|
HC EOSINOPHIL SMEAR
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 89190
|
| Hospital Charge Code |
900910030
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Cash Price |
$23.10
|
| Rate for Payer: Central Health Plan Commercial |
$33.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16.80
|
| Rate for Payer: Galaxy Health WC |
$35.70
|
| Rate for Payer: Global Benefits Group Commercial |
$25.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: Networks By Design Commercial |
$27.30
|
| Rate for Payer: Prime Health Services Commercial |
$35.70
|
|
|
HC EO WADJTBL POSITION LOCK PREFAB
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
CPT L3760
|
| Hospital Charge Code |
905353760
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Adventist Health Commercial |
$143.00
|
| Rate for Payer: Blue Shield of California Commercial |
$552.70
|
| Rate for Payer: Blue Shield of California EPN |
$360.36
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Central Health Plan Commercial |
$572.00
|
| Rate for Payer: Cigna of CA HMO |
$500.50
|
| Rate for Payer: Cigna of CA PPO |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$643.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$476.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$272.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$442.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.00
|
| Rate for Payer: Multiplan Commercial |
$536.25
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.34
|
| Rate for Payer: United Healthcare All Other HMO |
$261.19
|
| Rate for Payer: United Healthcare HMO Rider |
$255.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.16
|
|
|
HC EO WADJTBL POSITION LOCK PREFAB
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
CPT L3760
|
| Hospital Charge Code |
915353760
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$143.00 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Adventist Health Commercial |
$143.00
|
| Rate for Payer: Blue Shield of California Commercial |
$552.70
|
| Rate for Payer: Blue Shield of California EPN |
$360.36
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Central Health Plan Commercial |
$572.00
|
| Rate for Payer: Cigna of CA HMO |
$500.50
|
| Rate for Payer: Cigna of CA PPO |
$500.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$643.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$476.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$272.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$442.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.00
|
| Rate for Payer: Multiplan Commercial |
$536.25
|
| Rate for Payer: Networks By Design Commercial |
$464.75
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.34
|
| Rate for Payer: United Healthcare All Other HMO |
$261.19
|
| Rate for Payer: United Healthcare HMO Rider |
$255.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.16
|
|
|
HC EO WADJTBL POSITION LOCK PREFAB
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
CPT L3760
|
| Hospital Charge Code |
915353760
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$234.16 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Adventist Health Commercial |
$293.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$393.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.92
|
| Rate for Payer: Blue Shield of California Commercial |
$552.70
|
| Rate for Payer: Blue Shield of California EPN |
$360.36
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Central Health Plan Commercial |
$572.00
|
| Rate for Payer: Cigna of CA HMO |
$500.50
|
| Rate for Payer: Cigna of CA PPO |
$500.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$607.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$607.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$607.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$643.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$492.09
|
| Rate for Payer: InnovAge PACE Commercial |
$357.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$476.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$442.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$500.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$500.50
|
| Rate for Payer: Multiplan Commercial |
$536.25
|
| Rate for Payer: Networks By Design Commercial |
$357.50
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: Riverside University Health System MISP |
$286.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$429.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$429.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.34
|
| Rate for Payer: United Healthcare All Other HMO |
$261.19
|
| Rate for Payer: United Healthcare HMO Rider |
$255.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$607.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Vantage Medical Group Senior |
$607.75
|
|
|
HC EO WADJTBL POSITION LOCK PREFAB
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
CPT L3760
|
| Hospital Charge Code |
905353760
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$234.16 |
| Max. Negotiated Rate |
$643.50 |
| Rate for Payer: Adventist Health Commercial |
$293.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$393.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$536.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.92
|
| Rate for Payer: Blue Shield of California Commercial |
$552.70
|
| Rate for Payer: Blue Shield of California EPN |
$360.36
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Cash Price |
$393.25
|
| Rate for Payer: Central Health Plan Commercial |
$572.00
|
| Rate for Payer: Cigna of CA HMO |
$500.50
|
| Rate for Payer: Cigna of CA PPO |
$500.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$607.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$607.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$607.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$286.00
|
| Rate for Payer: EPIC Health Plan Senior |
$286.00
|
| Rate for Payer: Galaxy Health WC |
$607.75
|
| Rate for Payer: Global Benefits Group Commercial |
$429.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$643.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$492.09
|
| Rate for Payer: InnovAge PACE Commercial |
$357.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$476.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$543.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$442.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$293.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$500.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$500.50
|
| Rate for Payer: Multiplan Commercial |
$536.25
|
| Rate for Payer: Networks By Design Commercial |
$357.50
|
