|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
IP
|
$5,462.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,092.40 |
| Max. Negotiated Rate |
$4,915.80 |
| Rate for Payer: Adventist Health Commercial |
$1,092.40
|
| Rate for Payer: Cash Price |
$2,457.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,369.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,823.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,184.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,184.80
|
| Rate for Payer: Galaxy Health WC |
$4,642.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,915.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,468.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,222.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.40
|
| Rate for Payer: Multiplan Commercial |
$4,096.50
|
| Rate for Payer: Networks By Design Commercial |
$3,550.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,642.70
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
IP
|
$5,462.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,092.40 |
| Max. Negotiated Rate |
$4,915.80 |
| Rate for Payer: Adventist Health Commercial |
$1,092.40
|
| Rate for Payer: Cash Price |
$2,457.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,369.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,823.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,184.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,184.80
|
| Rate for Payer: Galaxy Health WC |
$4,642.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,915.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,468.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,222.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.40
|
| Rate for Payer: Multiplan Commercial |
$4,096.50
|
| Rate for Payer: Networks By Design Commercial |
$3,550.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,642.70
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
OP
|
$5,462.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$101.16 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,092.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$2,457.90
|
| Rate for Payer: Cash Price |
$2,457.90
|
| Rate for Payer: Cash Price |
$2,457.90
|
| Rate for Payer: Cash Price |
$2,457.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,369.60
|
| Rate for Payer: Cigna of CA HMO |
$3,495.68
|
| Rate for Payer: Cigna of CA PPO |
$4,041.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,823.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$4,642.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,915.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,468.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$101.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$4,096.50
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,550.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,642.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,277.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,731.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,731.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,731.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC EXC BEN LES-HD/HND/FT 3.1-4.CM
|
Facility
|
IP
|
$8,799.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
900501737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,759.80 |
| Max. Negotiated Rate |
$7,919.10 |
| Rate for Payer: Adventist Health Commercial |
$1,759.80
|
| Rate for Payer: Cash Price |
$3,959.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,039.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,159.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,519.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,519.60
|
| Rate for Payer: Galaxy Health WC |
$7,479.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,279.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,919.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,587.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,191.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.80
|
| Rate for Payer: Multiplan Commercial |
$6,599.25
|
| Rate for Payer: Networks By Design Commercial |
$5,719.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,479.15
|
|
|
HC EXC BEN LES-HD/HND/FT 3.1-4.CM
|
Facility
|
OP
|
$8,799.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
900501737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$7,919.10 |
| Rate for Payer: Adventist Health Commercial |
$1,759.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$3,959.55
|
| Rate for Payer: Cash Price |
$3,959.55
|
| Rate for Payer: Cash Price |
$3,959.55
|
| Rate for Payer: Cash Price |
$3,959.55
|
| Rate for Payer: Central Health Plan Commercial |
$7,039.20
|
| Rate for Payer: Cigna of CA HMO |
$5,631.36
|
| Rate for Payer: Cigna of CA PPO |
$6,511.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,159.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$7,479.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,279.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,919.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,587.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,283.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$6,599.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$5,719.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$7,479.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,279.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,399.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,399.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,399.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,399.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC EXC BEN LES TRUNK 0.6-1.0 CM
|
Facility
|
OP
|
$3,520.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
900501242
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.45 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Cigna of CA HMO |
$2,252.80
|
| Rate for Payer: Cigna of CA PPO |
$2,604.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$276.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,112.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,760.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,760.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,760.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,760.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC EXC BEN LES TRUNK 0.6-1.0 CM
|
Facility
|
IP
|
$3,520.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
900501242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$704.00 |
| Max. Negotiated Rate |
$3,168.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,408.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,408.00
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,076.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
|
|
HC EXC BEN LES TRUNK 0.6-1.0 CM
|
Facility
|
IP
|
$3,520.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
900501242
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$704.00 |
| Max. Negotiated Rate |
$3,168.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,408.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,408.00
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,076.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
|
|
HC EXC BEN LES TRUNK 0.6-1.0 CM
|
Facility
|
OP
|
$3,520.00
|
|
|
Service Code
|
CPT 11401
|
| Hospital Charge Code |
900501242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$250.26 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Cigna of CA HMO |
$2,252.80
|
| Rate for Payer: Cigna of CA PPO |
$2,604.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$250.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$276.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,112.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,760.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
IP
|
$3,200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$640.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Adventist Health Commercial |
$640.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,560.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,280.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,280.00
|
| Rate for Payer: Galaxy Health WC |
$2,720.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,920.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,880.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,888.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.00
|
| Rate for Payer: Multiplan Commercial |
$2,400.00
|
| Rate for Payer: Networks By Design Commercial |
$2,080.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,720.00
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
IP
|
$3,200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$640.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Adventist Health Commercial |
$640.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,560.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,280.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,280.00
|
| Rate for Payer: Galaxy Health WC |
$2,720.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,920.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,880.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,888.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.00
|
| Rate for Payer: Multiplan Commercial |
$2,400.00
|
| Rate for Payer: Networks By Design Commercial |
$2,080.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,720.00
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
OP
|
$3,200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$640.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,560.00
|
| Rate for Payer: Cigna of CA HMO |
$2,048.00
|
| Rate for Payer: Cigna of CA PPO |
$2,368.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,720.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,920.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,880.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,400.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,080.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$2,720.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,600.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,600.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,600.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,600.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
OP
|
$3,200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
905501287
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,312.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$436.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,560.00
|
| Rate for Payer: Cigna of CA HMO |
$2,048.00
|
| Rate for Payer: Cigna of CA PPO |
$2,368.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,720.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,920.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,880.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,400.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,080.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$2,720.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,920.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,920.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
