|
HC EXCHG BLD TRANS NEWBORN
|
Facility
|
OP
|
$2,017.00
|
|
|
Service Code
|
CPT 36450
|
| Hospital Charge Code |
906812206
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$224.77 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$403.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$555.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$833.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$611.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$555.48
|
| 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: Blue Shield of California Commercial |
$1,232.39
|
| Rate for Payer: Blue Shield of California EPN |
$804.78
|
| Rate for Payer: Cash Price |
$1,109.35
|
| Rate for Payer: Cash Price |
$1,109.35
|
| Rate for Payer: Cash Price |
$1,109.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,613.60
|
| Rate for Payer: Cigna of CA HMO |
$1,290.88
|
| Rate for Payer: Cigna of CA PPO |
$1,492.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$833.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$611.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$555.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$749.90
|
| Rate for Payer: EPIC Health Plan Senior |
$555.48
|
| Rate for Payer: Galaxy Health WC |
$1,714.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,210.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,815.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$910.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$224.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$555.48
|
| Rate for Payer: InnovAge PACE Commercial |
$833.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,345.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$248.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$555.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$403.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$744.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$744.34
|
| Rate for Payer: Multiplan Commercial |
$1,512.75
|
| Rate for Payer: Networks By Design Commercial |
$1,311.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$555.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,714.45
|
| Rate for Payer: Prime Health Services Medicare |
$588.81
|
| Rate for Payer: Riverside University Health System MISP |
$611.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,210.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,210.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$555.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$833.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$611.03
|
| Rate for Payer: Vantage Medical Group Senior |
$555.48
|
|
|
HC EXCHG BLD TRANS OTHER THAN NEWBORN
|
Facility
|
OP
|
$2,017.00
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
906812205
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$199.16 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$403.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$555.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$833.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$611.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$555.48
|
| 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: Blue Shield of California Commercial |
$1,232.39
|
| Rate for Payer: Blue Shield of California EPN |
$804.78
|
| Rate for Payer: Cash Price |
$1,109.35
|
| Rate for Payer: Cash Price |
$1,109.35
|
| Rate for Payer: Cash Price |
$1,109.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,613.60
|
| Rate for Payer: Cigna of CA HMO |
$1,290.88
|
| Rate for Payer: Cigna of CA PPO |
$1,492.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$833.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$611.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$555.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$749.90
|
| Rate for Payer: EPIC Health Plan Senior |
$555.48
|
| Rate for Payer: Galaxy Health WC |
$1,714.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,210.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,815.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$910.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$199.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$555.48
|
| Rate for Payer: InnovAge PACE Commercial |
$833.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,345.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$555.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$403.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$744.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$744.34
|
| Rate for Payer: Multiplan Commercial |
$1,512.75
|
| Rate for Payer: Networks By Design Commercial |
$1,311.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$555.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,714.45
|
| Rate for Payer: Prime Health Services Medicare |
$588.81
|
| Rate for Payer: Riverside University Health System MISP |
$611.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,210.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,210.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$555.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$833.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$611.03
|
| Rate for Payer: Vantage Medical Group Senior |
$555.48
|
|
|
HC EXCHG BLD TRANS OTHER THAN NEWBORN
|
Facility
|
IP
|
$2,017.00
|
|
|
Service Code
|
CPT 36455
|
| Hospital Charge Code |
906812205
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$403.40 |
| Max. Negotiated Rate |
$1,815.30 |
| Rate for Payer: Adventist Health Commercial |
$403.40
|
| Rate for Payer: Cash Price |
$1,109.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,613.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$806.80
|
| Rate for Payer: EPIC Health Plan Senior |
$806.80
|
| Rate for Payer: Galaxy Health WC |
$1,714.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,210.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,815.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,345.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$768.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,248.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$403.40
|
| Rate for Payer: Multiplan Commercial |
$1,512.75
|
| Rate for Payer: Networks By Design Commercial |
$1,311.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,714.45
|
|
|
HC EXCISION ANAL LESION(S)
|
Facility
|
IP
|
$6,378.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
