|
HC FINE NEEDLE ASP W IMAGE
|
Facility
|
OP
|
$293.00
|
|
|
Service Code
|
CPT 10022
|
| Hospital Charge Code |
903800168
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$58.60 |
| Max. Negotiated Rate |
$263.70 |
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Adventist Health Commercial |
$473.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$177.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,436.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,011.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,301.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,774.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$141.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,145.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,376.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1,490.58
|
| Rate for Payer: Blue Shield of California Commercial |
$184.59
|
| Rate for Payer: Blue Shield of California EPN |
$116.32
|
| Rate for Payer: Blue Shield of California EPN |
$939.30
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$1,064.70
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,892.80
|
| Rate for Payer: Cigna of CA HMO |
$1,514.24
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$1,750.84
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,011.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,011.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$249.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,011.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,656.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$205.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$946.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Senior |
$117.20
|
| Rate for Payer: EPIC Health Plan Senior |
$946.40
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Galaxy Health WC |
$2,011.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,419.60
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,129.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$186.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,502.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$858.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,395.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$172.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$473.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$205.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,656.20
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Multiplan Commercial |
$1,774.50
|
| Rate for Payer: Networks By Design Commercial |
$1,537.90
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,011.10
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Riverside University Health System MISP |
$117.20
|
| Rate for Payer: Riverside University Health System MISP |
$946.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,419.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,419.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,183.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$146.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,183.00
|
| Rate for Payer: United Healthcare All Other HMO |
$146.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,183.00
|
| Rate for Payer: United Healthcare HMO Rider |
$146.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,183.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$146.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,011.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,011.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,011.10
|
|
|
HC FINE NEEDLE ASP W IMAGE
|
Facility
|
OP
|
$2,366.00
|
|
|
Service Code
|
CPT 10022
|
| Hospital Charge Code |
903800168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$473.20 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$473.20
|
| Rate for Payer: Adventist Health Commercial |
$58.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,011.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,301.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,774.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,145.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$141.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,376.30
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$1,064.70
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$1,064.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,892.80
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Cigna of CA HMO |
$1,514.24
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$1,750.84
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,011.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$249.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,011.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,011.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$249.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,656.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$205.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$946.40
|
| Rate for Payer: EPIC Health Plan Senior |
$117.20
|
| Rate for Payer: EPIC Health Plan Senior |
$946.40
|
| Rate for Payer: Galaxy Health WC |
$2,011.10
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,419.60
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,129.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$186.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,502.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$858.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,395.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$172.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$473.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$205.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,656.20
|
| Rate for Payer: Multiplan Commercial |
$1,774.50
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$1,537.90
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,011.10
|
