|
HC CROSSMATCH IS
|
Facility
|
IP
|
$734.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
900904577
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$146.80 |
| Max. Negotiated Rate |
$660.60 |
| Rate for Payer: Cash Price |
$330.30
|
| Rate for Payer: Central Health Plan Commercial |
$587.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.60
|
| Rate for Payer: Galaxy Health WC |
$623.90
|
| Rate for Payer: Global Benefits Group Commercial |
$440.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$660.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$489.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$279.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.80
|
| Rate for Payer: Multiplan Commercial |
$550.50
|
| Rate for Payer: Networks By Design Commercial |
$477.10
|
| Rate for Payer: Prime Health Services Commercial |
$623.90
|
|
|
HC CROSSMATCH IS
|
Facility
|
OP
|
$734.00
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
900904577
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$123.38 |
| Max. Negotiated Rate |
$660.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$213.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$261.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$319.37
|
| Rate for Payer: Blue Distinction Transplant |
$440.40
|
| Rate for Payer: Blue Shield of California Commercial |
$453.61
|
| Rate for Payer: Blue Shield of California EPN |
$356.72
|
| Rate for Payer: Caremore Medicare Advantage |
$213.41
|
| Rate for Payer: Cash Price |
$330.30
|
| Rate for Payer: Cash Price |
$330.30
|
| Rate for Payer: Central Health Plan Commercial |
$587.20
|
| Rate for Payer: Cigna of CA HMO |
$469.76
|
| Rate for Payer: Cigna of CA PPO |
$543.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: Dignity Health Media |
$213.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| Rate for Payer: Galaxy Health WC |
$623.90
|
| Rate for Payer: Global Benefits Group Commercial |
$440.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$660.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$550.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$349.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$352.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$213.41
|
| Rate for Payer: InnovAge PACE Commercial |
$320.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$489.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| Rate for Payer: Multiplan Commercial |
$550.50
|
| Rate for Payer: Networks By Design Commercial |
$477.10
|
| Rate for Payer: Prime Health Services Commercial |
$623.90
|
| Rate for Payer: Prime Health Services Medicare |
$226.21
|
| Rate for Payer: Riverside University Health System MISP |
$234.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$440.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$440.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC CROSSMATCH XM
|
Facility
|
IP
|
$814.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
900904551
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$162.80 |
| Max. Negotiated Rate |
$732.60 |
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Central Health Plan Commercial |
$651.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$325.60
|
| Rate for Payer: Galaxy Health WC |
$691.90
|
| Rate for Payer: Global Benefits Group Commercial |
$488.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$732.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$542.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$310.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.80
|
| Rate for Payer: Multiplan Commercial |
$610.50
|
| Rate for Payer: Networks By Design Commercial |
$529.10
|
| Rate for Payer: Prime Health Services Commercial |
$691.90
|
|
|
HC CROSSMATCH XM
|
Facility
|
OP
|
$814.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
900904551
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$123.38 |
| Max. Negotiated Rate |
$732.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$213.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$141.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$261.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$319.37
|
| Rate for Payer: Blue Distinction Transplant |
$488.40
|
| Rate for Payer: Blue Shield of California Commercial |
$503.05
|
| Rate for Payer: Blue Shield of California EPN |
$395.60
|
| Rate for Payer: Caremore Medicare Advantage |
$213.41
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Cash Price |
$366.30
|
| Rate for Payer: Central Health Plan Commercial |
$651.20
|
| Rate for Payer: Cigna of CA HMO |
$520.96
|
| Rate for Payer: Cigna of CA PPO |
$602.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: Dignity Health Media |
$213.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| Rate for Payer: Galaxy Health WC |
$691.90
|
| Rate for Payer: Global Benefits Group Commercial |
$488.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$732.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$610.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$349.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$352.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$213.41
|
| Rate for Payer: InnovAge PACE Commercial |
$320.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$542.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| Rate for Payer: Multiplan Commercial |
$610.50
|
| Rate for Payer: Networks By Design Commercial |
$529.10
|
| Rate for Payer: Prime Health Services Commercial |
$691.90
|
| Rate for Payer: Prime Health Services Medicare |
$226.21
|
| Rate for Payer: Riverside University Health System MISP |
$234.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$488.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$488.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC CRPRA CVRNSA-CRPS SPNGSM SHNT, UNI OR BI
|
Facility
|
IP
|
$11,441.00
|
|
|
Service Code
|
CPT 54430
|
| Hospital Charge Code |
900504430
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,288.20 |
| Max. Negotiated Rate |
$10,296.90 |
| Rate for Payer: Cash Price |
$5,148.45
|
| Rate for Payer: Central Health Plan Commercial |
$9,152.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,576.40
|
| Rate for Payer: Galaxy Health WC |
$9,724.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,864.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,296.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,631.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,288.20
|
| Rate for Payer: Multiplan Commercial |
$8,580.75
|
| Rate for Payer: Networks By Design Commercial |
$7,436.65
|
| Rate for Payer: Prime Health Services Commercial |
$9,724.85
|
|
|
HC CRPRA CVRNSA-CRPS SPNGSM SHNT, UNI OR BI
|
Facility
|
OP
|
$11,441.00
|
|
|
Service Code
|
CPT 54430
|
| Hospital Charge Code |
900504430
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,296.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,724.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,292.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,292.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,864.60
