EPN |
$111.38
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Central Health Plan Commercial |
$176.80
|
| Rate for Payer: Cigna of CA HMO |
$154.70
|
| Rate for Payer: Cigna of CA PPO |
$154.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.40
|
| Rate for Payer: EPIC Health Plan Senior |
$88.40
|
| Rate for Payer: Galaxy Health WC |
$187.85
|
| Rate for Payer: Global Benefits Group Commercial |
$132.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.20
|
| Rate for Payer: Multiplan Commercial |
$165.75
|
| Rate for Payer: Networks By Design Commercial |
$143.65
|
| Rate for Payer: Prime Health Services Commercial |
$187.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$82.94
|
| Rate for Payer: United Healthcare All Other HMO |
$80.73
|
| Rate for Payer: United Healthcare HMO Rider |
$78.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.38
|
|
|
HC EO RIGID W/O JNTS SFT INTERFAC
|
Facility
|
IP
|
$221.00
|
|
|
Service Code
|
CPT L3762
|
| Hospital Charge Code |
915353762
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$44.20 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Adventist Health Commercial |
$44.20
|
| Rate for Payer: Blue Shield of California Commercial |
$177.24
|
| Rate for Payer: Blue Shield of California EPN |
$111.38
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Central Health Plan Commercial |
$176.80
|
| Rate for Payer: Cigna of CA HMO |
$154.70
|
| Rate for Payer: Cigna of CA PPO |
$154.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.40
|
| Rate for Payer: EPIC Health Plan Senior |
$88.40
|
| Rate for Payer: Galaxy Health WC |
$187.85
|
| Rate for Payer: Global Benefits Group Commercial |
$132.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.20
|
| Rate for Payer: Multiplan Commercial |
$165.75
|
| Rate for Payer: Networks By Design Commercial |
$143.65
|
| Rate for Payer: Prime Health Services Commercial |
$187.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$82.94
|
| Rate for Payer: United Healthcare All Other HMO |
$80.73
|
| Rate for Payer: United Healthcare HMO Rider |
$78.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.38
|
|
|
HC EO RIGID W/O JNTS SFT INTERFAC
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT L3762
|
| Hospital Charge Code |
915353762
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$72.38 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Adventist Health Commercial |
$90.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$187.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$121.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.56
|
| Rate for Payer: Blue Shield of California Commercial |
$177.24
|
| Rate for Payer: Blue Shield of California EPN |
$111.38
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Central Health Plan Commercial |
$176.80
|
| Rate for Payer: Cigna of CA HMO |
$154.70
|
| Rate for Payer: Cigna of CA PPO |
$154.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$187.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$187.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$187.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.40
|
| Rate for Payer: EPIC Health Plan Senior |
$88.40
|
| Rate for Payer: Galaxy Health WC |
$187.85
|
| Rate for Payer: Global Benefits Group Commercial |
$132.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$105.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$154.70
|
| Rate for Payer: Multiplan Commercial |
$165.75
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$187.85
|
| Rate for Payer: Riverside University Health System MISP |
$88.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$82.94
|
| Rate for Payer: United Healthcare All Other HMO |
$80.73
|
| Rate for Payer: United Healthcare HMO Rider |
$78.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$187.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$187.85
|
| Rate for Payer: Vantage Medical Group Senior |
$187.85
|
|
|
HC EO RIGID W/O JNTS SFT INTERFAC
|
Facility
|
OP
|
$221.00
|
|
|
Service Code
|
CPT L3762
|
| Hospital Charge Code |
905353762
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$72.38 |
| Max. Negotiated Rate |
$198.90 |
| Rate for Payer: Adventist Health Commercial |
$90.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$187.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$121.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.56
|
| Rate for Payer: Blue Shield of California Commercial |
$177.24
|
| Rate for Payer: Blue Shield of California EPN |
$111.38
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Cash Price |
$99.45
|
| Rate for Payer: Central Health Plan Commercial |
$176.80
|
| Rate for Payer: Cigna of CA HMO |
$154.70
|
| Rate for Payer: Cigna of CA PPO |
$154.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$187.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$187.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$187.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$154.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.40
|
| Rate for Payer: EPIC Health Plan Senior |
$88.40
|
| Rate for Payer: Galaxy Health WC |
$187.85
|
| Rate for Payer: Global Benefits Group Commercial |
$132.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$198.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$105.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$140.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$130.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$154.70
|
| Rate for Payer: Multiplan Commercial |
$165.75
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$187.85
|
| Rate for Payer: Riverside University Health System MISP |
$88.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$132.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$132.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$82.94
|
| Rate for Payer: United Healthcare All Other HMO |
$80.73
|
| Rate for Payer: United Healthcare HMO Rider |
$78.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$72.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$187.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$187.85
|
| Rate for Payer: Vantage Medical Group Senior |
$187.85
|
|
|
HC EOSINOPHIL CT DIR
|
Facility
|
IP
|
$96.00