904000014
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,275.60 |
| Max. Negotiated Rate |
$5,740.20 |
| Rate for Payer: Adventist Health Commercial |
$1,275.60
|
| Rate for Payer: Cash Price |
$3,507.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,102.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,551.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,551.20
|
| Rate for Payer: Galaxy Health WC |
$5,421.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,826.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,740.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,254.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,430.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,947.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,275.60
|
| Rate for Payer: Multiplan Commercial |
$4,783.50
|
| Rate for Payer: Networks By Design Commercial |
$4,145.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,421.30
|
|
|
HC EXCISION ANAL LESION(S)
|
Facility
|
OP
|
$6,378.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
904000014
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$163.93 |
| Max. Negotiated Rate |
$5,740.20 |
| Rate for Payer: Adventist Health Commercial |
$1,275.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,484.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,484.48
|
| 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: Blue Shield of California Commercial |
$3,896.96
|
| Rate for Payer: Blue Shield of California EPN |
$2,544.82
|
| Rate for Payer: Cash Price |
$3,507.90
|
| Rate for Payer: Cash Price |
$3,507.90
|
| Rate for Payer: Cash Price |
$3,507.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,102.40
|
| Rate for Payer: Cigna of CA HMO |
$4,081.92
|
| Rate for Payer: Cigna of CA PPO |
$4,719.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,484.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,704.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3,484.48
|
| Rate for Payer: Galaxy Health WC |
$5,421.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,826.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,740.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,714.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$163.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,484.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5,226.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,254.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$181.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,484.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,275.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,669.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,669.20
|
| Rate for Payer: Multiplan Commercial |
$4,783.50
|
| Rate for Payer: Networks By Design Commercial |
$4,145.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,484.48
|
| Rate for Payer: Prime Health Services Commercial |
$5,421.30
|
| Rate for Payer: Prime Health Services Medicare |
$3,693.55
|
| Rate for Payer: Riverside University Health System MISP |
$3,832.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,826.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,826.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,189.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,189.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,189.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,189.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,484.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,484.48
|
|
|
HC EXCISION OF CYST, FIBROADENOMA OR OTHER BENIGN OR MAGLIGNANT TUMOR
|
Facility
|
OP
|
$13,254.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
950442246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$362.44 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$2,650.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,865.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,298.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,352.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,865.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,752.28
|
| Rate for Payer: Blue Shield of California Commercial |
$4,851.77
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$7,289.70
|
| Rate for Payer: Cash Price |
$7,289.70
|
| Rate for Payer: Cash Price |
$7,289.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,603.20
|
| Rate for Payer: Cigna of CA HMO |
$8,482.56
|
| Rate for Payer: Cigna of CA PPO |
$9,807.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,298.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,352.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,865.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,568.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,865.48
|
| Rate for Payer: Galaxy Health WC |
$11,265.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,952.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,928.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,979.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,865.48
|
| Rate for Payer: InnovAge PACE Commercial |
$7,298.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,840.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,865.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,650.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,519.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,519.74
|
| Rate for Payer: Multiplan Commercial |
$9,940.50
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: Networks By Design Commercial |
$8,615.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,865.48
|
| Rate for Payer: Preferred Health Network WC |
$7,910.49
|
| Rate for Payer: Prime Health Services Commercial |
$11,265.90
|
| Rate for Payer: Prime Health Services Medicare |
$5,157.41
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Riverside University Health System MISP |
$5,352.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,952.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,865.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,298.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,352.03
|
| Rate for Payer: Vantage Medical Group Senior |
$4,865.48
|
|
|
HC EXCISION OF CYST, FIBROADENOMA OR OTHER BENIGN OR MAGLIGNANT TUMOR
|
Facility
|
IP
|
$13,254.00
|
|
|
Service Code
|
CPT 19120
|
| Hospital Charge Code |
950442246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,650.80 |
