|
HC CELL EXPANSION
|
Facility
OP
|
$426.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900918001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$85.20 |
| Max. Negotiated Rate |
$11,399.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$140.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,032.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$140.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$869.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,060.09
|
| Rate for Payer: BCBS Transplant Transplant |
$255.60
|
| Rate for Payer: Blue Shield of California Commercial |
$263.27
|
| Rate for Payer: Blue Shield of California EPN |
$207.04
|
| Rate for Payer: Caremore Medicare Advantage |
$140.73
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Cash Price |
$191.70
|
| Rate for Payer: Central Health Plan Commercial |
$340.80
|
| Rate for Payer: Cigna of CA HMO |
$272.64
|
| Rate for Payer: Cigna of CA PPO |
$315.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$140.73
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.73
|
| Rate for Payer: Galaxy Health WC |
$362.10
|
| Rate for Payer: Global Benefits Group Commercial |
$255.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$383.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$319.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$230.80
|
| Rate for Payer: IEHP medi-cal |
$232.20
|
| Rate for Payer: IEHP Medicare Advantage |
$140.73
|
| Rate for Payer: Innovage PACE Commercial |
$211.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$284.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$140.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$188.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$188.58
|
| Rate for Payer: Multiplan Commercial |
$319.50
|
| Rate for Payer: Networks By Design Commercial |
$276.90
|
| Rate for Payer: Prime Health Services Commercial |
$362.10
|
| Rate for Payer: Prime Health Services Medicare |
$149.17
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$255.60
|
| Rate for Payer: Riverside University Health MISP |
$154.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$255.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$255.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.99
|
| Rate for Payer: United Healthcare All Other HMO |
$113.99
|
| Rate for Payer: United Healthcare HMO Rider |
$113.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,399.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Vantage Medical Group Senior |
$140.73
|
|
|
HC CELL EXPANSION
|
Facility
OP
|
$342.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900912601
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$1,060.09 |
| Rate for Payer: Adventist Health Medi-Cal |
$140.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,032.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$140.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$869.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,060.09
|
| Rate for Payer: BCBS Transplant Transplant |
$205.20
|
| Rate for Payer: Blue Shield of California Commercial |
$211.36
|
| Rate for Payer: Blue Shield of California EPN |
$166.21
|
| Rate for Payer: Caremore Medicare Advantage |
$140.73
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Cash Price |
$153.90
|
| Rate for Payer: Central Health Plan Commercial |
$273.60
|
| Rate for Payer: Cigna of CA HMO |
$218.88
|
| Rate for Payer: Cigna of CA PPO |
$253.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$140.73
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.73
|
| Rate for Payer: Galaxy Health WC |
$290.70
|
| Rate for Payer: Global Benefits Group Commercial |
$205.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$307.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$256.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$230.80
|
| Rate for Payer: IEHP medi-cal |
$232.20
|
| Rate for Payer: IEHP Medicare Advantage |
$140.73
|
| Rate for Payer: Innovage PACE Commercial |
$211.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$228.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$140.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$188.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$188.58
|
| Rate for Payer: Multiplan Commercial |
$256.50
|
| Rate for Payer: Networks By Design Commercial |
$222.30
|
| Rate for Payer: Prime Health Services Commercial |
$290.70
|
| Rate for Payer: Prime Health Services Medicare |
$149.17
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$205.20
|
| Rate for Payer: Riverside University Health MISP |
$154.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$205.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$205.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.99
|
| Rate for Payer: United Healthcare All Other HMO |
$113.99
|
| Rate for Payer: United Healthcare HMO Rider |
$113.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Vantage Medical Group Senior |
$140.73
|
|
|
HC CELL EXPANSION
|
Facility
IP
|
$393.00
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900918001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.60 |
| Max. Negotiated Rate |
$353.70 |
| Rate for Payer: Cash Price |
$176.85
|
| Rate for Payer: Central Health Plan Commercial |
$314.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.20
|
| Rate for Payer: Galaxy Health WC |
$334.05
|
| Rate for Payer: Global Benefits Group Commercial |
