|
HC EWHO W/JOINT(S) CF
|
Facility
|
OP
|
$2,095.00
|
|
|
Service Code
|
CPT L3764
|
| Hospital Charge Code |
905353764
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$686.11 |
| Max. Negotiated Rate |
$1,885.50 |
| Rate for Payer: Adventist Health Commercial |
$858.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,780.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,152.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,571.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,230.39
|
| Rate for Payer: Blue Shield of California Commercial |
$1,619.43
|
| Rate for Payer: Blue Shield of California EPN |
$1,055.88
|
| Rate for Payer: Cash Price |
$1,152.25
|
| Rate for Payer: Cash Price |
$1,152.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,676.00
|
| Rate for Payer: Cigna of CA HMO |
$1,466.50
|
| Rate for Payer: Cigna of CA PPO |
$1,466.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,780.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,780.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,780.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$838.00
|
| Rate for Payer: EPIC Health Plan Senior |
$838.00
|
| Rate for Payer: Galaxy Health WC |
$1,780.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,257.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,885.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,336.06
|
| Rate for Payer: InnovAge PACE Commercial |
$1,047.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,397.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,475.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,296.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$858.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,466.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,466.50
|
| Rate for Payer: Multiplan Commercial |
$1,571.25
|
| Rate for Payer: Networks By Design Commercial |
$1,047.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,780.75
|
| Rate for Payer: Riverside University Health System MISP |
$838.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,257.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,257.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$786.25
|
| Rate for Payer: United Healthcare All Other HMO |
$765.30
|
| Rate for Payer: United Healthcare HMO Rider |
$748.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$686.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,780.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,780.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,780.75
|
|
|
HC EXAMINATION OF VAGINA
|
Facility
|
IP
|
$643.00
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
904000018
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.60 |
| Max. Negotiated Rate |
$578.70 |
| Rate for Payer: Adventist Health Commercial |
$128.60
|
| Rate for Payer: Cash Price |
$353.65
|
| Rate for Payer: Central Health Plan Commercial |
$514.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$257.20
|
| Rate for Payer: EPIC Health Plan Senior |
$257.20
|
| Rate for Payer: Galaxy Health WC |
$546.55
|
| Rate for Payer: Global Benefits Group Commercial |
$385.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$578.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$428.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$398.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.60
|
| Rate for Payer: Multiplan Commercial |
$482.25
|
| Rate for Payer: Networks By Design Commercial |
$417.95
|
| Rate for Payer: Prime Health Services Commercial |
$546.55
|
|
|
HC EXAMINATION OF VAGINA
|
Facility
|
OP
|
$643.00
|
|
|
Service Code
|
CPT 57452
|
| Hospital Charge Code |
904000018
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.60 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$128.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$255.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$311.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$377.63
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$407.27
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$353.65
|
| Rate for Payer: Cash Price |
$353.65
|
| Rate for Payer: Cash Price |
$353.65
|
| Rate for Payer: Central Health Plan Commercial |
$514.40
|
| Rate for Payer: Cigna of CA HMO |
$411.52
|
| Rate for Payer: Cigna of CA PPO |
$475.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$383.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$281.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$255.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.07
|
| Rate for Payer: EPIC Health Plan Senior |
$255.61
|
| Rate for Payer: Galaxy Health WC |
$546.55
|
| Rate for Payer: Global Benefits Group Commercial |
$385.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$578.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$419.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$199.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$255.61
|
| Rate for Payer: InnovAge PACE Commercial |
$383.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$428.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$255.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$342.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$342.52
|
| Rate for Payer: Multiplan Commercial |
$482.25
|
| Rate for Payer: Multiplan WC |
$407.27
|
| Rate for Payer: Networks By Design Commercial |
$417.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$255.61
|
| Rate for Payer: Preferred Health Network WC |
$415.58
|
| Rate for Payer: Prime Health Services Commercial |
$546.55
|
| Rate for Payer: Prime Health Services Medicare |
$270.95
|
| Rate for Payer: Prime Health Services WC |
$403.11
|
| Rate for Payer: Riverside University Health System MISP |
$281.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$385.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$255.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$383.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$281.17
|
| Rate for Payer: Vantage Medical Group Senior |
$255.61
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
IP
|
$4,209.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$841.80 |
| Max. Negotiated Rate |
$3,788.10 |
| Rate for Payer: Adventist Health Commercial |
$841.80
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,367.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,683.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,683.60
|
| Rate for Payer: Galaxy Health WC |
$3,577.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,525.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,788.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,807.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,603.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,605.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$841.80
|
| Rate for Payer: Multiplan Commercial |
$3,156.75
|
| Rate for Payer: Networks By Design Commercial |
$2,735.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,577.65
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
IP
|
$4,209.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$841.80 |
| Max. Negotiated Rate |
$3,788.10 |
| Rate for Payer: Adventist Health Commercial |
$841.80
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,367.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,683.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,683.60
|
| Rate for Payer: Galaxy Health WC |
$3,577.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,525.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,788.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,807.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,603.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,605.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$841.80