IP
|
$3,200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$640.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Adventist Health Commercial |
$640.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,560.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,280.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,280.00
|
| Rate for Payer: Galaxy Health WC |
$2,720.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,920.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,880.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,888.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.00
|
| Rate for Payer: Multiplan Commercial |
$2,400.00
|
| Rate for Payer: Networks By Design Commercial |
$2,080.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,720.00
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
OP
|
$3,200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$99.90 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$640.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$910.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,560.00
|
| Rate for Payer: Cigna of CA HMO |
$2,048.00
|
| Rate for Payer: Cigna of CA PPO |
$2,368.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,720.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,920.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,880.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$99.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,400.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,080.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$2,720.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,920.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,600.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
IP
|
$3,200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
905501287
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$640.00 |
| Max. Negotiated Rate |
$2,880.00 |
| Rate for Payer: Adventist Health Commercial |
$640.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,560.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,280.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,280.00
|
| Rate for Payer: Galaxy Health WC |
$2,720.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,920.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,880.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,888.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.00
|
| Rate for Payer: Multiplan Commercial |
$2,400.00
|
| Rate for Payer: Networks By Design Commercial |
$2,080.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,720.00
|
|
|
HC EXC BEN LES TRUNK LT 0.5 CM
|
Facility
|
OP
|
$3,200.00
|
|
|
Service Code
|
CPT 11400
|
| Hospital Charge Code |
900501287
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,312.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$436.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,560.00
|
| Rate for Payer: Cigna of CA HMO |
$2,048.00
|
| Rate for Payer: Cigna of CA PPO |
$2,368.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,720.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,920.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,880.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,032.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$110.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$640.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,400.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,080.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$2,720.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,920.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,920.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC EXC FACIAL LESION 0.6-1.0 CM
|
Facility
|
IP
|
$3,520.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
900501588
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$704.00 |
| Max. Negotiated Rate |
$3,168.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,408.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,408.00
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,076.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
|
|
HC EXC FACIAL LESION 0.6-1.0 CM
|
Facility
|
IP
|
$3,520.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
900501588
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$704.00 |
| Max. Negotiated Rate |
$3,168.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,408.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,408.00
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,076.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
|
|
HC EXC FACIAL LESION 0.6-1.0 CM
|
Facility
|
OP
|
$3,520.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
900501588
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$307.57 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$704.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Cigna of CA HMO |
$2,252.80
|
| Rate for Payer: Cigna of CA PPO |
$2,604.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,112.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,760.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,760.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,760.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,760.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC EXC FACIAL LESION 0.6-1.0 CM
|
Facility
|
OP
|
$3,520.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
900501588
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$307.57 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,443.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$729.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Cash Price |
$1,584.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.00
|
| Rate for Payer: Cigna of CA HMO |
$2,252.80
|
| Rate for Payer: Cigna of CA PPO |
$2,604.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$2,992.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,235.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$307.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$2,640.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,288.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,112.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,112.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC EXC FACIAL LESION 1.1-2.0 CM
|
Facility
|
IP
|
$4,640.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
902890020
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$928.00 |
| Max. Negotiated Rate |
$4,176.00 |
| Rate for Payer: Adventist Health Commercial |
$928.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,712.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,248.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,856.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,856.00
|
| Rate for Payer: Galaxy Health WC |
$3,944.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,784.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,176.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,946.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,737.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.00
|
| Rate for Payer: Multiplan Commercial |
$3,480.00
|
| Rate for Payer: Networks By Design Commercial |
$3,016.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,944.00
|
|
|
HC EXC FACIAL LESION 1.1-2.0 CM
|
Facility
|
OP
|
$4,640.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
902890020
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$152.08 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,902.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$808.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,712.00
|
| Rate for Payer: Cigna of CA HMO |
$2,969.60
|
| Rate for Payer: Cigna of CA PPO |
$3,433.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,248.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$3,944.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,784.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,176.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,946.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$152.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$3,480.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,016.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,944.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,784.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,784.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC EXC FACIAL LESION 1.1-2.0 CM
|
Facility
|
IP
|
$4,640.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
902890020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$928.00 |
| Max. Negotiated Rate |
$4,176.00 |
| Rate for Payer: Adventist Health Commercial |
$928.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,712.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,248.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,856.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,856.00
|
| Rate for Payer: Galaxy Health WC |
$3,944.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,784.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,176.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,946.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,737.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.00
|
| Rate for Payer: Multiplan Commercial |
$3,480.00
|
| Rate for Payer: Networks By Design Commercial |
$3,016.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,944.00
|
|
|
HC EXC FACIAL LESION 1.1-2.0 CM
|
Facility
|
OP
|
$4,640.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
902890020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$137.67 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$928.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$910.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Cash Price |
$2,088.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,712.00
|
| Rate for Payer: Cigna of CA HMO |
$2,969.60
|
| Rate for Payer: Cigna of CA PPO |
$3,433.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,248.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$3,944.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,784.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,176.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$137.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,946.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$152.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,275.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$3,480.00
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,016.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,944.00
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,784.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,320.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