| Rate for Payer: Riverside University Health System MISP |
$946.40
|
| Rate for Payer: Riverside University Health System MISP |
$117.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,419.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,183.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$146.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,183.00
|
| Rate for Payer: United Healthcare All Other HMO |
$146.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,183.00
|
| Rate for Payer: United Healthcare HMO Rider |
$146.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,183.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$146.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,011.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,011.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,011.10
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
OP
|
$319.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$63.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$63.80
|
| Rate for Payer: Adventist Health Commercial |
$332.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| 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 Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,331.20
|
| Rate for Payer: Central Health Plan Commercial |
$255.20
|
| Rate for Payer: Cigna of CA HMO |
$1,064.96
|
| Rate for Payer: Cigna of CA HMO |
$204.16
|
| Rate for Payer: Cigna of CA PPO |
$1,231.36
|
| Rate for Payer: Cigna of CA PPO |
$236.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,164.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$223.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$1,414.40
|
| Rate for Payer: Galaxy Health WC |
$271.15
|
| Rate for Payer: Global Benefits Group Commercial |
$998.40
|
| Rate for Payer: Global Benefits Group Commercial |
$191.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$287.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,497.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,056.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$202.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$239.25
|
| Rate for Payer: Multiplan Commercial |
$1,248.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$207.35
|
| Rate for Payer: Networks By Design Commercial |
$1,081.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$271.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,414.40
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$191.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$998.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$832.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| 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 HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| 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 Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
IP
|
$1,664.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.80 |
| Max. Negotiated Rate |
$1,497.60 |
| Rate for Payer: Adventist Health Commercial |
$332.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,331.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,164.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$665.60
|
| Rate for Payer: EPIC Health Plan Senior |
$665.60
|
| Rate for Payer: Galaxy Health WC |
$1,414.40
|
| Rate for Payer: Global Benefits Group Commercial |
$998.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,497.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,056.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$981.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.80
|
| Rate for Payer: Multiplan Commercial |
$1,248.00
|
| Rate for Payer: Networks By Design Commercial |
$1,081.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,414.40
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
OP
|
$1,664.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$332.80 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$332.80
|
| Rate for Payer: Adventist Health Commercial |
$63.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Adventist Health Medi-Cal |
$522.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$378.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$378.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| 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 Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,048.32
|
| Rate for Payer: Blue Shield of California Commercial |
$200.97
|
| Rate for Payer: Blue Shield of California EPN |
$126.64
|
| Rate for Payer: Blue Shield of California EPN |
$660.61
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Cash Price |
$143.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,331.20
|
| Rate for Payer: Central Health Plan Commercial |
$255.20
|
| Rate for Payer: Cigna of CA HMO |
$204.16
|
| Rate for Payer: Cigna of CA HMO |
$1,064.96
|
| Rate for Payer: Cigna of CA PPO |
$1,231.36
|
| Rate for Payer: Cigna of CA PPO |
$236.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$223.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,164.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$271.15
|
| Rate for Payer: Galaxy Health WC |
$1,414.40
|
| Rate for Payer: Global Benefits Group Commercial |
$191.40
|
| Rate for Payer: Global Benefits Group Commercial |
$998.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$287.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,497.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,056.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$202.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$731.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$239.25
|
| Rate for Payer: Multiplan Commercial |
$1,248.00
|
| Rate for Payer: Networks By Design Commercial |
$1,081.60
|
| Rate for Payer: Networks By Design Commercial |
$207.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,414.40
|
| Rate for Payer: Prime Health Services Commercial |
$271.15