| Rate for Payer: Prime Health Services Commercial |
$607.75
|
| Rate for Payer: Riverside University Health System MISP |
$286.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$429.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$429.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.34
|
| Rate for Payer: United Healthcare All Other HMO |
$261.19
|
| Rate for Payer: United Healthcare HMO Rider |
$255.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$607.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Vantage Medical Group Senior |
$607.75
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$435.00
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
905353702
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$87.00
|
| Rate for Payer: Blue Shield of California Commercial |
$336.25
|
| Rate for Payer: Blue Shield of California EPN |
$219.24
|
| Rate for Payer: Cash Price |
$239.25
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$304.50
|
| Rate for Payer: Cigna of CA PPO |
$304.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$290.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$269.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.00
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$282.75
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.26
|
| Rate for Payer: United Healthcare All Other HMO |
$158.91
|
| Rate for Payer: United Healthcare HMO Rider |
$155.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.46
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$435.00
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
915353702
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$178.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$326.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$255.48
|
| Rate for Payer: Blue Shield of California Commercial |
$336.25
|
| Rate for Payer: Blue Shield of California EPN |
$219.24
|
| Rate for Payer: Cash Price |
$239.25
|
| Rate for Payer: Cash Price |
$239.25
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$304.50
|
| Rate for Payer: Cigna of CA PPO |
$304.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$369.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$369.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$284.13
|
| Rate for Payer: InnovAge PACE Commercial |
$217.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$290.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$269.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$304.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$304.50
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$217.50
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: Riverside University Health System MISP |
$174.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$261.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$261.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.26
|
| Rate for Payer: United Healthcare All Other HMO |
$158.91
|
| Rate for Payer: United Healthcare HMO Rider |
$155.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.75
|
| Rate for Payer: Vantage Medical Group Senior |
$369.75
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
OP
|
$435.00
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
905353702
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$178.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$326.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$255.48
|
| Rate for Payer: Blue Shield of California Commercial |
$336.25
|
| Rate for Payer: Blue Shield of California EPN |
$219.24
|
| Rate for Payer: Cash Price |
$239.25
|
| Rate for Payer: Cash Price |
$239.25
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$304.50
|
| Rate for Payer: Cigna of CA PPO |
$304.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$369.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$369.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$369.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$284.13
|
| Rate for Payer: InnovAge PACE Commercial |
$217.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$290.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$269.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$304.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$304.50
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$217.50
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: Riverside University Health System MISP |
$174.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$261.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$261.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.26
|
| Rate for Payer: United Healthcare All Other HMO |
$158.91
|
| Rate for Payer: United Healthcare HMO Rider |
$155.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$369.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$369.75
|
| Rate for Payer: Vantage Medical Group Senior |
$369.75
|
|
|
HC EO W/O JOINTS CF
|
Facility
|
IP
|
$435.00
|
|
|
Service Code
|
CPT L3702
|
| Hospital Charge Code |
915353702
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Adventist Health Commercial |
$87.00
|
| Rate for Payer: Blue Shield of California Commercial |
$336.25
|
| Rate for Payer: Blue Shield of California EPN |
$219.24
|
| Rate for Payer: Cash Price |
$239.25
|
| Rate for Payer: Central Health Plan Commercial |
$348.00
|
| Rate for Payer: Cigna of CA HMO |
$304.50
|
| Rate for Payer: Cigna of CA PPO |
$304.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.00
|
| Rate for Payer: EPIC Health Plan Senior |
$174.00
|
| Rate for Payer: Galaxy Health WC |
$369.75
|
| Rate for Payer: Global Benefits Group Commercial |
$261.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$391.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$290.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$165.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$269.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.00
|
| Rate for Payer: Multiplan Commercial |
$326.25
|
| Rate for Payer: Networks By Design Commercial |
$282.75
|
| Rate for Payer: Prime Health Services Commercial |
$369.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$163.26
|
| Rate for Payer: United Healthcare All Other HMO |
$158.91
|
| Rate for Payer: United Healthcare HMO Rider |
$155.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$142.46
|
|
|
HC EP BARD TEMP PACING BAL-TIP
|
Facility
|
OP
|
$851.00
|
|
| Hospital Charge Code |
906812350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$516.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$468.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$638.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$412.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$499.79