|
| Rate for Payer: Cash Price |
$5,148.45
|
| Rate for Payer: Cash Price |
$5,148.45
|
| Rate for Payer: Cash Price |
$5,148.45
|
| Rate for Payer: Cash Price |
$5,148.45
|
| Rate for Payer: Central Health Plan Commercial |
$9,152.80
|
| Rate for Payer: Cigna of CA PPO |
$8,466.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,724.85
|
| Rate for Payer: Dignity Health Media |
$9,724.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,724.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,576.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,576.40
|
| Rate for Payer: Galaxy Health WC |
$9,724.85
|
| Rate for Payer: Global Benefits Group Commercial |
$6,864.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,296.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,580.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,631.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$929.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,288.20
|
| Rate for Payer: Multiplan Commercial |
$8,580.75
|
| Rate for Payer: Networks By Design Commercial |
$7,436.65
|
| Rate for Payer: Prime Health Services Commercial |
$9,724.85
|
| Rate for Payer: Riverside University Health System MISP |
$4,576.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,864.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,720.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,720.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,720.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,720.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,724.85
|
| Rate for Payer: Vantage Medical Group Senior |
$9,724.85
|
|
|
HC CRYABLATION BONE
|
Facility
|
IP
|
$23,220.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,644.00 |
| Max. Negotiated Rate |
$20,898.00 |
| Rate for Payer: Cash Price |
$10,449.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,576.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,288.00
|
| Rate for Payer: Galaxy Health WC |
$19,737.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,932.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,898.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,487.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,846.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,644.00
|
| Rate for Payer: Multiplan Commercial |
$17,415.00
|
| Rate for Payer: Networks By Design Commercial |
$15,093.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,737.00
|
|
|
HC CRYABLATION BONE
|
Facility
|
OP
|
$23,220.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$20,898.00 |
| 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 |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$13,932.00
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$10,449.00
|
| Rate for Payer: Cash Price |
$10,449.00
|
| Rate for Payer: Cash Price |
$10,449.00
|
| Rate for Payer: Cash Price |
$10,449.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,576.00
|
| Rate for Payer: Cigna of CA PPO |
$17,182.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$19,737.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,932.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,898.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17,415.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,487.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,644.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$17,415.00
|
| Rate for Payer: Networks By Design Commercial |
$15,093.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,737.00
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,932.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,610.00
|
| Rate for Payer: United Healthcare All Other HMO |
$11,610.00
|
| Rate for Payer: United Healthcare HMO Rider |
$11,610.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,610.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CRYABLATION BONE
|
Facility
|
IP
|
$23,220.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$4,644.00 |
| Max. Negotiated Rate |
$20,898.00 |
| Rate for Payer: Cash Price |
$10,449.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,576.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,288.00
|
| Rate for Payer: Galaxy Health WC |
$19,737.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,932.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,898.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,487.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,846.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,644.00
|
| Rate for Payer: Multiplan Commercial |
$17,415.00
|
| Rate for Payer: Networks By Design Commercial |
$15,093.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,737.00
|
|
|
HC CRYABLATION BONE
|
Facility
|
OP
|
$23,220.00
|
|
|
Service Code
|
CPT 20999
|
| Hospital Charge Code |
909020151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$20,898.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,243.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,718.38
|
| Rate for Payer: Blue Distinction Transplant |
$13,932.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$10,449.00
|
| Rate for Payer: Cash Price |
$10,449.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,576.00
|
| Rate for Payer: Cigna of CA PPO |
$17,182.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: Dignity Health Media |
$294.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$19,737.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,932.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,898.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17,415.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$486.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$294.64
|
| Rate for Payer: InnovAge PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,487.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,644.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$17,415.00
|
| Rate for Payer: Networks By Design Commercial |
$15,093.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,737.00
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Riverside University Health System MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,932.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC CRYO ABLATE BONE TUMOR(S) PERQ
|
Facility
|
IP
|
$17,328.00
|
|
|
Service Code
|
CPT 20983
|
| Hospital Charge Code |
909020983
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,465.60 |
| Max. Negotiated Rate |
$15,595.20 |
| Rate for Payer: Cash Price |
$7,797.60
|
| Rate for Payer: Central Health Plan Commercial |
$13,862.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,931.20
|
| Rate for Payer: Galaxy Health WC |
$14,728.80
|
| Rate for Payer: Global Benefits Group Commercial |
$10,396.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,595.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,557.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,601.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,465.60
