|
HC FEEDER HABERMAN REGULAR
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901603250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.70
|
| Rate for Payer: Blue Shield of California Commercial |
$51.99
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC FEEDER HABERMAN REGULAR
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901603250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC FEET BOTH 1 VIEW
|
Facility
|
IP
|
$852.00
|
|
|
Service Code
|
CPT 73620 50
|
| Hospital Charge Code |
909001641
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$170.40 |
| Max. Negotiated Rate |
$766.80 |
| Rate for Payer: Adventist Health Commercial |
$170.40
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Central Health Plan Commercial |
$681.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$596.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.80
|
| Rate for Payer: EPIC Health Plan Senior |
$340.80
|
| Rate for Payer: Galaxy Health WC |
$724.20
|
| Rate for Payer: Global Benefits Group Commercial |
$511.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$766.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$502.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.40
|
| Rate for Payer: Multiplan Commercial |
$639.00
|
| Rate for Payer: Networks By Design Commercial |
$553.80
|
| Rate for Payer: Prime Health Services Commercial |
$724.20
|
|
|
HC FEET BOTH 1 VIEW
|
Facility
|
OP
|
$852.00
|
|
|
Service Code
|
CPT 73620 50
|
| Hospital Charge Code |
909001641
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$766.80 |
| Rate for Payer: Adventist Health Commercial |
$170.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$124.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$724.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$468.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$639.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$102.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$142.72
|
| Rate for Payer: Blue Shield of California Commercial |
$536.76
|
| Rate for Payer: Blue Shield of California EPN |
$338.24
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Cash Price |
$383.40
|
| Rate for Payer: Central Health Plan Commercial |
$681.60
|
| Rate for Payer: Cigna of CA HMO |
$545.28
|
| Rate for Payer: Cigna of CA PPO |
$630.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$724.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$724.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$724.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$596.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.80
|
| Rate for Payer: EPIC Health Plan Senior |
$340.80
|
| Rate for Payer: Galaxy Health WC |
$724.20
|
| Rate for Payer: Global Benefits Group Commercial |
$511.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$766.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$541.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$502.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$596.40
|
| Rate for Payer: Multiplan Commercial |
$639.00
|
| Rate for Payer: Networks By Design Commercial |
$553.80
|
| Rate for Payer: Prime Health Services Commercial |
$724.20
|
| Rate for Payer: Riverside University Health System MISP |
$340.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$511.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$511.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$724.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$724.20
|
| Rate for Payer: Vantage Medical Group Senior |
$724.20
|
|
|
HC FEMALE GENITAL SYTM PROC UNLST
|
Facility
|
IP
|
$1,615.00
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
900501441
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$1,453.50 |
| Rate for Payer: Adventist Health Commercial |
$323.00
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,292.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,130.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.00
|
| Rate for Payer: EPIC Health Plan Senior |
$646.00
|
| Rate for Payer: Galaxy Health WC |
$1,372.75
|
| Rate for Payer: Global Benefits Group Commercial |
$969.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,453.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,025.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$952.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.00
|
| Rate for Payer: Multiplan Commercial |
$1,211.25
|
| Rate for Payer: Networks By Design Commercial |
$1,049.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,372.75
|
|
|
HC FEMALE GENITAL SYTM PROC UNLST
|
Facility
|
OP
|
$1,615.00
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
900501441
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$260.03 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$323.00
|
| 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 |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$407.27
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,292.00
|
| Rate for Payer: Cigna of CA HMO |
$1,033.60
|
| Rate for Payer: Cigna of CA PPO |
$1,195.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,130.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.05
|
| Rate for Payer: EPIC Health Plan Senior |
$286.03
|
| Rate for Payer: Galaxy Health WC |
$1,372.75
|
| Rate for Payer: Global Benefits Group Commercial |
$969.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,453.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$426.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,025.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$1,211.25
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$1,049.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$260.03
|
| Rate for Payer: Preferred Health Network WC |
$415.58
|
| Rate for Payer: Prime Health Services Commercial |
$1,372.75
|
| Rate for Payer: Prime Health Services Medicare |
$275.63
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Riverside University Health System MISP |
$286.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$807.50
|
| Rate for Payer: United Healthcare All Other HMO |
$807.50
|
| Rate for Payer: United Healthcare HMO Rider |