$235.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$353.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.60
|
| Rate for Payer: Multiplan Commercial |
$294.75
|
| Rate for Payer: Networks By Design Commercial |
$255.45
|
| Rate for Payer: Prime Health Services Commercial |
$334.05
|
|
|
HC CELL MORPHOLOGY (VISUAL)
|
Facility
IP
|
$131.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
900910073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$117.90 |
| Rate for Payer: Cash Price |
$58.95
|
| Rate for Payer: Central Health Plan Commercial |
$104.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.40
|
| Rate for Payer: Galaxy Health WC |
$111.35
|
| Rate for Payer: Global Benefits Group Commercial |
$78.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.20
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
| Rate for Payer: Networks By Design Commercial |
$85.15
|
| Rate for Payer: Prime Health Services Commercial |
$111.35
|
|
|
HC CELL MORPHOLOGY (VISUAL)
|
Facility
OP
|
$13.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
900910073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$30.53 |
| Rate for Payer: Adventist Health Medi-Cal |
$3.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.53
|
| Rate for Payer: BCBS Transplant Transplant |
$7.80
|
| Rate for Payer: Blue Shield of California Commercial |
$8.03
|
| Rate for Payer: Blue Shield of California EPN |
$6.32
|
| Rate for Payer: Caremore Medicare Advantage |
$3.80
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Central Health Plan Commercial |
$10.40
|
| Rate for Payer: Cigna of CA HMO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$9.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.80
|
| Rate for Payer: Galaxy Health WC |
$11.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.23
|
| Rate for Payer: IEHP medi-cal |
$6.27
|
| Rate for Payer: IEHP Medicare Advantage |
$3.80
|
| Rate for Payer: Innovage PACE Commercial |
$5.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.09
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
| Rate for Payer: Networks By Design Commercial |
$8.45
|
| Rate for Payer: Prime Health Services Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Medicare |
$4.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.80
|
| Rate for Payer: Riverside University Health MISP |
$4.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.08
|
| Rate for Payer: United Healthcare All Other HMO |
$3.08
|
| Rate for Payer: United Healthcare HMO Rider |
$3.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: Vantage Medical Group Senior |
$3.80
|
|
|
HC CELL MORPHOLOGY VISUAL INDIVIDUAL
|
Facility
IP
|
$131.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
900912021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$117.90 |
| Rate for Payer: Cash Price |
$58.95
|
| Rate for Payer: Central Health Plan Commercial |
$104.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.40
|
| Rate for Payer: Galaxy Health WC |
$111.35
|
| Rate for Payer: Global Benefits Group Commercial |
$78.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.20
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
| Rate for Payer: Networks By Design Commercial |
$85.15
|
| Rate for Payer: Prime Health Services Commercial |
$111.35
|
|
|
HC CELL MORPHOLOGY VISUAL INDIVIDUAL
|
Facility
OP
|
$13.00
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
900912021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$30.53 |
| Rate for Payer: Adventist Health Medi-Cal |
$3.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.53
|
| Rate for Payer: BCBS Transplant Transplant |
$7.80
|
| Rate for Payer: Blue Shield of California Commercial |
$8.03
|
| Rate for Payer: Blue Shield of California EPN |
$6.32
|
| Rate for Payer: Caremore Medicare Advantage |
$3.80
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Central Health Plan Commercial |
$10.40
|
| Rate for Payer: Cigna of CA HMO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$9.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.13
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.80
|
| Rate for Payer: Galaxy Health WC |
$11.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.23
|
| Rate for Payer: IEHP medi-cal |
$6.27
|
| Rate for Payer: IEHP Medicare Advantage |
$3.80
|
| Rate for Payer: Innovage PACE Commercial |
$5.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.09
|
| Rate for Payer: Multiplan Commercial |
$9.75
|
| Rate for Payer: Networks By Design Commercial |
$8.45
|
| Rate for Payer: Prime Health Services Commercial |
$11.05
|
| Rate for Payer: Prime Health Services Medicare |
$4.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.80
|
| Rate for Payer: Riverside University Health MISP |
$4.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.08
|
| Rate for Payer: United Healthcare All Other HMO |
$3.08
|
| Rate for Payer: United Healthcare HMO Rider |
$3.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: Vantage Medical Group Senior |
$3.80
|
|
|
HC CEMENTOPLASTY
|
Facility
IP
|
$805.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909080999
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$724.50 |
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
|
|
HC CEMENTOPLASTY
|
Facility
OP
|
$805.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909080999
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$4,710.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$389.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$475.59