|
| Rate for Payer: Blue Shield of California Commercial |
$519.96
|
| Rate for Payer: Blue Shield of California EPN |
$339.55
|
| Rate for Payer: Cash Price |
$468.05
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: Cigna of CA HMO |
$544.64
|
| Rate for Payer: Cigna of CA PPO |
$629.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$723.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$723.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$723.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: InnovAge PACE Commercial |
$425.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$324.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$526.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$595.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$595.70
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
| Rate for Payer: Riverside University Health System MISP |
$340.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.50
|
| Rate for Payer: United Healthcare All Other HMO |
$425.50
|
| Rate for Payer: United Healthcare HMO Rider |
$425.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$723.35
|
| Rate for Payer: Vantage Medical Group Senior |
$723.35
|
|
|
HC EP BARD TEMP PACING BAL-TIP
|
Facility
|
IP
|
$851.00
|
|
| Hospital Charge Code |
906812350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$765.90 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Cash Price |
$468.05
|
| Rate for Payer: Central Health Plan Commercial |
$680.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$324.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$526.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.20
|
| Rate for Payer: Multiplan Commercial |
$638.25
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
|
|
HC EP DF BARD CONFORMA 7F
|
Facility
|
OP
|
$3,803.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812374
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$760.60 |
| Max. Negotiated Rate |
$3,422.70 |
| Rate for Payer: Adventist Health Commercial |
$760.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,309.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,232.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,091.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,852.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,841.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,233.50
|
| Rate for Payer: Blue Shield of California Commercial |
$2,323.63
|
| Rate for Payer: Blue Shield of California EPN |
$1,517.40
|
| Rate for Payer: Cash Price |
$2,091.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,042.40
|
| Rate for Payer: Cigna of CA HMO |
$2,433.92
|
| Rate for Payer: Cigna of CA PPO |
$2,814.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,232.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,232.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,232.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.20
|
| Rate for Payer: Galaxy Health WC |
$3,232.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,422.70
|
| Rate for Payer: InnovAge PACE Commercial |
$1,901.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,536.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,354.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,662.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,662.10
|
| Rate for Payer: Multiplan Commercial |
$2,852.25
|
| Rate for Payer: Networks By Design Commercial |
$2,471.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,521.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,901.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,901.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,901.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,901.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,232.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,232.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,232.55
|
|
|
HC EP DF BARD CONFORMA 7F
|
Facility
|
IP
|
$3,803.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812374
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$760.60 |
| Max. Negotiated Rate |
$3,422.70 |
| Rate for Payer: Adventist Health Commercial |
$760.60
|
| Rate for Payer: Cash Price |
$2,091.65
|
| Rate for Payer: Central Health Plan Commercial |
$3,042.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.20
|
| Rate for Payer: Galaxy Health WC |
$3,232.55
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,422.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,536.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,354.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.60
|
| Rate for Payer: Multiplan Commercial |
$2,852.25
|
| Rate for Payer: Networks By Design Commercial |
$2,471.95
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.55
|
|
|
HC EP DF BIO WEB CS DECA
|
Facility
|
OP
|
$2,295.40
|
|
| Hospital Charge Code |
906812451
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$459.08 |
| Max. Negotiated Rate |
$2,065.86 |
| Rate for Payer: Adventist Health Commercial |
$459.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,394.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,951.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,262.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,721.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,111.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,348.09
|
| Rate for Payer: Blue Shield of California Commercial |
$1,402.49
|
| Rate for Payer: Blue Shield of California EPN |
$915.86
|
| Rate for Payer: Cash Price |
$1,262.47
|
| Rate for Payer: Central Health Plan Commercial |
$1,836.32
|
| Rate for Payer: Cigna of CA HMO |
$1,469.06
|
| Rate for Payer: Cigna of CA PPO |
$1,698.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,951.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,951.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,951.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$918.16
|
| Rate for Payer: EPIC Health Plan Senior |
$918.16
|
| Rate for Payer: Galaxy Health WC |
$1,951.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1,377.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,065.86
|
| Rate for Payer: InnovAge PACE Commercial |
$1,147.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,531.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$874.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,420.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,606.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,606.78
|
| Rate for Payer: Multiplan Commercial |
$1,721.55
|
| Rate for Payer: Networks By Design Commercial |
$1,492.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,951.09
|