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$998.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$191.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$191.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$998.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$832.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.50
|
| Rate for Payer: United Healthcare All Other HMO |
$832.00
|
| Rate for Payer: United Healthcare All Other HMO |
$159.50
|
| Rate for Payer: United Healthcare HMO Rider |
$159.50
|
| Rate for Payer: United Healthcare HMO Rider |
$832.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$832.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| 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 Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC FINE NEEDLE ASP WO IMAGE
|
Facility
|
IP
|
$1,664.00
|
|
|
Service Code
|
CPT 10021
|
| Hospital Charge Code |
903800167
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$332.80 |
| Max. Negotiated Rate |
$1,497.60 |
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.80
|
| Rate for Payer: Multiplan Commercial |
$1,248.00
|
| Rate for Payer: Networks By Design Commercial |
$1,081.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,414.40
|
| Rate for Payer: Adventist Health Commercial |
$332.80
|
| Rate for Payer: Cash Price |
$748.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,331.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,164.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$665.60
|
| Rate for Payer: EPIC Health Plan Senior |
$665.60
|
| Rate for Payer: Galaxy Health WC |
$1,414.40
|
| Rate for Payer: Global Benefits Group Commercial |
$998.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,497.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,056.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$981.76
|
|
|
HC FINGERS MIN 2 VIEWS
|
Facility
|
IP
|
$736.00
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
909001521
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$147.20 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Adventist Health Commercial |
$147.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Central Health Plan Commercial |
$588.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$515.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$294.40
|
| Rate for Payer: EPIC Health Plan Senior |
$294.40
|
| Rate for Payer: Galaxy Health WC |
$625.60
|
| Rate for Payer: Global Benefits Group Commercial |
$441.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$662.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$467.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$434.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.20
|
| Rate for Payer: Multiplan Commercial |
$552.00
|
| Rate for Payer: Networks By Design Commercial |
$478.40
|
| Rate for Payer: Prime Health Services Commercial |
$625.60
|
|
|
HC FINGERS MIN 2 VIEWS
|
Facility
|
OP
|
$736.00
|
|
|
Service Code
|
CPT 73140
|
| Hospital Charge Code |
909001521
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$662.40 |
| Rate for Payer: Adventist Health Commercial |
$147.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$156.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.09
|
| Rate for Payer: Blue Shield of California Commercial |
$463.68
|
| Rate for Payer: Blue Shield of California EPN |
$292.19
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Cash Price |
$331.20
|
| Rate for Payer: Central Health Plan Commercial |
$588.80
|
| Rate for Payer: Cigna of CA HMO |
$471.04
|
| Rate for Payer: Cigna of CA PPO |
$544.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$515.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$625.60
|
| Rate for Payer: Global Benefits Group Commercial |
$441.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$662.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$467.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$552.00
|
| Rate for Payer: Networks By Design Commercial |
$478.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.93
|
| Rate for Payer: Prime Health Services Commercial |
$625.60
|
| Rate for Payer: Prime Health Services Medicare |
$118.65
|
| Rate for Payer: Riverside University Health System MISP |
$123.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$441.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$441.60
|
| 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: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC FISH INTERPHASE 100-300 CELLS
|
Facility
|
IP
|
$592.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900918011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$118.40 |
| Max. Negotiated Rate |
$532.80 |
| Rate for Payer: Adventist Health Commercial |
$118.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Central Health Plan Commercial |
$473.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$414.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$236.80
|
| Rate for Payer: EPIC Health Plan Senior |
$236.80
|
| Rate for Payer: Galaxy Health WC |
$503.20
|
| Rate for Payer: Global Benefits Group Commercial |
$355.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$532.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$375.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$349.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.40
|
| Rate for Payer: Multiplan Commercial |
$444.00
|
| Rate for Payer: Networks By Design Commercial |
$384.80
|
| Rate for Payer: Prime Health Services Commercial |
$503.20
|
|
|
HC FISH INTERPHASE 100-300 CELLS
|
Facility
|
OP
|
$515.00
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900918011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.46 |
| Max. Negotiated Rate |
$2,647.34 |
| Rate for Payer: Adventist Health Commercial |
$103.00
|
| Rate for Payer: Adventist Health Commercial |