|
| Rate for Payer: BCBS Transplant Transplant |
$483.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Central Health Plan Commercial |
$644.00
|
| Rate for Payer: Cigna of CA PPO |
$595.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$724.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$603.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$486.16
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$161.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$603.75
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CENTRL MOTR STDY UPPER & LOWER
|
Facility
IP
|
$2,113.00
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
900600322
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$422.60 |
| Max. Negotiated Rate |
$1,901.70 |
| Rate for Payer: Cash Price |
$950.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,690.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$845.20
|
| Rate for Payer: Galaxy Health WC |
$1,796.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,267.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,901.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,409.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.60
|
| Rate for Payer: Multiplan Commercial |
$1,584.75
|
| Rate for Payer: Networks By Design Commercial |
$1,373.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,796.05
|
|
|
HC CENTRL MOTR STDY UPPER & LOWER
|
Facility
OP
|
$2,113.00
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
900600322
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$422.60 |
| Max. Negotiated Rate |
$2,155.44 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,306.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,128.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,959.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,436.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,306.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,825.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,248.36
|
| Rate for Payer: BCBS Transplant Transplant |
$1,267.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,305.83
|
| Rate for Payer: Blue Shield of California EPN |
$1,026.92
|
| Rate for Payer: Caremore Medicare Advantage |
$1,306.33
|
| Rate for Payer: Cash Price |
$950.85
|
| Rate for Payer: Cash Price |
$950.85
|
| Rate for Payer: Cash Price |
$950.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,690.40
|
| Rate for Payer: Cigna of CA HMO |
$1,352.32
|
| Rate for Payer: Cigna of CA PPO |
$1,563.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,959.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,763.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,306.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,306.33
|
| Rate for Payer: Galaxy Health WC |
$1,796.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,267.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,901.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,584.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,142.38
|
| Rate for Payer: IEHP medi-cal |
$2,155.44
|
| Rate for Payer: IEHP Medicare Advantage |
$1,306.33
|
| Rate for Payer: Innovage PACE Commercial |
$1,959.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,409.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,306.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,750.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,750.48
|
| Rate for Payer: Multiplan Commercial |
$1,584.75
|
| Rate for Payer: Networks By Design Commercial |
$1,373.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,796.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,384.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,267.80
|
| Rate for Payer: Riverside University Health MISP |
$1,436.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,267.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,267.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,959.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,436.96
|
| Rate for Payer: Vantage Medical Group Senior |
$1,306.33
|
|
|
HC CENTROMERE AB
|
Facility
IP
|
$162.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900913527
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$145.80 |
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Central Health Plan Commercial |
$129.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.80
|
| Rate for Payer: Galaxy Health WC |
$137.70
|
| Rate for Payer: Global Benefits Group Commercial |
$97.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$145.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$108.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.40
|
| Rate for Payer: Multiplan Commercial |
$121.50
|
| Rate for Payer: Networks By Design Commercial |
$105.30
|
| Rate for Payer: Prime Health Services Commercial |
$137.70
|
|
|
HC CENTROMERE AB
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
900913527
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$106.99 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$88.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.99
|
| Rate for Payer: BCBS Transplant Transplant |
$13.20
|
| Rate for Payer: Blue Shield of California Commercial |
$13.60
|
| Rate for Payer: Blue Shield of California EPN |
$10.69
|
| Rate for Payer: Caremore Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.05
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$19.76
|
| Rate for Payer: IEHP medi-cal |
$19.88
|
| Rate for Payer: IEHP Medicare Advantage |