$807.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$807.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$260.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC FEMALE GENITAL SYTM PROC UNLST
|
Facility
|
OP
|
$1,615.00
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
900501441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$260.03 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$323.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$260.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$260.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$781.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$939.45
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$407.27
|
| 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 |
$726.75
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,292.00
|
| Rate for Payer: Cigna of CA HMO |
$1,033.60
|
| Rate for Payer: Cigna of CA PPO |
$1,195.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$286.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$260.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,130.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.05
|
| Rate for Payer: EPIC Health Plan Senior |
$286.03
|
| Rate for Payer: Galaxy Health WC |
$1,372.75
|
| Rate for Payer: Global Benefits Group Commercial |
$969.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,453.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$426.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$260.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,025.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$364.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$1,211.25
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$1,049.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$260.03
|
| Rate for Payer: Preferred Health Network WC |
$415.58
|
| Rate for Payer: Prime Health Services Commercial |
$1,372.75
|
| Rate for Payer: Prime Health Services Medicare |
$275.63
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Riverside University Health System MISP |
$286.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$807.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$260.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$286.03
|
| Rate for Payer: Vantage Medical Group Senior |
$260.03
|
|
|
HC FEMALE GENITAL SYTM PROC UNLST
|
Facility
|
IP
|
$1,615.00
|
|
|
Service Code
|
CPT 58999
|
| Hospital Charge Code |
900501441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.00 |
| Max. Negotiated Rate |
$1,453.50 |
| Rate for Payer: Adventist Health Commercial |
$323.00
|
| Rate for Payer: Cash Price |
$726.75
|
| Rate for Payer: Central Health Plan Commercial |
$1,292.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,130.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.00
|
| Rate for Payer: EPIC Health Plan Senior |
$646.00
|
| Rate for Payer: Galaxy Health WC |
$1,372.75
|
| Rate for Payer: Global Benefits Group Commercial |
$969.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,453.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,025.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$952.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$323.00
|
| Rate for Payer: Multiplan Commercial |
$1,211.25
|
| Rate for Payer: Networks By Design Commercial |
$1,049.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,372.75
|
|
|
HC FEMORAL LENGTH SOCK
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
CPT L2850
|
| Hospital Charge Code |
905352850
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.38 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Adventist Health Commercial |
$91.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$190.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$168.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.30
|
| Rate for Payer: Blue Shield of California Commercial |
$179.65
|
| Rate for Payer: Blue Shield of California EPN |
$112.90
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Central Health Plan Commercial |
$179.20
|
| Rate for Payer: Cigna of CA HMO |
$156.80
|
| Rate for Payer: Cigna of CA PPO |
$156.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$190.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$190.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$190.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Senior |
$89.60
|
| Rate for Payer: Galaxy Health WC |
$190.40
|
| Rate for Payer: Global Benefits Group Commercial |
$134.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$201.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$42.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$142.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$46.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$132.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$156.80
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$112.00
|
| Rate for Payer: Prime Health Services Commercial |
$190.40
|
| Rate for Payer: Riverside University Health System MISP |
$89.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$134.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$134.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$84.07
|
| Rate for Payer: United Healthcare All Other HMO |
$81.83
|
| Rate for Payer: United Healthcare HMO Rider |
$80.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$190.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$190.40
|
| Rate for Payer: Vantage Medical Group Senior |
$190.40
|
|
|
HC FEMORAL LENGTH SOCK
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
CPT L2850
|
| Hospital Charge Code |
915352850
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$42.38 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Adventist Health Commercial |
$91.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$190.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$168.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.30
|
| Rate for Payer: Blue Shield of California Commercial |
$179.65
|
| Rate for Payer: Blue Shield of California EPN |
$112.90
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Central Health Plan Commercial |