|
| Rate for Payer: Multiplan Commercial |
$3,156.75
|
| Rate for Payer: Networks By Design Commercial |
$2,735.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,577.65
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
OP
|
$4,209.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.51 |
| Max. Negotiated Rate |
$3,788.10 |
| Rate for Payer: Adventist Health Commercial |
$841.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,367.20
|
| Rate for Payer: Cigna of CA HMO |
$2,693.76
|
| Rate for Payer: Cigna of CA PPO |
$3,114.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$3,577.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,525.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,788.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,807.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$841.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$3,156.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,735.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,577.65
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,525.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,104.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,104.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,104.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,104.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
OP
|
$4,209.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$123.58 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$841.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$893.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,367.20
|
| Rate for Payer: Cigna of CA HMO |
$2,693.76
|
| Rate for Payer: Cigna of CA PPO |
$3,114.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$3,577.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,525.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,788.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$123.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,807.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$841.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$3,156.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,735.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,577.65
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,525.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
IP
|
$4,209.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$841.80 |
| Max. Negotiated Rate |
$3,788.10 |
| Rate for Payer: Adventist Health Commercial |
$841.80
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,367.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,683.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,683.60
|
| Rate for Payer: Galaxy Health WC |
$3,577.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,525.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,788.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,807.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,603.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,605.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$841.80
|
| Rate for Payer: Multiplan Commercial |
$3,156.75
|
| Rate for Payer: Networks By Design Commercial |
$2,735.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,577.65
|
|
|
HC EX BENIGN LES 1.0 - 2.0 CM
|
Facility
|
OP
|
$4,209.00
|
|
|
Service Code
|
CPT 11402
|
| Hospital Charge Code |
900501013
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$136.51 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,725.69
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Cash Price |
$2,314.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,367.20
|
| Rate for Payer: Cigna of CA HMO |
$2,693.76
|
| Rate for Payer: Cigna of CA PPO |
$3,114.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$3,577.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,525.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,788.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,807.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$841.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$3,156.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$2,735.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,577.65
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,525.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,525.40
|
| 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 |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EX BENIGN LES 2.1 - 3.0 CM
|
Facility
|
IP
|
$5,346.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
900501586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,069.20 |
| Max. Negotiated Rate |
$4,811.40 |
| Rate for Payer: Adventist Health Commercial |
$1,069.20
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,138.40
|
| Rate for Payer: Galaxy Health WC |
$4,544.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,207.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,811.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,565.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,036.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,309.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,069.20
|
| Rate for Payer: Multiplan Commercial |
$4,009.50
|
| Rate for Payer: Networks By Design Commercial |
$3,474.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,544.10
|
|
|
HC EX BENIGN LES 2.1 - 3.0 CM
|
Facility
|
IP
|
$5,346.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
900501586
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,069.20 |
| Max. Negotiated Rate |
$4,811.40 |
| Rate for Payer: Adventist Health Commercial |
$1,069.20
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,276.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,138.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,138.40
|
| Rate for Payer: Galaxy Health WC |
$4,544.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,207.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,811.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,565.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,036.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,309.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,069.20
|
| Rate for Payer: Multiplan Commercial |
$4,009.50
|
| Rate for Payer: Networks By Design Commercial |
$3,474.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,544.10
|
|
|
HC EX BENIGN LES 2.1 - 3.0 CM
|
Facility
|
OP
|
$5,346.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
900501586
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$347.47 |
| Max. Negotiated Rate |
$4,811.40 |
| Rate for Payer: Adventist Health Commercial |
$1,069.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,276.80
|
| Rate for Payer: Cigna of CA HMO |
$3,421.44
|
| Rate for Payer: Cigna of CA PPO |
$3,956.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$4,544.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,207.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,811.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,565.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,069.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$4,009.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,474.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$4,544.10
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,207.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,673.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,673.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,673.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EX BENIGN LES 2.1 - 3.0 CM