| Max. Negotiated Rate |
$11,928.60 |
| Rate for Payer: Adventist Health Commercial |
$2,650.80
|
| Rate for Payer: Cash Price |
$7,289.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,603.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,301.60
|
| Rate for Payer: Galaxy Health WC |
$11,265.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,952.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,928.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,840.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,049.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,204.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,650.80
|
| Rate for Payer: Multiplan Commercial |
$9,940.50
|
| Rate for Payer: Networks By Design Commercial |
$8,615.10
|
| Rate for Payer: Prime Health Services Commercial |
$11,265.90
|
|
|
HC EXCISION OF GUM LESION
|
Facility
|
OP
|
$10,150.00
|
|
|
Service Code
|
CPT 41825
|
| Hospital Charge Code |
900501744
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$212.21 |
| Max. Negotiated Rate |
$9,135.00 |
| Rate for Payer: Adventist Health Commercial |
$4,161.50
|
| 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 |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| 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 |
$6,565.51
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,120.00
|
| Rate for Payer: Cigna of CA HMO |
$6,496.00
|
| Rate for Payer: Cigna of CA PPO |
$7,511.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$8,627.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,090.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,135.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,770.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$212.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$7,612.50
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$6,597.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,627.50
|
| Rate for Payer: Prime Health Services Medicare |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,090.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,090.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC EXCISION OF GUM LESION
|
Facility
|
IP
|
$10,150.00
|
|
|
Service Code
|
CPT 41825
|
| Hospital Charge Code |
900501744
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,030.00 |
| Max. Negotiated Rate |
$9,135.00 |
| Rate for Payer: Adventist Health Commercial |
$2,030.00
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,060.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,060.00
|
| Rate for Payer: Galaxy Health WC |
$8,627.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,090.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,135.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,770.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,867.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,282.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.00
|
| Rate for Payer: Multiplan Commercial |
$7,612.50
|
| Rate for Payer: Networks By Design Commercial |
$6,597.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,627.50
|
|
|
HC EXCISION OF GUM LESION
|
Facility
|
OP
|
$10,150.00
|
|
|
Service Code
|
CPT 41825
|
| Hospital Charge Code |
900501744
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$212.21 |
| Max. Negotiated Rate |
$9,135.00 |
| Rate for Payer: Adventist Health Commercial |
$2,030.00
|
| 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 |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| 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 |
$6,565.51
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,120.00
|
| Rate for Payer: Cigna of CA HMO |
$6,496.00
|
| Rate for Payer: Cigna of CA PPO |
$7,511.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$8,627.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,090.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,135.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,770.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$212.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$7,612.50
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$6,597.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,627.50
|
| Rate for Payer: Prime Health Services Medicare |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,090.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,075.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,075.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,075.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC EXCISION OF GUM LESION
|
Facility
|
IP
|
$10,150.00
|
|
|
Service Code
|
CPT 41825
|
| Hospital Charge Code |
900501744
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,030.00 |
| Max. Negotiated Rate |
$9,135.00 |
| Rate for Payer: Adventist Health Commercial |
$2,030.00
|
| Rate for Payer: Cash Price |
$5,582.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,060.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,060.00
|
| Rate for Payer: Galaxy Health WC |
$8,627.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,090.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,135.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,770.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,867.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,282.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,030.00
|
| Rate for Payer: Multiplan Commercial |
$7,612.50
|
| Rate for Payer: Networks By Design Commercial |
$6,597.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,627.50
|
|
|
HC EXCISION OF LINGUAL FRENUM
|
Facility
|
OP
|
$3,659.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
900501757
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$3,293.10 |
| Rate for Payer: Adventist Health Commercial |
$731.80
|
| 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 |
$2,823.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,882.11
|
| 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 |
$2,998.82
|
| Rate for Payer: Cash Price |
$2,012.45
|
| Rate for Payer: Cash Price |
$2,012.45
|
| Rate for Payer: Cash Price |
$2,012.45
|
| Rate for Payer: Cash Price |
$2,012.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,927.20
|
| Rate for Payer: Cigna of CA HMO |
$2,341.76
|
| Rate for Payer: Cigna of CA PPO |
$2,707.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,070.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,882.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,540.85