| Rate for Payer: Riverside University Health System MISP |
$918.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,377.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,377.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,147.70
|
| Rate for Payer: United Healthcare All Other HMO |
$1,147.70
|
| Rate for Payer: United Healthcare HMO Rider |
$1,147.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,147.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,951.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,951.09
|
| Rate for Payer: Vantage Medical Group Senior |
$1,951.09
|
|
|
HC EP DF BIO WEB CS DECA
|
Facility
|
IP
|
$2,295.40
|
|
| Hospital Charge Code |
906812451
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$459.08 |
| Max. Negotiated Rate |
$2,065.86 |
| Rate for Payer: Adventist Health Commercial |
$459.08
|
| Rate for Payer: Cash Price |
$1,262.47
|
| Rate for Payer: Central Health Plan Commercial |
$1,836.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$918.16
|
| Rate for Payer: EPIC Health Plan Senior |
$918.16
|
| Rate for Payer: Galaxy Health WC |
$1,951.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1,377.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,065.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,531.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$874.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,420.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.08
|
| Rate for Payer: Multiplan Commercial |
$1,721.55
|
| Rate for Payer: Networks By Design Commercial |
$1,492.01
|
| Rate for Payer: Prime Health Services Commercial |
$1,951.09
|
|
|
HC EP DF BIO WEB DUODECA NAV
|
Facility
|
OP
|
$2,760.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$2,484.00 |
| Rate for Payer: Adventist Health Commercial |
$552.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,518.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,070.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,260.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,528.21
|
| Rate for Payer: Blue Shield of California Commercial |
$2,133.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,391.04
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,208.00
|
| Rate for Payer: Cigna of CA HMO |
$1,932.00
|
| Rate for Payer: Cigna of CA PPO |
$1,932.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,346.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,346.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,104.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,104.00
|
| Rate for Payer: Galaxy Health WC |
$2,346.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,484.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,840.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,051.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,708.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,932.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,932.00
|
| Rate for Payer: Multiplan Commercial |
$2,070.00
|
| Rate for Payer: Networks By Design Commercial |
$1,380.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,104.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,656.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,656.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,035.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1,008.23
|
| Rate for Payer: United Healthcare HMO Rider |
$986.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$903.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,346.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,346.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,346.00
|
|
|
HC EP DF BIO WEB DUODECA NAV
|
Facility
|
IP
|
$2,760.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812546
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$2,484.00 |
| Rate for Payer: Adventist Health Commercial |
$552.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,133.48
|
| Rate for Payer: Blue Shield of California EPN |
$1,391.04
|
| Rate for Payer: Cash Price |
$1,518.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,208.00
|
| Rate for Payer: Cigna of CA HMO |
$1,932.00
|
| Rate for Payer: Cigna of CA PPO |
$1,932.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,104.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,104.00
|
| Rate for Payer: Galaxy Health WC |
$2,346.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,656.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,484.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,840.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,051.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,708.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$2,070.00
|
| Rate for Payer: Networks By Design Commercial |
$1,380.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,346.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,035.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1,008.23
|
| Rate for Payer: United Healthcare HMO Rider |
$986.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$903.90
|
|
|
HC EP DF BIO/WEB ISMUS
|
Facility
|
IP
|
$3,654.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$730.80 |
| Max. Negotiated Rate |
$3,288.60 |
| Rate for Payer: Adventist Health Commercial |
$730.80
|
| Rate for Payer: Cash Price |
$2,009.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,923.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,461.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,461.60
|
| Rate for Payer: Galaxy Health WC |
$3,105.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,192.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,288.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,437.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,392.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,261.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$730.80
|
| Rate for Payer: Multiplan Commercial |
$2,740.50
|
| Rate for Payer: Networks By Design Commercial |
$2,375.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,105.90
|
|
|
HC EP DF BIO/WEB ISMUS
|
Facility
|
OP
|
$3,654.00
|
|
|
Service Code
|
CPT C1731
|
| Hospital Charge Code |
906812369
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$730.80 |
| Max. Negotiated Rate |
$3,288.60 |
| Rate for Payer: Adventist Health Commercial |
$730.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,219.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,105.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,009.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,740.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,769.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,145.99
|