$118.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$51.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$51.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$294.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$294.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,904.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,904.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,647.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,647.34
|
| Rate for Payer: Blue Shield of California Commercial |
$372.96
|
| Rate for Payer: Blue Shield of California Commercial |
$324.45
|
| Rate for Payer: Blue Shield of California EPN |
$235.02
|
| Rate for Payer: Blue Shield of California EPN |
$204.46
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$266.40
|
| Rate for Payer: Cash Price |
$231.75
|
| Rate for Payer: Cash Price |
$231.75
|
| Rate for Payer: Central Health Plan Commercial |
$412.00
|
| Rate for Payer: Central Health Plan Commercial |
$473.60
|
| Rate for Payer: Cigna of CA HMO |
$378.88
|
| Rate for Payer: Cigna of CA HMO |
$329.60
|
| Rate for Payer: Cigna of CA PPO |
$438.08
|
| Rate for Payer: Cigna of CA PPO |
$381.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$360.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$414.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.46
|
| Rate for Payer: EPIC Health Plan Senior |
$56.31
|
| Rate for Payer: EPIC Health Plan Senior |
$56.31
|
| Rate for Payer: Galaxy Health WC |
$503.20
|
| Rate for Payer: Galaxy Health WC |
$437.75
|
| Rate for Payer: Global Benefits Group Commercial |
$355.20
|
| Rate for Payer: Global Benefits Group Commercial |
$309.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$532.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$463.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$83.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$54.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$54.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$51.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$327.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$375.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$60.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$103.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$118.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$68.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$68.59
|
| Rate for Payer: Multiplan Commercial |
$444.00
|
| Rate for Payer: Multiplan Commercial |
$386.25
|
| Rate for Payer: Networks By Design Commercial |
$334.75
|
| Rate for Payer: Networks By Design Commercial |
$384.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$51.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$51.19
|
| Rate for Payer: Prime Health Services Commercial |
$503.20
|
| Rate for Payer: Prime Health Services Commercial |
$437.75
|
| Rate for Payer: Prime Health Services Medicare |
$54.26
|
| Rate for Payer: Prime Health Services Medicare |
$54.26
|
| Rate for Payer: Riverside University Health System MISP |
$56.31
|
| Rate for Payer: Riverside University Health System MISP |
$56.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$309.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$355.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$355.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$309.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare All Other HMO |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare HMO Rider |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$51.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$51.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC FISH INTERPHASE 25-99 CELLS
|
Facility
|
OP
|
$154.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900918010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$2,117.87 |
| Rate for Payer: Adventist Health Commercial |
$30.80
|
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$42.38
|
| Rate for Payer: Adventist Health Medi-Cal |
$42.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$255.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$255.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,523.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,523.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,117.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,117.87
|
| Rate for Payer: Blue Shield of California Commercial |
$134.19
|
| Rate for Payer: Blue Shield of California Commercial |
$97.02
|
| Rate for Payer: Blue Shield of California EPN |
$84.56
|
| Rate for Payer: Blue Shield of California EPN |
$61.14
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Cigna of CA HMO |
$136.32
|
| Rate for Payer: Cigna of CA HMO |
$98.56
|
| Rate for Payer: Cigna of CA PPO |
$157.62
|
| Rate for Payer: Cigna of CA PPO |
$113.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$63.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$107.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.93
|
| Rate for Payer: EPIC Health Plan Senior |
$46.62
|
| Rate for Payer: EPIC Health Plan Senior |
$46.62
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$69.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$69.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$58.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$97.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$64.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$64.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$59.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$56.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$56.79
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$42.38
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$42.38
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
| Rate for Payer: Prime Health Services Medicare |
$44.92
|
| Rate for Payer: Prime Health Services Medicare |
$44.92
|
| Rate for Payer: Riverside University Health System MISP |
$46.62
|
| Rate for Payer: Riverside University Health System MISP |