|
| Rate for Payer: EPIC Health Plan Senior |
$1,882.11
|
| Rate for Payer: Galaxy Health WC |
$3,110.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,195.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,293.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,086.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,882.11
|
| Rate for Payer: InnovAge PACE Commercial |
$2,823.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,440.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,394.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,882.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$731.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,522.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,522.03
|
| Rate for Payer: Multiplan Commercial |
$2,744.25
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$2,378.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,882.11
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$3,110.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,995.04
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,070.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,195.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,829.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,829.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,829.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,882.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,823.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,070.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,882.11
|
|
|
HC EXCISION OF LINGUAL FRENUM
|
Facility
|
IP
|
$3,659.00
|
|
|
Service Code
|
CPT 41115
|
| Hospital Charge Code |
900501757
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$731.80 |
| Max. Negotiated Rate |
$3,293.10 |
| Rate for Payer: Adventist Health Commercial |
$731.80
|
| Rate for Payer: Cash Price |
$2,012.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,927.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,463.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,463.60
|
| Rate for Payer: Galaxy Health WC |
$3,110.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,195.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,293.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,440.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,394.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,264.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$731.80
|
| Rate for Payer: Multiplan Commercial |
$2,744.25
|
| Rate for Payer: Networks By Design Commercial |
$2,378.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,110.15
|
|
|
HC EXCISION/REPAIR EYELID GT 1/4
|
Facility
|
OP
|
$9,878.00
|
|
|
Service Code
|
CPT 67966
|
| Hospital Charge Code |
900501712
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,890.20 |
| Rate for Payer: Adventist Health Commercial |
$1,975.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,964.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,723.01
|
| Rate for Payer: Cash Price |
$5,432.90
|
| Rate for Payer: Cash Price |
$5,432.90
|
| Rate for Payer: Cash Price |
$5,432.90
|
| Rate for Payer: Cash Price |
$5,432.90
|
| Rate for Payer: Central Health Plan Commercial |
$7,902.40
|
| Rate for Payer: Cigna of CA HMO |
$6,321.92
|
| Rate for Payer: Cigna of CA PPO |
$7,309.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,260.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,964.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,001.75
|
| Rate for Payer: EPIC Health Plan Senior |
$2,964.26
|
| Rate for Payer: Galaxy Health WC |
$8,396.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,926.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,890.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,861.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,964.26
|
| Rate for Payer: InnovAge PACE Commercial |
$4,446.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,588.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$877.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,964.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,975.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,972.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,972.11
|
| Rate for Payer: Multiplan Commercial |
$7,408.50
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: Networks By Design Commercial |
$6,420.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,964.26
|
| Rate for Payer: Preferred Health Network WC |
$4,819.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,396.30
|
| Rate for Payer: Prime Health Services Medicare |
$3,142.12
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Riverside University Health System MISP |
$3,260.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,926.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,939.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,939.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,939.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,939.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,964.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,964.26
|
|
|
HC EXCISION/REPAIR EYELID GT 1/4
|
Facility
|
IP
|
$9,878.00
|
|
|
Service Code
|
CPT 67966
|
| Hospital Charge Code |
900501712
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,975.60 |
| Max. Negotiated Rate |
$8,890.20 |
| Rate for Payer: Adventist Health Commercial |
$1,975.60
|
| Rate for Payer: Cash Price |
$5,432.90
|
| Rate for Payer: Central Health Plan Commercial |
$7,902.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,951.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,951.20
|
| Rate for Payer: Galaxy Health WC |
$8,396.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,926.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,890.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,588.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,763.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,114.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,975.60
|
| Rate for Payer: Multiplan Commercial |
$7,408.50
|
| Rate for Payer: Networks By Design Commercial |
$6,420.70
|
| Rate for Payer: Prime Health Services Commercial |
$8,396.30
|
|
|
HC EXCISION TONGUE LESION W/O CLOSURE
|
Facility
|
IP
|
$10,189.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
900501147