| Rate for Payer: Blue Shield of California Commercial |
$2,232.59
|
| Rate for Payer: Blue Shield of California EPN |
$1,457.95
|
| Rate for Payer: Cash Price |
$2,009.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,923.20
|
| Rate for Payer: Cigna of CA HMO |
$2,338.56
|
| Rate for Payer: Cigna of CA PPO |
$2,703.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,105.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,105.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,105.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,461.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,461.60
|
| Rate for Payer: Galaxy Health WC |
$3,105.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,192.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,288.60
|
| Rate for Payer: InnovAge PACE Commercial |
$1,827.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,437.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,392.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,261.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$730.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,557.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,557.80
|
| Rate for Payer: Multiplan Commercial |
$2,740.50
|
| Rate for Payer: Networks By Design Commercial |
$2,375.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,105.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,461.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,192.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,192.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,827.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,827.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,827.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,105.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,105.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3,105.90
|
|
|
HC EP DF BIO/WEB LASSO 10 POLE
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
906812365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC EP DF BIO/WEB LASSO 10 POLE
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
906812365
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,290.47
|
| Rate for Payer: Blue Shield of California Commercial |
$2,382.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC EP DF BIO/WEB LASSO NAV 20MM
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
906812411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC EP DF BIO/WEB LASSO NAV 20MM
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
906812411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,368.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,290.47
|
| Rate for Payer: Blue Shield of California Commercial |
$2,382.90
|
| Rate for Payer: Blue Shield of California EPN |
$1,556.10
|
| Rate for Payer: Cash Price |
$2,145.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,950.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC EP DF MED ACHIEVE
|
Facility
|
IP
|
$3,705.00
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
906812544
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$741.00 |
| Max. Negotiated Rate |
$3,334.50 |
| Rate for Payer: Adventist Health Commercial |
$741.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,863.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,867.32
|
| Rate for Payer: Cash Price |
$2,037.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,964.00
|
| Rate for Payer: Cigna of CA HMO |
$2,593.50
|
| Rate for Payer: Cigna of CA PPO |
$2,593.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,482.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,482.00
|
| Rate for Payer: Galaxy Health WC |
$3,149.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,334.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,471.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,411.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,293.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.00
|
| Rate for Payer: Multiplan Commercial |
$2,778.75
|
| Rate for Payer: Networks By Design Commercial |
$1,852.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,149.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,390.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,353.44
|
| Rate for Payer: United Healthcare HMO Rider |
$1,324.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,213.39
|
|
|
HC EP DF MED ACHIEVE
|
Facility
|
OP
|
$3,705.00
|
|
|
Service Code
|
CPT C1730
|
| Hospital Charge Code |
906812544
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$741.00 |
| Max. Negotiated Rate |
$3,334.50 |
| Rate for Payer: Adventist Health Commercial |
$741.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,149.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,037.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,778.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,691.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,051.46
|
| Rate for Payer: Blue Shield of California Commercial |
$2,863.97
|
| Rate for Payer: Blue Shield of California EPN |
$1,867.32
|
| Rate for Payer: Cash Price |
$2,037.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,964.00
|
| Rate for Payer: Cigna of CA HMO |
$2,593.50
|
| Rate for Payer: Cigna of CA PPO |
$2,593.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,149.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,149.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,149.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,482.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,482.00
|
| Rate for Payer: Galaxy Health WC |
$3,149.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,334.50
|
| Rate for Payer: InnovAge PACE Commercial |
$1,852.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,471.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,411.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,293.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,593.50
|
| Rate for Payer: Multiplan Commercial |
$2,778.75
|
| Rate for Payer: Networks By Design Commercial |
$1,852.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,149.25
|
| Rate for Payer: Riverside University Health System MISP |
$1,482.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,223.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,223.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,390.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1,353.44
|
| Rate for Payer: United Healthcare HMO Rider |
$1,324.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,213.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,149.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,149.25
|
| Rate for Payer: Vantage Medical Group Senior |
$3,149.25
|
|