$46.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$127.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$34.33
|
| Rate for Payer: United Healthcare All Other HMO |
$34.33
|
| Rate for Payer: United Healthcare All Other HMO |
$34.33
|
| Rate for Payer: United Healthcare HMO Rider |
$34.33
|
| Rate for Payer: United Healthcare HMO Rider |
$34.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34.33
|
| Rate for Payer: Upland Medical Group Pediatric |
$42.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$42.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$63.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.62
|
| Rate for Payer: Vantage Medical Group Senior |
$42.38
|
| Rate for Payer: Vantage Medical Group Senior |
$42.38
|
|
|
HC FISH INTERPHASE 25-99 CELLS
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 88274
|
| Hospital Charge Code |
900918010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Adventist Health Commercial |
$42.60
|
| Rate for Payer: Cash Price |
$95.85
|
| Rate for Payer: Central Health Plan Commercial |
$170.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$149.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.20
|
| Rate for Payer: EPIC Health Plan Senior |
$85.20
|
| Rate for Payer: Galaxy Health WC |
$181.05
|
| Rate for Payer: Global Benefits Group Commercial |
$127.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$191.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$135.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$125.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.60
|
| Rate for Payer: Multiplan Commercial |
$159.75
|
| Rate for Payer: Networks By Design Commercial |
$138.45
|
| Rate for Payer: Prime Health Services Commercial |
$181.05
|
|
|
HC FISH PROBE CYTOGEN 10-30 CELLS
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900918009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$180.90 |
| Rate for Payer: Adventist Health Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$90.45
|
| Rate for Payer: Central Health Plan Commercial |
$160.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.40
|
| Rate for Payer: EPIC Health Plan Senior |
$80.40
|
| Rate for Payer: Galaxy Health WC |
$170.85
|
| Rate for Payer: Global Benefits Group Commercial |
$120.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$118.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.20
|
| Rate for Payer: Multiplan Commercial |
$150.75
|
| Rate for Payer: Networks By Design Commercial |
$130.65
|
| Rate for Payer: Prime Health Services Commercial |
$170.85
|
|
|
HC FISH PROBE CYTOGEN 10-30 CELLS
|
Facility
|
OP
|
$143.00
|
|
|
Service Code
|
CPT 88273
|
| Hospital Charge Code |
900918009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$1,921.77 |
| Rate for Payer: Adventist Health Commercial |
$28.60
|
| Rate for Payer: Adventist Health Commercial |
$40.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$34.81
|
| Rate for Payer: Adventist Health Medi-Cal |
$34.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$235.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,382.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,382.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,921.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,921.77
|
| Rate for Payer: Blue Shield of California Commercial |
$126.63
|
| Rate for Payer: Blue Shield of California Commercial |
$90.09
|
| Rate for Payer: Blue Shield of California EPN |
$79.80
|
| Rate for Payer: Blue Shield of California EPN |
$56.77
|
| Rate for Payer: Cash Price |
$90.45
|
| Rate for Payer: Cash Price |
$90.45
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Cash Price |
$64.35
|
| Rate for Payer: Central Health Plan Commercial |
$114.40
|
| Rate for Payer: Central Health Plan Commercial |
$160.80
|
| Rate for Payer: Cigna of CA HMO |
$128.64
|
| Rate for Payer: Cigna of CA HMO |
$91.52
|
| Rate for Payer: Cigna of CA PPO |
$148.74
|
| Rate for Payer: Cigna of CA PPO |
$105.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$100.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$140.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.44
|
| Rate for Payer: EPIC Health Plan Senior |
$38.29
|
| Rate for Payer: EPIC Health Plan Senior |
$38.29
|
| Rate for Payer: Galaxy Health WC |
$170.85
|
| Rate for Payer: Galaxy Health WC |
$121.55
|
| Rate for Payer: Global Benefits Group Commercial |
$120.60
|
| Rate for Payer: Global Benefits Group Commercial |
$85.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$180.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$128.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$57.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$49.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$49.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$90.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$127.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$46.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$46.65
|
| Rate for Payer: Multiplan Commercial |
$150.75
|
| Rate for Payer: Multiplan Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$92.95
|
| Rate for Payer: Networks By Design Commercial |
$130.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$34.81
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$34.81
|
| Rate for Payer: Prime Health Services Commercial |
$170.85
|
| Rate for Payer: Prime Health Services Commercial |
$121.55
|
| Rate for Payer: Prime Health Services Medicare |
$36.90
|
| Rate for Payer: Prime Health Services Medicare |
$36.90
|
| Rate for Payer: Riverside University Health System MISP |
$38.29
|
| Rate for Payer: Riverside University Health System MISP |
$38.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$85.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$120.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$120.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$85.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.20