|
| Rate for Payer: Multiplan Commercial |
$12,996.00
|
| Rate for Payer: Networks By Design Commercial |
$11,263.20
|
| Rate for Payer: Prime Health Services Commercial |
$14,728.80
|
|
|
HC CRYO ABLATE BONE TUMOR(S) PERQ
|
Facility
|
OP
|
$17,328.00
|
|
|
Service Code
|
CPT 20983
|
| Hospital Charge Code |
909020983
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$651.49 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,938.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$12,220.24
|
| Rate for Payer: Blue Distinction Transplant |
$10,396.80
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$8,938.53
|
| Rate for Payer: Cash Price |
$7,797.60
|
| Rate for Payer: Cash Price |
$7,797.60
|
| Rate for Payer: Central Health Plan Commercial |
$13,862.40
|
| Rate for Payer: Cigna of CA PPO |
$12,822.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$14,728.80
|
| Rate for Payer: Global Benefits Group Commercial |
$10,396.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,595.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,996.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,659.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,748.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,938.53
|
| Rate for Payer: InnovAge PACE Commercial |
$13,407.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,557.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$651.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,465.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,977.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$12,996.00
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$11,263.20
|
| Rate for Payer: Preferred Health Network WC |
$12,469.63
|
| Rate for Payer: Prime Health Services Commercial |
$14,728.80
|
| Rate for Payer: Prime Health Services Medicare |
$9,474.84
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Riverside University Health System MISP |
$9,832.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,396.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC CRYOABLATION-LUNG
|
Facility
|
IP
|
$12,226.00
|
|
|
Service Code
|
CPT 32994
|
| Hospital Charge Code |
909020150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,445.20 |
| Max. Negotiated Rate |
$11,003.40 |
| Rate for Payer: Cash Price |
$5,501.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,780.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,890.40
|
| Rate for Payer: Galaxy Health WC |
$10,392.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,335.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,003.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,154.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,658.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,445.20
|
| Rate for Payer: Multiplan Commercial |
$9,169.50
|
| Rate for Payer: Networks By Design Commercial |
$7,946.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,392.10
|
|
|
HC CRYOABLATION-LUNG
|
Facility
|
OP
|
$12,226.00
|
|
|
Service Code
|
CPT 32994
|
| Hospital Charge Code |
909020150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,445.20 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Distinction Transplant |
$7,335.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Cash Price |
$5,501.70
|
| Rate for Payer: Cash Price |
$5,501.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,780.80
|
| Rate for Payer: Cigna of CA PPO |
$9,047.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Dignity Health Media |
$12,861.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,147.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Galaxy Health WC |
$10,392.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,335.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,003.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,169.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21,221.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,861.31
|
| Rate for Payer: InnovAge PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,154.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,941.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,445.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan Commercial |
$9,169.50
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Networks By Design Commercial |
$7,946.90
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,392.10
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health System MISP |
$14,147.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,335.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
HC CRYOABLATION PROBE
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C2618
|
| Hospital Charge Code |
909020059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CRYOABLATION PROBE
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C2618
|
| Hospital Charge Code |
909020059
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$4,526.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,526.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,888.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,304.12
|
| Rate for Payer: Blue Distinction Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,453.10
|
| Rate for Payer: Blue Shield of California EPN |
$1,907.10
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Media |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,925.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CRYO ABLAT LIVER TUMOR
|
Facility
|
IP
|
$11,870.00
|
|
|
Service Code
|
CPT 47381
|
| Hospital Charge Code |
909000269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,374.00 |
| Max. Negotiated Rate |
$10,683.00 |
| Rate for Payer: Cash Price |
$5,341.50
|
| Rate for Payer: Central Health Plan Commercial |
$9,496.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,748.00
|
| Rate for Payer: Galaxy Health WC |
$10,089.50
|
| Rate for Payer: Global Benefits Group Commercial |
$7,122.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,683.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,917.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,522.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,374.00
|
| Rate for Payer: Multiplan Commercial |
$8,902.50
|
| Rate for Payer: Networks By Design Commercial |
$7,715.50
|
| Rate for Payer: Prime Health Services Commercial |
$10,089.50
|
|
|
HC CRYO ABLAT LIVER TUMOR
|
Facility
|
OP
|
$11,870.00
|
|
|
Service Code
|
CPT 47381
|
| Hospital Charge Code |
909000269
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$350.15 |
| Max. Negotiated Rate |
$11,071.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,089.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,528.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,528.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,122.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Cash Price |
$5,341.50
|
| Rate for Payer: Cash Price |
$5,341.50
|
| Rate for Payer: Central Health Plan Commercial |
$9,496.00