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
900910031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$86.40 |
| Rate for Payer: Adventist Health Commercial |
$19.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Central Health Plan Commercial |
$76.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.40
|
| Rate for Payer: EPIC Health Plan Senior |
$38.40
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
|
|
HC EOSINOPHIL CT DIR
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
900910031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$25.87 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Adventist Health Commercial |
$19.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.54
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.87
|
| Rate for Payer: Blue Shield of California Commercial |
$60.48
|
| Rate for Payer: Blue Shield of California Commercial |
$12.60
|
| Rate for Payer: Blue Shield of California EPN |
$38.11
|
| Rate for Payer: Blue Shield of California EPN |
$7.94
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: Central Health Plan Commercial |
$76.80
|
| Rate for Payer: Cigna of CA HMO |
$61.44
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$71.04
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.19
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.40
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.54
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.54
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Medicare |
$2.69
|
| Rate for Payer: Prime Health Services Medicare |
$2.69
|
| Rate for Payer: Riverside University Health System MISP |
$2.79
|
| Rate for Payer: Riverside University Health System MISP |
$2.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.06
|
| Rate for Payer: United Healthcare All Other HMO |
$2.06
|
| Rate for Payer: United Healthcare All Other HMO |
$2.06
|
| Rate for Payer: United Healthcare HMO Rider |
$2.06
|
| Rate for Payer: United Healthcare HMO Rider |
$2.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.06
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2.54
|
| Rate for Payer: Vantage Medical Group Senior |
$2.54
|
|
|
HC EOSINOPHIL SMEAR
|
Facility
|
IP
|
$157.00
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
900910030
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.40 |
| Max. Negotiated Rate |
$141.30 |
| Rate for Payer: Adventist Health Commercial |
$31.40
|
| Rate for Payer: Cash Price |
$70.65
|
| Rate for Payer: Central Health Plan Commercial |
$125.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$109.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.80
|
| Rate for Payer: EPIC Health Plan Senior |
$62.80
|
| Rate for Payer: Galaxy Health WC |
$133.45
|
| Rate for Payer: Global Benefits Group Commercial |
$94.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$141.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$99.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$92.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.40
|
| Rate for Payer: Multiplan Commercial |
$117.75
|
| Rate for Payer: Networks By Design Commercial |
$102.05
|
| Rate for Payer: Prime Health Services Commercial |
$133.45
|
|
|
HC EOSINOPHIL SMEAR
|
Facility
|
OP
|
$157.00
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
900910030
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$141.30 |
| Rate for Payer: Adventist Health Commercial |
$31.40
|
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.00
|
| Rate for Payer: Blue Shield of California Commercial |
$26.46
|
| Rate for Payer: Blue Shield of California Commercial |
$98.91
|
| Rate for Payer: Blue Shield of California EPN |
$16.67
|
| Rate for Payer: Blue Shield of California EPN |
$62.33
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$70.65
|
| Rate for Payer: Cash Price |
$70.65
|
| Rate for Payer: Central Health Plan Commercial |
$125.60
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$26.88
|
| Rate for Payer: Cigna of CA HMO |
$100.48
|
| Rate for Payer: Cigna of CA PPO |
$31.08
|
| Rate for Payer: Cigna of CA PPO |
$116.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$109.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.55
|
| Rate for Payer: EPIC Health Plan Senior |
$6.37
|
| Rate for Payer: EPIC Health Plan Senior |
$6.37
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Galaxy Health WC |
$133.45
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Global Benefits Group Commercial |
$94.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$141.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$99.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.76
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Multiplan Commercial |
$117.75
|
| Rate for Payer: Networks By Design Commercial |
$102.05
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.79
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
| Rate for Payer: Prime Health Services Commercial |
$133.45
|
| Rate for Payer: Prime Health Services Medicare |
$6.14
|
| Rate for Payer: Prime Health Services Medicare |
$6.14
|
| Rate for Payer: Riverside University Health System MISP |
$6.37
|
| Rate for Payer: Riverside University Health System MISP |
$6.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$94.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$94.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.69
|
| Rate for Payer: United Healthcare All Other HMO |
$4.69
|
| Rate for Payer: United Healthcare All Other HMO |
$4.69
|
| Rate for Payer: United Healthcare HMO Rider |
$4.69
|
| Rate for Payer: United Healthcare HMO Rider |
$4.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.79
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.37
|
| Rate for Payer: Vantage Medical Group Senior |
$5.79
|
| Rate for Payer: Vantage Medical Group Senior |
$5.79
|
|
|
HC EO WADJTBL POSITION LOCK PREFAB
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
CPT L3760
|
| Hospital Charge Code |
905353760
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Adventist Health Commercial |
$143.00
|
| Rate for Payer: Blue Shield of California Commercial |
$573.43
|
| Rate for Payer: Blue Shield of California EPN |
$360.36
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Central Health Plan Commercial |