|
| Rate for Payer: United Healthcare All Other HMO |
$28.20
|
| Rate for Payer: United Healthcare All Other HMO |
$28.20
|
| Rate for Payer: United Healthcare HMO Rider |
$28.20
|
| Rate for Payer: United Healthcare HMO Rider |
$28.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$34.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$34.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.29
|
| Rate for Payer: Vantage Medical Group Senior |
$34.81
|
| Rate for Payer: Vantage Medical Group Senior |
$34.81
|
|
|
HC FISH PROBE CYTOGEN 3-5 CELLS
|
Facility
|
IP
|
$182.00
|
|
|
Service Code
|
CPT 88272
|
| Hospital Charge Code |
900918008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.80
|
| Rate for Payer: EPIC Health Plan Senior |
$72.80
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$107.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
|
|
HC FISH PROBE CYTOGEN 3-5 CELLS
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
CPT 88272
|
| Hospital Charge Code |
900918008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.20 |
| Max. Negotiated Rate |
$1,804.11 |
| Rate for Payer: Adventist Health Commercial |
$26.20
|
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$40.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$40.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$196.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$196.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,297.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,297.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,804.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,804.11
|
| Rate for Payer: Blue Shield of California Commercial |
$114.66
|
| Rate for Payer: Blue Shield of California Commercial |
$82.53
|
| Rate for Payer: Blue Shield of California EPN |
$72.25
|
| Rate for Payer: Blue Shield of California EPN |
$52.01
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Cash Price |
$58.95
|
| Rate for Payer: Cash Price |
$58.95
|
| Rate for Payer: Central Health Plan Commercial |
$104.80
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Cigna of CA HMO |
$116.48
|
| Rate for Payer: Cigna of CA HMO |
$83.84
|
| Rate for Payer: Cigna of CA PPO |
$134.68
|
| Rate for Payer: Cigna of CA PPO |
$96.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.16
|
| Rate for Payer: EPIC Health Plan Senior |
$44.77
|
| Rate for Payer: EPIC Health Plan Senior |
$44.77
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Galaxy Health WC |
$111.35
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Global Benefits Group Commercial |
$78.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$117.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$66.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$50.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$50.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$54.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$54.54
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Multiplan Commercial |
$98.25
|
| Rate for Payer: Networks By Design Commercial |
$85.15
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$40.70
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
| Rate for Payer: Prime Health Services Commercial |
$111.35
|
| Rate for Payer: Prime Health Services Medicare |
$43.14
|
| Rate for Payer: Prime Health Services Medicare |
$43.14
|
| Rate for Payer: Riverside University Health System MISP |
$44.77
|
| Rate for Payer: Riverside University Health System MISP |
$44.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$109.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$109.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.97
|
| Rate for Payer: United Healthcare All Other HMO |
$32.97
|
| Rate for Payer: United Healthcare All Other HMO |
$32.97
|
| Rate for Payer: United Healthcare HMO Rider |
$32.97
|
| Rate for Payer: United Healthcare HMO Rider |
$32.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.97
|
| Rate for Payer: Upland Medical Group Pediatric |
$40.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$40.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.77
|
| Rate for Payer: Vantage Medical Group Senior |
$40.70
|
| Rate for Payer: Vantage Medical Group Senior |
$40.70
|
|
|
HC FISH PROBE CYTOGEN EA
|
Facility
|
IP
|
$385.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900918007
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$346.50 |
| Rate for Payer: Adventist Health Commercial |
$77.00
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Central Health Plan Commercial |
$308.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Senior |
$154.00
|
| Rate for Payer: Galaxy Health WC |
$327.25
|
| Rate for Payer: Global Benefits Group Commercial |
$231.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$346.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.00
|
| Rate for Payer: Multiplan Commercial |
$288.75
|
| Rate for Payer: Networks By Design Commercial |
$250.25
|
| Rate for Payer: Prime Health Services Commercial |
$327.25
|
|
|
HC FISH PROBE CYTOGEN EA
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
900918007
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$1,715.87 |
| Rate for Payer: Adventist Health Commercial |
$72.40
|
| Rate for Payer: Adventist Health Commercial |
$77.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$21.42
|
| Rate for Payer: Adventist Health Medi-Cal |
$21.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$157.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,234.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,234.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,715.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,715.87
|
| Rate for Payer: Blue Shield of California Commercial |
$242.55
|
| Rate for Payer: Blue Shield of California Commercial |
$228.06
|
| Rate for Payer: Blue Shield of California EPN |
$152.84
|