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,037.80 |
| Max. Negotiated Rate |
$9,170.10 |
| Rate for Payer: Adventist Health Commercial |
$2,037.80
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Central Health Plan Commercial |
$8,151.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,075.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,075.60
|
| Rate for Payer: Galaxy Health WC |
$8,660.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,170.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,796.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,882.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,306.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,037.80
|
| Rate for Payer: Multiplan Commercial |
$7,641.75
|
| Rate for Payer: Networks By Design Commercial |
$6,622.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,660.65
|
|
|
HC EXCISION TONGUE LESION W/O CLOSURE
|
Facility
|
IP
|
$10,189.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
900501147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,037.80 |
| Max. Negotiated Rate |
$9,170.10 |
| Rate for Payer: Adventist Health Commercial |
$2,037.80
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Central Health Plan Commercial |
$8,151.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,075.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,075.60
|
| Rate for Payer: Galaxy Health WC |
$8,660.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,170.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,796.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,882.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,306.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,037.80
|
| Rate for Payer: Multiplan Commercial |
$7,641.75
|
| Rate for Payer: Networks By Design Commercial |
$6,622.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,660.65
|
|
|
HC EXCISION TONGUE LESION W/O CLOSURE
|
Facility
|
OP
|
$10,189.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
900501147
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$253.95 |
| Max. Negotiated Rate |
$9,170.10 |
| Rate for Payer: Adventist Health Commercial |
$2,037.80
|
| 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 |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| 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 |
$6,565.51
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Central Health Plan Commercial |
$8,151.20
|
| Rate for Payer: Cigna of CA HMO |
$6,520.96
|
| Rate for Payer: Cigna of CA PPO |
$7,539.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$8,660.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,170.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,796.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,037.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$7,641.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$6,622.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,660.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,094.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,094.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,094.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,094.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC EXCISION TONGUE LESION W/O CLOSURE
|
Facility
|
OP
|
$10,189.00
|
|
|
Service Code
|
CPT 41110
|
| Hospital Charge Code |
900501147
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$253.95 |
| Max. Negotiated Rate |
$9,170.10 |
| Rate for Payer: Adventist Health Commercial |
$4,177.49
|
| 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 |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| 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 |
$6,565.51
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Cash Price |
$5,603.95
|
| Rate for Payer: Central Health Plan Commercial |
$8,151.20
|
| Rate for Payer: Cigna of CA HMO |
$6,520.96
|
| Rate for Payer: Cigna of CA PPO |
$7,539.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$8,660.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,170.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,796.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,037.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$7,641.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$6,622.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,660.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,113.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,113.40
|
| 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 |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC EXCISION VAGINAL SEPTUM
|
Facility
|
IP
|
$11,566.00
|
|
|
Service Code
|
CPT 57130
|
| Hospital Charge Code |
900500130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,313.20 |
| Max. Negotiated Rate |
$10,409.40 |
| Rate for Payer: Adventist Health Commercial |
$2,313.20
|
| Rate for Payer: Cash Price |
$6,361.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,252.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,626.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,626.40
|
| Rate for Payer: Galaxy Health WC |
$9,831.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,409.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,714.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,406.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,159.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,313.20
|
| Rate for Payer: Multiplan Commercial |
$8,674.50
|
| Rate for Payer: Networks By Design Commercial |
$7,517.90
|
| Rate for Payer: Prime Health Services Commercial |
$9,831.10
|
|
|
HC EXCISION VAGINAL SEPTUM
|
Facility
|
OP
|
$11,566.00
|
|
|
Service Code
|
CPT 57130
|
| Hospital Charge Code |
900500130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.88 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$2,313.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,039.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,039.91
|
| 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 |
$6,436.87
|
| 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 |
$6,361.30
|
| Rate for Payer: Cash Price |
$6,361.30
|
| Rate for Payer: Cash Price |
$6,361.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,252.80
|
| Rate for Payer: Cigna of CA HMO |
$7,402.24
|
| Rate for Payer: Cigna of CA PPO |
$8,558.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,443.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,039.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,453.88