$572.00
|
| Rate for Payer: Cigna of CA HMO |
$500.50
|
| Rate for Payer: Cigna of CA PPO |
$500.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$643.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.00
|
| Rate for Payer: Multiplan Commercial |
$536.25
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.34
|
| Rate for Payer: United Healthcare All Other HMO |
$261.19
|
| Rate for Payer: United Healthcare HMO Rider |
$255.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.16
|
|
|
HC EO WADJTBL POSITION LOCK PREFAB
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
CPT L3760
|
| Hospital Charge Code |
915353760
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$234.16 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Adventist Health Commercial |
$293.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$393.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$415.92
|
| Rate for Payer: Blue Shield of California Commercial |
$573.43
|
| Rate for Payer: Blue Shield of California EPN |
$360.36
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Central Health Plan Commercial |
$572.00
|
| Rate for Payer: Cigna of CA HMO |
$500.50
|
| Rate for Payer: Cigna of CA PPO |
$500.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$607.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$607.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$607.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$643.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$492.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$543.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$500.50
|
| Rate for Payer: Multiplan Commercial |
$536.25
|
| Rate for Payer: Networks By Design Commercial |
$357.50
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: Riverside University Health System MISP |
$286.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$429.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$429.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.34
|
| Rate for Payer: United Healthcare All Other HMO |
$261.19
|
| Rate for Payer: United Healthcare HMO Rider |
$255.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$607.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Vantage Medical Group Senior |
$607.75
|
|
|
HC EO WADJTBL POSITION LOCK PREFAB
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
CPT L3760
|
| Hospital Charge Code |
915353760
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Adventist Health Commercial |
$143.00
|
| Rate for Payer: Blue Shield of California Commercial |
$573.43
|
| Rate for Payer: Blue Shield of California EPN |
$360.36
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Central Health Plan Commercial |
$572.00
|
| Rate for Payer: Cigna of CA HMO |
$500.50
|
| Rate for Payer: Cigna of CA PPO |
$500.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$643.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.00
|
| Rate for Payer: Multiplan Commercial |
$536.25
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.34
|
| Rate for Payer: United Healthcare All Other HMO |
$261.19
|
| Rate for Payer: United Healthcare HMO Rider |
$255.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.16
|
|
|
HC EO WADJTBL POSITION LOCK PREFAB
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
CPT L3760
|
| Hospital Charge Code |
905353760
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$234.16 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Adventist Health Commercial |
$293.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$393.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$415.92
|
| Rate for Payer: Blue Shield of California Commercial |
$573.43
|
| Rate for Payer: Blue Shield of California EPN |
$360.36
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Cash Price |
$321.75
|
| Rate for Payer: Central Health Plan Commercial |
$572.00
|
| Rate for Payer: Cigna of CA HMO |
$500.50
|
| Rate for Payer: Cigna of CA PPO |
$500.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$607.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$607.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$607.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$643.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$492.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$454.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$543.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$421.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$500.50
|
| Rate for Payer: Multiplan Commercial |
$536.25
|
| Rate for Payer: Networks By Design Commercial |
$357.50
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: Riverside University Health System MISP |
$286.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$429.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$429.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.34
|
| Rate for Payer: United Healthcare All Other HMO |
$261.19
|
| Rate for Payer: United Healthcare HMO Rider |
$255.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$607.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Vantage Medical Group Senior |
$607.75
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$435.00
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
915353702
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$87.00
|
| Rate for Payer: Blue Shield of California Commercial |
$348.87
|
| Rate for Payer: Blue Shield of California EPN |
$219.24
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$304.50
|
| Rate for Payer: Cigna of CA PPO |
$304.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$304.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$276.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$256.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.00
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$282.75
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.26
|
| Rate for Payer: United Healthcare All Other HMO |
$158.91
|
| Rate for Payer: United Healthcare HMO Rider |
$155.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.46
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$435.00
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
905353702