$179.20
|
| Rate for Payer: Cigna of CA HMO |
$156.80
|
| Rate for Payer: Cigna of CA PPO |
$156.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$190.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$190.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$190.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Senior |
$89.60
|
| Rate for Payer: Galaxy Health WC |
$190.40
|
| Rate for Payer: Global Benefits Group Commercial |
$134.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$201.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$42.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$142.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$46.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$132.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$156.80
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$112.00
|
| Rate for Payer: Prime Health Services Commercial |
$190.40
|
| Rate for Payer: Riverside University Health System MISP |
$89.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$134.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$134.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$84.07
|
| Rate for Payer: United Healthcare All Other HMO |
$81.83
|
| Rate for Payer: United Healthcare HMO Rider |
$80.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$190.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$190.40
|
| Rate for Payer: Vantage Medical Group Senior |
$190.40
|
|
|
HC FEMORAL LENGTH SOCK
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
CPT L2850
|
| Hospital Charge Code |
905352850
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Adventist Health Commercial |
$44.80
|
| Rate for Payer: Blue Shield of California Commercial |
$179.65
|
| Rate for Payer: Blue Shield of California EPN |
$112.90
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Central Health Plan Commercial |
$179.20
|
| Rate for Payer: Cigna of CA HMO |
$156.80
|
| Rate for Payer: Cigna of CA PPO |
$156.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Senior |
$89.60
|
| Rate for Payer: Galaxy Health WC |
$190.40
|
| Rate for Payer: Global Benefits Group Commercial |
$134.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$201.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$142.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$132.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.80
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$145.60
|
| Rate for Payer: Prime Health Services Commercial |
$190.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$84.07
|
| Rate for Payer: United Healthcare All Other HMO |
$81.83
|
| Rate for Payer: United Healthcare HMO Rider |
$80.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73.36
|
|
|
HC FEMORAL LENGTH SOCK
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
CPT L2850
|
| Hospital Charge Code |
915352850
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Adventist Health Commercial |
$44.80
|
| Rate for Payer: Blue Shield of California Commercial |
$179.65
|
| Rate for Payer: Blue Shield of California EPN |
$112.90
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Central Health Plan Commercial |
$179.20
|
| Rate for Payer: Cigna of CA HMO |
$156.80
|
| Rate for Payer: Cigna of CA PPO |
$156.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$156.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.60
|
| Rate for Payer: EPIC Health Plan Senior |
$89.60
|
| Rate for Payer: Galaxy Health WC |
$190.40
|
| Rate for Payer: Global Benefits Group Commercial |
$134.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$201.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$142.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$132.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.80
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$145.60
|
| Rate for Payer: Prime Health Services Commercial |
$190.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$84.07
|
| Rate for Payer: United Healthcare All Other HMO |
$81.83
|
| Rate for Payer: United Healthcare HMO Rider |
$80.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73.36
|
|
|
HC FEMORAL NERVE BLOCK SINGLE
|
Facility
|
OP
|
$2,413.00
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
900501590
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.37 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$482.60
|
| 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 |
$1,361.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,402.00
|
| Rate for Payer: Cash Price |
$1,085.85
|
| Rate for Payer: Cash Price |
$1,085.85
|
| Rate for Payer: Cash Price |
$1,085.85
|
| Rate for Payer: Cash Price |
$1,085.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,930.40
|
| Rate for Payer: Cigna of CA HMO |
$1,544.32
|
| Rate for Payer: Cigna of CA PPO |
$1,785.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$998.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$907.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,689.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,498.00
|
| Rate for Payer: EPIC Health Plan Senior |
$998.67
|
| Rate for Payer: Galaxy Health WC |
$2,051.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,447.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,171.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,488.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$907.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,532.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$93.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$975.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,216.56
|
| Rate for Payer: Multiplan Commercial |
$1,809.75
|
| Rate for Payer: Multiplan WC |
$1,402.00
|
| Rate for Payer: Networks By Design Commercial |
$1,568.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$907.88
|
| Rate for Payer: Preferred Health Network WC |
$1,430.61
|
| Rate for Payer: Prime Health Services Commercial |
$2,051.05
|
| Rate for Payer: Prime Health Services Medicare |
$962.35
|
| Rate for Payer: Prime Health Services WC |
$1,387.69
|
| Rate for Payer: Riverside University Health System MISP |