|
| Rate for Payer: EPIC Health Plan Senior |
$4,039.91
|
| Rate for Payer: Galaxy Health WC |
$9,831.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,939.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,409.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,625.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$278.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,039.91
|
| Rate for Payer: InnovAge PACE Commercial |
$6,059.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,714.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$308.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,039.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,313.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,413.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,413.48
|
| Rate for Payer: Multiplan Commercial |
$8,674.50
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: Networks By Design Commercial |
$7,517.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,039.91
|
| Rate for Payer: Preferred Health Network WC |
$6,568.23
|
| Rate for Payer: Prime Health Services Commercial |
$9,831.10
|
| Rate for Payer: Prime Health Services Medicare |
$4,282.30
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Riverside University Health System MISP |
$4,443.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,939.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,039.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,039.91
|
|
|
HC EXC SKIN LESION 0.6-1.0 CM
|
Facility
|
IP
|
$6,131.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
902890016
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,226.20 |
| Max. Negotiated Rate |
$5,517.90 |
| Rate for Payer: Adventist Health Commercial |
$1,226.20
|
| Rate for Payer: Cash Price |
$3,372.05
|
| Rate for Payer: Central Health Plan Commercial |
$4,904.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,452.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,452.40
|
| Rate for Payer: Galaxy Health WC |
$5,211.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,678.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,517.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,089.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,335.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,795.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.20
|
| Rate for Payer: Multiplan Commercial |
$4,598.25
|
| Rate for Payer: Networks By Design Commercial |
$3,985.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,211.35
|
|
|
HC EXC SKIN LESION 0.6-1.0 CM
|
Facility
|
OP
|
$6,131.00
|
|
|
Service Code
|
CPT 11421
|
| Hospital Charge Code |
902890016
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$127.32 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$2,513.71
|
| 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 |
$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 |
$3,372.05
|
| Rate for Payer: Cash Price |
$3,372.05
|
| Rate for Payer: Cash Price |
$3,372.05
|
| Rate for Payer: Cash Price |
$3,372.05
|
| Rate for Payer: Central Health Plan Commercial |
$4,904.80
|
| Rate for Payer: Cigna of CA HMO |
$3,923.84
|
| Rate for Payer: Cigna of CA PPO |
$4,536.94
|
| 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 |
$5,211.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,678.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,517.90
|
| 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 |
$4,089.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$893.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.20
|
| 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 |
$4,598.25
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$3,985.15
|
| 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 |
$5,211.35
|
| 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 |
$3,678.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,678.60
|
| 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 EXC SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$6,744.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
902890017
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,348.80 |
| Max. Negotiated Rate |
$6,069.60 |
| Rate for Payer: Adventist Health Commercial |
$1,348.80
|
| Rate for Payer: Cash Price |
$3,709.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,395.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,697.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,697.60
|
| Rate for Payer: Galaxy Health WC |
$5,732.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,046.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,069.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,498.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,569.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,174.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,348.80
|
| Rate for Payer: Multiplan Commercial |
$5,058.00
|
| Rate for Payer: Networks By Design Commercial |
$4,383.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,732.40
|
|
|
HC EXC SKIN LESION 1.1-2.0 CM
|
Facility
|
OP
|
$6,744.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
902890017
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$6,069.60 |
| Rate for Payer: Adventist Health Commercial |
$2,765.04
|
| 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 |
$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 |
$3,709.20
|
| Rate for Payer: Cash Price |
$3,709.20
|
| Rate for Payer: Cash Price |
$3,709.20
|
| Rate for Payer: Cash Price |
$3,709.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,395.20
|
| Rate for Payer: Cigna of CA HMO |
$4,316.16
|
| Rate for Payer: Cigna of CA PPO |
$4,990.56
|
| 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 |
$5,732.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,046.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,069.60
|
| 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 |
$4,498.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,348.80
|
| 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 |
$5,058.00
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$4,383.60
|
| 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 |
$5,732.40
|
| 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 |
$4,046.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,046.40
|
| 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
|
|