| Rate for Payer: Blue Shield of California EPN |
$143.71
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$162.90
|
| Rate for Payer: Cash Price |
$162.90
|
| Rate for Payer: Central Health Plan Commercial |
$289.60
|
| Rate for Payer: Central Health Plan Commercial |
$308.00
|
| Rate for Payer: Cigna of CA HMO |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$231.68
|
| Rate for Payer: Cigna of CA PPO |
$284.90
|
| Rate for Payer: Cigna of CA PPO |
$267.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$253.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.34
|
| Rate for Payer: EPIC Health Plan Senior |
$23.56
|
| Rate for Payer: EPIC Health Plan Senior |
$23.56
|
| Rate for Payer: Galaxy Health WC |
$327.25
|
| Rate for Payer: Galaxy Health WC |
$307.70
|
| Rate for Payer: Global Benefits Group Commercial |
$231.00
|
| Rate for Payer: Global Benefits Group Commercial |
$217.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$346.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$325.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$229.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28.70
|
| Rate for Payer: Multiplan Commercial |
$288.75
|
| Rate for Payer: Multiplan Commercial |
$271.50
|
| Rate for Payer: Networks By Design Commercial |
$235.30
|
| Rate for Payer: Networks By Design Commercial |
$250.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21.42
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21.42
|
| Rate for Payer: Prime Health Services Commercial |
$327.25
|
| Rate for Payer: Prime Health Services Commercial |
$307.70
|
| Rate for Payer: Prime Health Services Medicare |
$22.71
|
| Rate for Payer: Prime Health Services Medicare |
$22.71
|
| Rate for Payer: Riverside University Health System MISP |
$23.56
|
| Rate for Payer: Riverside University Health System MISP |
$23.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$217.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$217.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare All Other HMO |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare HMO Rider |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$21.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.56
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
| Rate for Payer: Vantage Medical Group Senior |
$21.42
|
|
|
HC FISTULA/SINUS TRACT INJ
|
Facility
|
OP
|
$477.00
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
909000108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$95.40 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$95.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$405.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$262.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$357.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Central Health Plan Commercial |
$381.60
|
| Rate for Payer: Cigna of CA HMO |
$305.28
|
| Rate for Payer: Cigna of CA PPO |
$352.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$405.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$405.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$405.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$333.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.80
|
| Rate for Payer: EPIC Health Plan Senior |
$190.80
|
| Rate for Payer: Galaxy Health WC |
$405.45
|
| Rate for Payer: Global Benefits Group Commercial |
$286.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$429.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$384.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$302.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$424.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$281.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$333.90
|
| Rate for Payer: Multiplan Commercial |
$357.75
|
| Rate for Payer: Networks By Design Commercial |
$310.05
|
| Rate for Payer: Prime Health Services Commercial |
$405.45
|
| Rate for Payer: Riverside University Health System MISP |
$190.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$286.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$238.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$405.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$405.45
|
| Rate for Payer: Vantage Medical Group Senior |
$405.45
|
|
|
HC FISTULA/SINUS TRACT INJ
|
Facility
|
IP
|
$477.00
|
|
|
Service Code
|
CPT 20501
|
| Hospital Charge Code |
909000108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$95.40 |
| Max. Negotiated Rate |
$429.30 |
| Rate for Payer: Adventist Health Commercial |
$95.40
|
| Rate for Payer: Cash Price |
$214.65
|
| Rate for Payer: Central Health Plan Commercial |
$381.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$333.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$190.80
|
| Rate for Payer: EPIC Health Plan Senior |
$190.80
|
| Rate for Payer: Galaxy Health WC |
$405.45
|
| Rate for Payer: Global Benefits Group Commercial |
$286.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$429.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$302.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$281.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$95.40
|
| Rate for Payer: Multiplan Commercial |
$357.75
|
| Rate for Payer: Networks By Design Commercial |
$310.05
|
| Rate for Payer: Prime Health Services Commercial |
$405.45
|
|
|
HC FIT & INSERT PESSARY SUPPORT D
|
Facility
|
OP
|
$749.00
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
900501760
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$129.31 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$149.80
|
| 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 |
$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 |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$407.27
|
| Rate for Payer: Cash Price |
$337.05
|
| Rate for Payer: Cash Price |
$337.05
|
| Rate for Payer: Cash Price |
$337.05
|
| Rate for Payer: Cash Price |
$337.05
|
| Rate for Payer: Central Health Plan Commercial |