$998.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,447.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,206.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,206.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,206.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,206.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$907.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,361.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$998.67
|
| Rate for Payer: Vantage Medical Group Senior |
$907.88
|
|
|
HC FEMORAL NERVE BLOCK SINGLE
|
Facility
|
IP
|
$2,413.00
|
|
|
Service Code
|
CPT 64447
|
| Hospital Charge Code |
900501590
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$482.60 |
| Max. Negotiated Rate |
$2,171.70 |
| Rate for Payer: Adventist Health Commercial |
$482.60
|
| Rate for Payer: Cash Price |
$1,085.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,930.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,689.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$965.20
|
| Rate for Payer: EPIC Health Plan Senior |
$965.20
|
| Rate for Payer: Galaxy Health WC |
$2,051.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,447.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,171.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,532.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,423.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$482.60
|
| Rate for Payer: Multiplan Commercial |
$1,809.75
|
| Rate for Payer: Networks By Design Commercial |
$1,568.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,051.05
|
|
|
HC FERNING
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
900912032
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Central Health Plan Commercial |
$36.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.40
|
| Rate for Payer: EPIC Health Plan Senior |
$18.40
|
| Rate for Payer: Galaxy Health WC |
$39.10
|
| Rate for Payer: Global Benefits Group Commercial |
$27.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$41.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.20
|
| Rate for Payer: Multiplan Commercial |
$34.50
|
| Rate for Payer: Networks By Design Commercial |
$29.90
|
| Rate for Payer: Prime Health Services Commercial |
$39.10
|
|
|
HC FERNING
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
900912032
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$43.17 |
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.17
|
| Rate for Payer: Blue Shield of California Commercial |
$28.98
|
| Rate for Payer: Blue Shield of California EPN |
$18.26
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Central Health Plan Commercial |
$36.80
|
| Rate for Payer: Cigna of CA HMO |
$29.44
|
| Rate for Payer: Cigna of CA PPO |
$34.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$39.10
|
| Rate for Payer: Global Benefits Group Commercial |
$27.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$41.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.80
|
| Rate for Payer: Multiplan Commercial |
$34.50
|
| Rate for Payer: Networks By Design Commercial |
$29.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.82
|
| Rate for Payer: Prime Health Services Commercial |
$39.10
|
| Rate for Payer: Prime Health Services Medicare |
$6.17
|
| Rate for Payer: Riverside University Health System MISP |
$6.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.72
|
| Rate for Payer: United Healthcare All Other HMO |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.72
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.40
|
| Rate for Payer: Vantage Medical Group Senior |
$5.82
|
|
|
HC FERRITIN
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
900910819
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$243.00 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$189.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$171.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$159.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
|
|
HC FERRITIN
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
900910819
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$137.81 |
| Rate for Payer: Adventist Health Commercial |
$20.00
|
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.63
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$99.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.81
|
| Rate for Payer: Blue Shield of California Commercial |
$170.10
|
| Rate for Payer: Blue Shield of California Commercial |
$63.00
|
| Rate for Payer: Blue Shield of California EPN |
$107.19
|
| Rate for Payer: Blue Shield of California EPN |
$39.70
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Central Health Plan Commercial |
$80.00
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: Cigna of CA HMO |
$172.80
|
| Rate for Payer: Cigna of CA HMO |
$64.00
|
| Rate for Payer: Cigna of CA PPO |
$199.80
|
| Rate for Payer: Cigna of CA PPO |
$74.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$70.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$189.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.49
|
| Rate for Payer: EPIC Health Plan Senior |
$14.99
|
| Rate for Payer: EPIC Health Plan Senior |
$14.99
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Galaxy Health WC |
$85.00
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Global Benefits Group Commercial |
$60.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$90.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.35
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$171.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.26
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Multiplan Commercial |
$75.00
|
| Rate for Payer: Networks By Design Commercial |
$65.00
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.63
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
| Rate for Payer: Prime Health Services Commercial |
$85.00
|
| Rate for Payer: Prime Health Services Medicare |
$14.45
|
| Rate for Payer: Prime Health Services Medicare |
$14.45
|
| Rate for Payer: Riverside University Health System MISP |
$14.99
|