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$178.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$326.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$253.04
|
| Rate for Payer: Blue Shield of California Commercial |
$348.87
|
| Rate for Payer: Blue Shield of California EPN |
$219.24
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$304.50
|
| Rate for Payer: Cigna of CA PPO |
$304.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$369.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$369.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$304.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$284.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$276.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$313.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$256.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$304.50
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$217.50
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: Riverside University Health System MISP |
$174.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$261.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$261.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.26
|
| Rate for Payer: United Healthcare All Other HMO |
$158.91
|
| Rate for Payer: United Healthcare HMO Rider |
$155.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.75
|
| Rate for Payer: Vantage Medical Group Senior |
$369.75
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$435.00
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
905353702
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$87.00
|
| Rate for Payer: Blue Shield of California Commercial |
$348.87
|
| Rate for Payer: Blue Shield of California EPN |
$219.24
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$304.50
|
| Rate for Payer: Cigna of CA PPO |
$304.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$304.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$276.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$256.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.00
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$282.75
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.26
|
| Rate for Payer: United Healthcare All Other HMO |
$158.91
|
| Rate for Payer: United Healthcare HMO Rider |
$155.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.46
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$435.00
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
915353702
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$178.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$326.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$253.04
|
| Rate for Payer: Blue Shield of California Commercial |
$348.87
|
| Rate for Payer: Blue Shield of California EPN |
$219.24
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Cash Price |
$195.75
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$304.50
|
| Rate for Payer: Cigna of CA PPO |
$304.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$369.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$369.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$304.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$284.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$276.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$313.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$256.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$304.50
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$217.50
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: Riverside University Health System MISP |
$174.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$261.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$261.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.26
|
| Rate for Payer: United Healthcare All Other HMO |
$158.91
|
| Rate for Payer: United Healthcare HMO Rider |
$155.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.75
|
| Rate for Payer: Vantage Medical Group Senior |
$369.75
|
|
|
HC EPHYS EVAL CCM DFIB LD INITIAL IMPL
|
Facility
|
OP
|
$3,315.00
|
|
|
Service Code
|
CPT 0930T
|
| Hospital Charge Code |
906811514
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$663.00 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$663.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,565.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,013.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,565.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,605.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,928.34
|
| 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 |
$1,491.75
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Cash Price |
$1,491.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,652.00
|
| Rate for Payer: Cigna of CA HMO |
$2,121.60
|
| Rate for Payer: Cigna of CA PPO |
$2,453.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,722.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,565.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,320.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,583.83
|
| Rate for Payer: EPIC Health Plan Senior |
$1,722.56
|
| Rate for Payer: Galaxy Health WC |
$2,817.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,983.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,568.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,105.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,203.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,192.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,098.39
|
| Rate for Payer: Multiplan Commercial |
$2,486.25
|
| Rate for Payer: Networks By Design Commercial |
$2,154.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,565.96
|
| Rate for Payer: Prime Health Services Commercial |
$2,817.75
|
| Rate for Payer: Prime Health Services Medicare |
$1,659.92
|
| Rate for Payer: Riverside University Health System MISP |
$1,722.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,989.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,989.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,565.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,348.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,722.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,565.96
|
|