$12.05
|
| Rate for Payer: Innovage PACE Commercial |
$18.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.15
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Prime Health Services Medicare |
$12.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: Riverside University Health MISP |
$13.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.76
|
| Rate for Payer: United Healthcare All Other HMO |
$9.76
|
| Rate for Payer: United Healthcare HMO Rider |
$9.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.26
|
| Rate for Payer: Vantage Medical Group Senior |
$12.05
|
|
|
HC CEREBRAL BLOOD FLOW
|
Facility
IP
|
$3,505.00
|
|
|
Service Code
|
CPT 78610
|
| Hospital Charge Code |
909301412
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$701.00 |
| Max. Negotiated Rate |
$3,154.50 |
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,804.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,402.00
|
| Rate for Payer: Galaxy Health WC |
$2,979.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,103.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,154.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,337.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$701.00
|
| Rate for Payer: Multiplan Commercial |
$2,628.75
|
| Rate for Payer: Networks By Design Commercial |
$2,278.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,979.25
|
|
|
HC CEREBRAL BLOOD FLOW
|
Facility
OP
|
$3,505.00
|
|
|
Service Code
|
CPT 78610
|
| Hospital Charge Code |
909301412
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$286.07 |
| Max. Negotiated Rate |
$3,154.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$675.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$910.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$675.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$286.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,070.75
|
| Rate for Payer: BCBS Transplant Transplant |
$2,103.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,166.09
|
| Rate for Payer: Blue Shield of California EPN |
$1,703.43
|
| Rate for Payer: Caremore Medicare Advantage |
$675.33
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Cash Price |
$1,577.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,804.00
|
| Rate for Payer: Cigna of CA HMO |
$2,243.20
|
| Rate for Payer: Cigna of CA PPO |
$2,593.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,013.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$911.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$675.33
|
| Rate for Payer: EPIC Health Plan Transplant |
$675.33
|
| Rate for Payer: Galaxy Health WC |
$2,979.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,103.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,154.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,628.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,107.54
|
| Rate for Payer: IEHP medi-cal |
$1,114.29
|
| Rate for Payer: IEHP Medicare Advantage |
$675.33
|
| Rate for Payer: Innovage PACE Commercial |
$1,013.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,337.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$675.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$701.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$904.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$904.94
|
| Rate for Payer: Multiplan Commercial |
$2,628.75
|
| Rate for Payer: Networks By Design Commercial |
$2,278.25
|
| Rate for Payer: Prime Health Services Commercial |
$2,979.25
|
| Rate for Payer: Prime Health Services Medicare |
$715.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,103.00
|
| Rate for Payer: Riverside University Health MISP |
$742.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,103.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,103.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$616.06
|
| Rate for Payer: United Healthcare All Other HMO |
$616.06
|
| Rate for Payer: United Healthcare HMO Rider |
$616.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$616.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,013.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.86
|
| Rate for Payer: Vantage Medical Group Senior |
$675.33
|
|
|
HC CERULOPLASMIN
|
Facility
OP
|
$31.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900910839
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$95.29 |
| Rate for Payer: Adventist Health Medi-Cal |
$10.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$78.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.29
|
| Rate for Payer: BCBS Transplant Transplant |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$19.16
|
| Rate for Payer: Blue Shield of California EPN |
$15.07
|
| Rate for Payer: Caremore Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Central Health Plan Commercial |
$24.80
|
| Rate for Payer: Cigna of CA HMO |
$19.84
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.50
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.74
|
| Rate for Payer: Galaxy Health WC |
$26.35
|
| Rate for Payer: Global Benefits Group Commercial |
$18.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.61
|
| Rate for Payer: IEHP medi-cal |
$17.72
|
| Rate for Payer: IEHP Medicare Advantage |
$10.74
|
| Rate for Payer: Innovage PACE Commercial |
$16.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: Networks By Design Commercial |
$20.15
|
| Rate for Payer: Prime Health Services Commercial |
$26.35
|