| Rate for Payer: Riverside University Health System MISP |
$14.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.04
|
| Rate for Payer: United Healthcare All Other HMO |
$11.04
|
| Rate for Payer: United Healthcare All Other HMO |
$11.04
|
| Rate for Payer: United Healthcare HMO Rider |
$11.04
|
| Rate for Payer: United Healthcare HMO Rider |
$11.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.04
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.63
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.99
|
| Rate for Payer: Vantage Medical Group Senior |
$13.63
|
| Rate for Payer: Vantage Medical Group Senior |
$13.63
|
|
|
HC FETAL BLEED SCREEN
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
CPT 85461
|
| Hospital Charge Code |
900904562
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Central Health Plan Commercial |
$236.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$118.40
|
| Rate for Payer: Galaxy Health WC |
$251.60
|
| Rate for Payer: Global Benefits Group Commercial |
$177.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$266.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.20
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: Networks By Design Commercial |
$192.40
|
| Rate for Payer: Prime Health Services Commercial |
$251.60
|
|
|
HC FETAL BLEED SCREEN
|
Facility
|
OP
|
$296.00
|
|
|
Service Code
|
CPT 85461
|
| Hospital Charge Code |
900904562
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$9.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$48.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$111.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.70
|
| Rate for Payer: Blue Shield of California Commercial |
$186.48
|
| Rate for Payer: Blue Shield of California EPN |
$117.51
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Central Health Plan Commercial |
$236.80
|
| Rate for Payer: Cigna of CA HMO |
$189.44
|
| Rate for Payer: Cigna of CA PPO |
$219.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.44
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$251.60
|
| Rate for Payer: Global Benefits Group Commercial |
$177.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$266.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.54
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: Networks By Design Commercial |
$192.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9.36
|
| Rate for Payer: Prime Health Services Commercial |
$251.60
|
| Rate for Payer: Prime Health Services Medicare |
$9.92
|
| Rate for Payer: Riverside University Health System MISP |
$10.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$177.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$177.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.58
|
| Rate for Payer: United Healthcare All Other HMO |
$7.58
|
| Rate for Payer: United Healthcare HMO Rider |
$7.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.30
|
| Rate for Payer: Vantage Medical Group Senior |
$9.36
|
|
|
HC FETAL DOPPLER UMBILICAL ARTERY
|
Facility
|
IP
|
$1,243.00
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
906601315
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$248.60 |
| Max. Negotiated Rate |
$1,118.70 |
| Rate for Payer: Adventist Health Commercial |
$248.60
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Central Health Plan Commercial |
$994.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$870.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.20
|
| Rate for Payer: EPIC Health Plan Senior |
$497.20
|
| Rate for Payer: Galaxy Health WC |
$1,056.55
|
| Rate for Payer: Global Benefits Group Commercial |
$745.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,118.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$789.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$733.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.60
|
| Rate for Payer: Multiplan Commercial |
$932.25
|
| Rate for Payer: Networks By Design Commercial |
$807.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,056.55
|
|
|
HC FETAL DOPPLER UMBILICAL ARTERY
|
Facility
|
OP
|
$1,243.00
|
|
|
Service Code
|
CPT 76820
|
| Hospital Charge Code |
906601315
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$66.62 |
| Max. Negotiated Rate |
$1,118.70 |
| Rate for Payer: Adventist Health Commercial |
$248.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$141.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$332.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$723.05
|
| Rate for Payer: Blue Shield of California Commercial |
$783.09
|
| Rate for Payer: Blue Shield of California EPN |
$493.47
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Central Health Plan Commercial |
$994.40
|
| Rate for Payer: Cigna of CA HMO |
$795.52
|
| Rate for Payer: Cigna of CA PPO |
$919.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$870.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$1,056.55
|
| Rate for Payer: Global Benefits Group Commercial |
$745.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,118.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$66.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$789.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$73.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$932.25
|
| Rate for Payer: Networks By Design Commercial |
$807.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$1,056.55
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$745.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$745.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$161.07
|
| Rate for Payer: United Healthcare All Other HMO |
$161.07
|
| Rate for Payer: United Healthcare HMO Rider |
$161.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$161.07
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC FETAL FIBRONECTIN
|
Facility
|
IP
|
$1,778.00
|
|
|
Service Code
|
CPT 82731
|
| Hospital Charge Code |
900912319
|
|
Hospital Revenue Code
|
304
|
| Min. Negotiated Rate |
$355.60 |
| Max. Negotiated Rate |
$1,600.20 |
| Rate for Payer: Adventist Health Commercial |
$355.60
|
| Rate for Payer: Cash Price |