|
Facility
|
OP
|
$5,346.00
|
|
|
Service Code
|
CPT 11403
|
| Hospital Charge Code |
900501586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$314.55 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,069.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$893.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$893.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Cash Price |
$2,940.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,276.80
|
| Rate for Payer: Cigna of CA HMO |
$3,421.44
|
| Rate for Payer: Cigna of CA PPO |
$3,956.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$983.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$893.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,206.87
|
| Rate for Payer: EPIC Health Plan Senior |
$893.98
|
| Rate for Payer: Galaxy Health WC |
$4,544.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,207.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,811.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,466.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$893.98
|
| Rate for Payer: InnovAge PACE Commercial |
$1,340.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,565.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$347.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,069.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,197.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,197.93
|
| Rate for Payer: Multiplan Commercial |
$4,009.50
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,474.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$893.98
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$4,544.10
|
| Rate for Payer: Prime Health Services Medicare |
$947.62
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$983.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,207.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$893.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,340.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$983.38
|
| Rate for Payer: Vantage Medical Group Senior |
$893.98
|
|
|
HC EX BENIGN LES 3.1 - 4.0 CM
|
Facility
|
OP
|
$8,074.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
900501791
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$152.41 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,614.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,440.70
|
| Rate for Payer: Cash Price |
$4,440.70
|
| Rate for Payer: Cash Price |
$4,440.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,459.20
|
| Rate for Payer: Cigna of CA HMO |
$5,167.36
|
| Rate for Payer: Cigna of CA PPO |
$5,974.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$6,862.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,844.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,266.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$152.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,385.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,614.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$6,055.50
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$5,248.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,862.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,844.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC EX BENIGN LES 3.1 - 4.0 CM
|
Facility
|
IP
|
$8,074.00
|
|
|
Service Code
|
CPT 11404
|
| Hospital Charge Code |
900501791
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,614.80 |
| Max. Negotiated Rate |
$7,266.60 |
| Rate for Payer: Adventist Health Commercial |
$1,614.80
|
| Rate for Payer: Cash Price |
$4,440.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,229.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,229.60
|
| Rate for Payer: Galaxy Health WC |
$6,862.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,844.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,266.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,385.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,076.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,997.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,614.80
|
| Rate for Payer: Multiplan Commercial |
$6,055.50
|
| Rate for Payer: Networks By Design Commercial |
$5,248.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,862.90
|
|
|
HC EX BENIGN LES GT 4CM
|
Facility
|
OP
|
$10,459.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
902890353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$498.54 |
| Max. Negotiated Rate |
$9,413.10 |
| Rate for Payer: Adventist Health Commercial |
$2,091.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,058.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,367.20
|
| Rate for Payer: Cigna of CA HMO |
$6,693.76
|
| Rate for Payer: Cigna of CA PPO |
$7,739.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$8,890.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,275.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,413.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$498.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,976.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,091.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$7,844.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$6,798.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$8,890.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,275.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC EX BENIGN LES GT 4CM
|
Facility
|
IP
|
$10,459.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
902890353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,091.80 |
| Max. Negotiated Rate |
$9,413.10 |
| Rate for Payer: Adventist Health Commercial |
$2,091.80
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,367.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,183.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,183.60
|
| Rate for Payer: Galaxy Health WC |
$8,890.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,275.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,413.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,976.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,984.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,474.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,091.80
|
| Rate for Payer: Multiplan Commercial |
$7,844.25
|
| Rate for Payer: Networks By Design Commercial |
$6,798.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,890.15
|
|
|
HC EX BENIGN LES GT 4CM
|
Facility
|
OP
|
$10,459.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
902890353
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,413.10 |
| Rate for Payer: Adventist Health Commercial |
$4,288.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,367.20
|
| Rate for Payer: Cigna of CA HMO |
$6,693.76
|
| Rate for Payer: Cigna of CA PPO |
$7,739.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$8,890.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,275.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,413.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,976.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$550.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,091.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$7,844.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$6,798.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$8,890.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,275.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,275.40
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC EX BENIGN LES GT 4CM
|
Facility
|
IP
|
$10,459.00
|
|
|
Service Code
|
CPT 11406
|