$599.20
|
| Rate for Payer: Cigna of CA HMO |
$479.36
|
| Rate for Payer: Cigna of CA PPO |
$554.26
|
| 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 |
$524.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.05
|
| Rate for Payer: EPIC Health Plan Senior |
$286.03
|
| Rate for Payer: Galaxy Health WC |
$636.65
|
| Rate for Payer: Global Benefits Group Commercial |
$449.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$674.10
|
| 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 |
$475.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$129.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$279.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$348.44
|
| Rate for Payer: Multiplan Commercial |
$561.75
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$486.85
|
| 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 |
$636.65
|
| 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 |
$449.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$374.50
|
| Rate for Payer: United Healthcare All Other HMO |
$374.50
|
| Rate for Payer: United Healthcare HMO Rider |
$374.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$374.50
|
| 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 FIT & INSERT PESSARY SUPPORT D
|
Facility
|
IP
|
$749.00
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
900501760
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$149.80 |
| Max. Negotiated Rate |
$674.10 |
| Rate for Payer: Adventist Health Commercial |
$149.80
|
| Rate for Payer: Cash Price |
$337.05
|
| Rate for Payer: Central Health Plan Commercial |
$599.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$524.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$299.60
|
| Rate for Payer: EPIC Health Plan Senior |
$299.60
|
| Rate for Payer: Galaxy Health WC |
$636.65
|
| Rate for Payer: Global Benefits Group Commercial |
$449.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$674.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$475.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$441.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.80
|
| Rate for Payer: Multiplan Commercial |
$561.75
|
| Rate for Payer: Networks By Design Commercial |
$486.85
|
| Rate for Payer: Prime Health Services Commercial |
$636.65
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
IP
|
$19,007.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$3,801.40 |
| Max. Negotiated Rate |
$17,106.30 |
| Rate for Payer: Adventist Health Commercial |
$3,801.40
|
| Rate for Payer: Cash Price |
$8,553.15
|
| Rate for Payer: Central Health Plan Commercial |
$15,205.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,304.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,602.80
|
| Rate for Payer: EPIC Health Plan Senior |
$7,602.80
|
| Rate for Payer: Galaxy Health WC |
$16,155.95
|
| Rate for Payer: Global Benefits Group Commercial |
$11,404.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,106.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,069.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,214.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,801.40
|
| Rate for Payer: Multiplan Commercial |
$14,255.25
|
| Rate for Payer: Networks By Design Commercial |
$12,354.55
|
| Rate for Payer: Prime Health Services Commercial |
$16,155.95
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
OP
|
$19,007.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$17,106.30 |
| Rate for Payer: Adventist Health Commercial |
$7,792.87
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,757.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| 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 |
$6,568.63
|
| Rate for Payer: Cash Price |
$8,553.15
|
| Rate for Payer: Cash Price |
$8,553.15
|
| Rate for Payer: Cash Price |
$8,553.15
|
| Rate for Payer: Cash Price |
$8,553.15
|
| Rate for Payer: Central Health Plan Commercial |
$15,205.60
|
| Rate for Payer: Cigna of CA HMO |
$12,164.48
|
| Rate for Payer: Cigna of CA PPO |
$14,065.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,304.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$16,155.95
|
| Rate for Payer: Global Benefits Group Commercial |
$11,404.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,106.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,069.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$988.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,801.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$14,255.25
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$12,354.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$16,155.95
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,404.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,404.20
|
| 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 |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC FIXATION OF DISTAL RADIAL FX
|
Facility
|
IP
|
$19,007.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
900501394
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,801.40 |
| Max. Negotiated Rate |
$17,106.30 |
| Rate for Payer: Adventist Health Commercial |
$3,801.40
|
| Rate for Payer: Cash Price |
$8,553.15
|
| Rate for Payer: Central Health Plan Commercial |
$15,205.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,304.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,602.80
|
| Rate for Payer: EPIC Health Plan Senior |
$7,602.80
|
| Rate for Payer: Galaxy Health WC |
$16,155.95
|
| Rate for Payer: Global Benefits Group Commercial |
$11,404.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,106.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,069.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,214.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,801.40
|
| Rate for Payer: Multiplan Commercial |
$14,255.25
|
| Rate for Payer: Networks By Design Commercial |
$12,354.55
|
| Rate for Payer: Prime Health Services Commercial |
$16,155.95
|
|