$800.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,422.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,244.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$711.20
|
| Rate for Payer: EPIC Health Plan Senior |
$711.20
|
| Rate for Payer: Galaxy Health WC |
$1,511.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,066.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,600.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,129.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,049.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$355.60
|
| Rate for Payer: Multiplan Commercial |
$1,333.50
|
| Rate for Payer: Networks By Design Commercial |
$1,155.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,511.30
|
|
|
HC FETAL FIBRONECTIN
|
Facility
|
OP
|
$1,778.00
|
|
|
Service Code
|
CPT 82731
|
| Hospital Charge Code |
900912319
|
|
Hospital Revenue Code
|
304
|
| Min. Negotiated Rate |
$52.17 |
| Max. Negotiated Rate |
$1,600.20 |
| Rate for Payer: Adventist Health Commercial |
$355.60
|
| Rate for Payer: Adventist Health Commercial |
$41.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$64.41
|
| Rate for Payer: Adventist Health Medi-Cal |
$64.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$472.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$472.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$64.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$979.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$979.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,361.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,361.80
|
| Rate for Payer: Blue Shield of California Commercial |
$129.15
|
| Rate for Payer: Blue Shield of California Commercial |
$1,120.14
|
| Rate for Payer: Blue Shield of California EPN |
$81.39
|
| Rate for Payer: Blue Shield of California EPN |
$705.87
|
| Rate for Payer: Cash Price |
$92.25
|
| Rate for Payer: Cash Price |
$92.25
|
| Rate for Payer: Cash Price |
$800.10
|
| Rate for Payer: Cash Price |
$800.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,422.40
|
| Rate for Payer: Central Health Plan Commercial |
$164.00
|
| Rate for Payer: Cigna of CA HMO |
$131.20
|
| Rate for Payer: Cigna of CA HMO |
$1,137.92
|
| Rate for Payer: Cigna of CA PPO |
$151.70
|
| Rate for Payer: Cigna of CA PPO |
$1,315.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,244.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$143.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.28
|
| Rate for Payer: EPIC Health Plan Senior |
$70.85
|
| Rate for Payer: EPIC Health Plan Senior |
$70.85
|
| Rate for Payer: Galaxy Health WC |
$174.25
|
| Rate for Payer: Galaxy Health WC |
$1,511.30
|
| Rate for Payer: Global Benefits Group Commercial |
$123.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,066.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$184.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,600.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$105.63
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$105.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$96.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$96.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$64.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,129.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$130.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$90.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$355.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$86.31
|
| Rate for Payer: Multiplan Commercial |
$153.75
|
| Rate for Payer: Multiplan Commercial |
$1,333.50
|
| Rate for Payer: Networks By Design Commercial |
$1,155.70
|
| Rate for Payer: Networks By Design Commercial |
$133.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$64.41
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$64.41
|
| Rate for Payer: Prime Health Services Commercial |
$174.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,511.30
|
| Rate for Payer: Prime Health Services Medicare |
$68.27
|
| Rate for Payer: Prime Health Services Medicare |
$68.27
|
| Rate for Payer: Riverside University Health System MISP |
$70.85
|
| Rate for Payer: Riverside University Health System MISP |
$70.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,066.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$123.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$123.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,066.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.17
|
| Rate for Payer: United Healthcare All Other HMO |
$52.17
|
| Rate for Payer: United Healthcare All Other HMO |
$52.17
|
| Rate for Payer: United Healthcare HMO Rider |
$52.17
|
| Rate for Payer: United Healthcare HMO Rider |
$52.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.17
|
| Rate for Payer: Upland Medical Group Pediatric |
$64.41
|
| Rate for Payer: Upland Medical Group Pediatric |
$64.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.85
|
| Rate for Payer: Vantage Medical Group Senior |
$64.41
|
| Rate for Payer: Vantage Medical Group Senior |
$64.41
|
|
|
HC FETAL FLUID DRAIN INCLUD US GU
|
Facility
|
IP
|
$1,111.00
|
|
|
Service Code
|
CPT 59074
|
| Hospital Charge Code |
910400098
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$222.20 |
| Max. Negotiated Rate |
$999.90 |
| Rate for Payer: Adventist Health Commercial |
$222.20
|
| Rate for Payer: Cash Price |
$499.95
|
| Rate for Payer: Central Health Plan Commercial |
$888.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$777.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$444.40
|
| Rate for Payer: EPIC Health Plan Senior |
$444.40
|
| Rate for Payer: Galaxy Health WC |
$944.35
|
| Rate for Payer: Global Benefits Group Commercial |
$666.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$999.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$705.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$655.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$222.20
|
| Rate for Payer: Multiplan Commercial |
$833.25
|
| Rate for Payer: Networks By Design Commercial |
$722.15
|
| Rate for Payer: Prime Health Services Commercial |
$944.35
|
|