| Hospital Charge Code |
902890353
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,091.80 |
| Max. Negotiated Rate |
$9,413.10 |
| Rate for Payer: Adventist Health Commercial |
$2,091.80
|
| Rate for Payer: Cash Price |
$5,752.45
|
| Rate for Payer: Central Health Plan Commercial |
$8,367.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,183.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,183.60
|
| Rate for Payer: Galaxy Health WC |
$8,890.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,275.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,413.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,976.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,984.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,474.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,091.80
|
| Rate for Payer: Multiplan Commercial |
$7,844.25
|
| Rate for Payer: Networks By Design Commercial |
$6,798.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,890.15
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
IP
|
$5,462.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,092.40 |
| Max. Negotiated Rate |
$4,915.80 |
| Rate for Payer: Adventist Health Commercial |
$1,092.40
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,369.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,184.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,184.80
|
| Rate for Payer: Galaxy Health WC |
$4,642.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,915.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,643.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,081.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,380.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.40
|
| Rate for Payer: Multiplan Commercial |
$4,096.50
|
| Rate for Payer: Networks By Design Commercial |
$3,550.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,642.70
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
IP
|
$5,462.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,092.40 |
| Max. Negotiated Rate |
$4,915.80 |
| Rate for Payer: Adventist Health Commercial |
$1,092.40
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,369.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,184.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,184.80
|
| Rate for Payer: Galaxy Health WC |
$4,642.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,915.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,643.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,081.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,380.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.40
|
| Rate for Payer: Multiplan Commercial |
$4,096.50
|
| Rate for Payer: Networks By Design Commercial |
$3,550.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,642.70
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
OP
|
$5,462.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$101.16 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$1,092.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,369.60
|
| Rate for Payer: Cigna of CA HMO |
$3,495.68
|
| Rate for Payer: Cigna of CA PPO |
$4,041.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$4,642.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,915.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,643.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$4,096.50
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,550.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,642.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,277.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,731.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,731.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,731.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC EX BENIGN LES LT 0.5 CM SCALP
|
Facility
|
OP
|
$5,462.00
|
|
|
Service Code
|
CPT 11420
|
| Hospital Charge Code |
900501014
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$101.16 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$2,239.42
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Cash Price |
$3,004.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,369.60
|
| Rate for Payer: Cigna of CA HMO |
$3,495.68
|
| Rate for Payer: Cigna of CA PPO |
$4,041.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$4,642.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,277.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,915.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,643.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$4,096.50
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$3,550.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$4,642.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,277.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,277.20
|
| 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 |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC EXC BEN LES-HD/HND/FT 3.1-4.CM
|
Facility
|
IP
|
$8,799.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
900501737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,759.80 |
| Max. Negotiated Rate |
$7,919.10 |
| Rate for Payer: Adventist Health Commercial |
$1,759.80
|
| Rate for Payer: Cash Price |
$4,839.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,039.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,519.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,519.60
|
| Rate for Payer: Galaxy Health WC |
$7,479.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,279.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,919.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,868.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,352.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,446.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.80
|
| Rate for Payer: Multiplan Commercial |
$6,599.25
|
| Rate for Payer: Networks By Design Commercial |
$5,719.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,479.15
|
|
|
HC EXC BEN LES-HD/HND/FT 3.1-4.CM
|
Facility
|
OP
|
$8,799.00
|
|
|
Service Code
|
CPT 11424
|
| Hospital Charge Code |
900501737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$7,919.10 |
| Rate for Payer: Adventist Health Commercial |
$1,759.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Cash Price |
$4,839.45
|
| Rate for Payer: Cash Price |
$4,839.45
|
| Rate for Payer: Cash Price |
$4,839.45
|
| Rate for Payer: Cash Price |
$4,839.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,039.20
|
| Rate for Payer: Cigna of CA HMO |
$5,631.36
|
| Rate for Payer: Cigna of CA PPO |
$6,511.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$7,479.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,279.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,919.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: InnovAge PACE Commercial |
$3,088.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,868.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,759.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,758.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$6,599.25
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$5,719.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$7,479.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,182.20
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,264.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,279.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,399.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,399.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,399.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,399.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