| Rate for Payer: Prime Health Services Medicare |
$11.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.60
|
| Rate for Payer: Riverside University Health MISP |
$11.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.70
|
| Rate for Payer: United Healthcare All Other HMO |
$8.70
|
| Rate for Payer: United Healthcare HMO Rider |
$8.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC CERULOPLASMIN
|
Facility
IP
|
$138.00
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
900910839
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$124.20 |
| Rate for Payer: Cash Price |
$62.10
|
| Rate for Payer: Central Health Plan Commercial |
$110.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.20
|
| Rate for Payer: Galaxy Health WC |
$117.30
|
| Rate for Payer: Global Benefits Group Commercial |
$82.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$124.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.60
|
| Rate for Payer: Multiplan Commercial |
$103.50
|
| Rate for Payer: Networks By Design Commercial |
$89.70
|
| Rate for Payer: Prime Health Services Commercial |
$117.30
|
|
|
HC CERVICAL CAP REMOVAL
|
Facility
IP
|
$466.00
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
910400031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.20 |
| Max. Negotiated Rate |
$419.40 |
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Central Health Plan Commercial |
$372.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.40
|
| Rate for Payer: Galaxy Health WC |
$396.10
|
| Rate for Payer: Global Benefits Group Commercial |
$279.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$419.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$310.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.20
|
| Rate for Payer: Multiplan Commercial |
$349.50
|
| Rate for Payer: Networks By Design Commercial |
$302.90
|
| Rate for Payer: Prime Health Services Commercial |
$396.10
|
|
|
HC CERVICAL CAP REMOVAL
|
Facility
OP
|
$466.00
|
|
|
Service Code
|
CPT 59899
|
| Hospital Charge Code |
910400031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.20 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$248.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$279.60
|
| Rate for Payer: Caremore Medicare Advantage |
$248.97
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Cash Price |
$209.70
|
| Rate for Payer: Central Health Plan Commercial |
$372.80
|
| Rate for Payer: Cigna of CA PPO |
$344.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$373.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$336.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$248.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$248.97
|
| Rate for Payer: Galaxy Health WC |
$396.10
|
| Rate for Payer: Global Benefits Group Commercial |
$279.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$419.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$349.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$408.31
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$248.97
|
| Rate for Payer: Innovage PACE Commercial |
$373.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$310.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$248.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$333.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$333.62
|
| Rate for Payer: Multiplan Commercial |
$349.50
|
| Rate for Payer: Networks By Design Commercial |
$302.90
|
| Rate for Payer: Prime Health Services Commercial |
$396.10
|
| Rate for Payer: Prime Health Services Medicare |
$263.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$279.60
|
| Rate for Payer: Riverside University Health MISP |
$273.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$279.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$233.00
|
| Rate for Payer: United Healthcare All Other HMO |
$233.00
|
| Rate for Payer: United Healthcare HMO Rider |
$233.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$233.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Vantage Medical Group Senior |
$248.97
|
|
|
HC CERVICAL DILATOR INSERTION
|
Facility
IP
|
$1,638.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
902400113
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$1,474.20 |
| Rate for Payer: Cash Price |
$737.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,310.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$655.20
|
| Rate for Payer: Galaxy Health WC |
$1,392.30
|
| Rate for Payer: Global Benefits Group Commercial |
$982.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,474.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,092.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$327.60
|
| Rate for Payer: Multiplan Commercial |
$1,228.50
|
| Rate for Payer: Networks By Design Commercial |
$1,064.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,392.30
|
|
|
HC CERVICAL DILATOR INSERTION
|
Facility
OP
|
$1,638.00
|
|
|
Service Code
|
CPT 59200
|
| Hospital Charge Code |
902400113
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$327.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$982.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,030.30
|
| Rate for Payer: Blue Shield of California EPN |
$800.98
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$737.10
|
| Rate for Payer: Cash Price |
$737.10
|
| Rate for Payer: Cash Price |
$737.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,310.40
|
| Rate for Payer: Cigna of CA HMO |
$1,048.32
|
| Rate for Payer: Cigna of CA PPO |
$1,212.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$1,392.30
|
| Rate for Payer: Global Benefits Group Commercial |
$982.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,474.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,228.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: IEHP medi-cal |
$661.35
|
| Rate for Payer: IEHP Medicare Advantage |
$400.82
|
| Rate for Payer: Innovage PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,092.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$327.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$1,228.50
|
| Rate for Payer: Networks By Design Commercial |
$1,064.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,392.30
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$982.80
|
| Rate for Payer: Riverside University Health MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$982.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$982.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC CERVICAL DISCOGRAPHY, 1 LEV
|
Facility
OP
|
$624.00
|
|
|
Service Code
|
CPT 62291
|
| Hospital Charge Code |
909000184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.80 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$530.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$343.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$343.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$374.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Central Health Plan Commercial |
$499.20
|
| Rate for Payer: Cigna of CA PPO |
$461.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$530.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$249.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$249.60
|
| Rate for Payer: Galaxy Health WC |
$530.40
|
| Rate for Payer: Global Benefits Group Commercial |
$374.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$561.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$468.00
|
| Rate for Payer: IEHP medi-cal |
$218.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$416.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.80
|
| Rate for Payer: Multiplan Commercial |
$468.00
|
| Rate for Payer: Networks By Design Commercial |
$405.60
|
| Rate for Payer: Prime Health Services Commercial |
$530.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$374.40
|
| Rate for Payer: Riverside University Health MISP |
$249.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$374.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$530.40
|
| Rate for Payer: Vantage Medical Group Senior |
$530.40
|
|
|
HC CERVICAL DISCOGRAPHY, 1 LEV
|
Facility
IP
|
$624.00
|
|
|
Service Code
|
CPT 62291
|
| Hospital Charge Code |
909000184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.80 |
| Max. Negotiated Rate |
$561.60 |
| Rate for Payer: Cash Price |
$280.80
|
| Rate for Payer: Central Health Plan Commercial |
$499.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$249.60
|
| Rate for Payer: Galaxy Health WC |
$530.40
|
| Rate for Payer: Global Benefits Group Commercial |
$374.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$561.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$416.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.80
|
| Rate for Payer: Multiplan Commercial |
$468.00
|
| Rate for Payer: Networks By Design Commercial |
$405.60
|
| Rate for Payer: Prime Health Services Commercial |
$530.40
|
|
|
HC CERVICAL PUNCTURE (FLUORO)
|
Facility
OP
|
$6,880.00
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
909000197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$370.06 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,128.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,504.00
|
| Rate for Payer: Cigna of CA PPO |
$5,091.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$5,848.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,128.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,192.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,160.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: IEHP medi-cal |
$610.60
|
| Rate for Payer: IEHP Medicare Advantage |
$370.06
|
| Rate for Payer: Innovage PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,588.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,376.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$5,160.00
|
| Rate for Payer: Networks By Design Commercial |
$4,472.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,848.00
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,128.00
|
| Rate for Payer: Riverside University Health MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,128.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC CERVICAL PUNCTURE (FLUORO)
|
Facility
IP
|
$6,880.00
|
|
|
Service Code
|
CPT 61050
|
| Hospital Charge Code |
909000197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,376.00 |
| Max. Negotiated Rate |
$6,192.00 |
| Rate for Payer: Cash Price |
$3,096.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,504.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,752.00
|
| Rate for Payer: Galaxy Health WC |
$5,848.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,128.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,192.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,588.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,376.00
|
| Rate for Payer: Multiplan Commercial |
$5,160.00
|
| Rate for Payer: Networks By Design Commercial |
$4,472.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,848.00
|
|