|
| Rate for Payer: Cigna of CA PPO |
$8,783.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,089.50
|
| Rate for Payer: Dignity Health Media |
$10,089.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,089.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,748.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,748.00
|
| Rate for Payer: Galaxy Health WC |
$10,089.50
|
| Rate for Payer: Global Benefits Group Commercial |
$7,122.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,683.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,902.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,154.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,917.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,374.00
|
| Rate for Payer: Multiplan Commercial |
$8,902.50
|
| Rate for Payer: Networks By Design Commercial |
$7,715.50
|
| Rate for Payer: Prime Health Services Commercial |
$10,089.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,748.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,122.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,089.50
|
| Rate for Payer: Vantage Medical Group Senior |
$10,089.50
|
|
|
HC CRYO ABLAT RENAL TUMOR
|
Facility
|
IP
|
$17,483.00
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
909000268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,496.60 |
| Max. Negotiated Rate |
$15,734.70 |
| Rate for Payer: Cash Price |
$7,867.35
|
| Rate for Payer: Central Health Plan Commercial |
$13,986.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,993.20
|
| Rate for Payer: Galaxy Health WC |
$14,860.55
|
| Rate for Payer: Global Benefits Group Commercial |
$10,489.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,734.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,661.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,661.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,496.60
|
| Rate for Payer: Multiplan Commercial |
$13,112.25
|
| Rate for Payer: Networks By Design Commercial |
$11,363.95
|
| Rate for Payer: Prime Health Services Commercial |
$14,860.55
|
|
|
HC CRYO ABLAT RENAL TUMOR
|
Facility
|
OP
|
$17,483.00
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
909000268
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,383.18 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,861.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26,109.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,861.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$17,583.26
|
| Rate for Payer: Blue Distinction Transplant |
$10,489.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$12,861.31
|
| Rate for Payer: Cash Price |
$7,867.35
|
| Rate for Payer: Cash Price |
$7,867.35
|
| Rate for Payer: Central Health Plan Commercial |
$13,986.40
|
| Rate for Payer: Cigna of CA PPO |
$12,937.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Dignity Health Media |
$12,861.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,147.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,362.77
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12,861.31
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,861.31
|
| Rate for Payer: Galaxy Health WC |
$14,860.55
|
| Rate for Payer: Global Benefits Group Commercial |
$10,489.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,734.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13,112.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,092.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21,221.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12,861.31
|
| Rate for Payer: InnovAge PACE Commercial |
$19,291.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,661.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,401.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,861.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,496.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,234.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,234.16
|
| Rate for Payer: Multiplan Commercial |
$13,112.25
|
| Rate for Payer: Multiplan WC |
$17,583.26
|
| Rate for Payer: Networks By Design Commercial |
$11,363.95
|
| Rate for Payer: Preferred Health Network WC |
$17,942.10
|
| Rate for Payer: Prime Health Services Commercial |
$14,860.55
|
| Rate for Payer: Prime Health Services Medicare |
$13,632.99
|
| Rate for Payer: Prime Health Services WC |
$17,403.84
|
| Rate for Payer: Riverside University Health System MISP |
$14,147.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,489.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,291.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,147.44
|
| Rate for Payer: Vantage Medical Group Senior |
$12,861.31
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
OP
|
$1,137.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$227.40 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$682.20
|
| Rate for Payer: Blue Shield of California Commercial |
$715.17
|
| Rate for Payer: Blue Shield of California EPN |
$555.99
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Central Health Plan Commercial |
$909.60
|
| Rate for Payer: Cigna of CA HMO |
$727.68
|
| Rate for Payer: Cigna of CA PPO |
$841.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$966.45
|
| Rate for Payer: Global Benefits Group Commercial |
$682.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,023.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$852.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$661.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$758.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$852.75
|
| Rate for Payer: Networks By Design Commercial |
$739.05
|
| Rate for Payer: Prime Health Services Commercial |
$966.45
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$682.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$682.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.50
|
| Rate for Payer: United Healthcare All Other HMO |
$568.50
|
| Rate for Payer: United Healthcare HMO Rider |
$568.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$568.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
IP
|
$1,137.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$227.40 |
| Max. Negotiated Rate |
$1,023.30 |
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Central Health Plan Commercial |
$909.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$454.80
|
| Rate for Payer: Galaxy Health WC |
$966.45
|
| Rate for Payer: Global Benefits Group Commercial |
$682.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,023.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$758.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$433.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.40
|
| Rate for Payer: Multiplan Commercial |
$852.75
|
| Rate for Payer: Networks By Design Commercial |
$739.05
|
| Rate for Payer: Prime Health Services Commercial |
$966.45
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
OP
|
$1,137.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$227.40 |
| Max. Negotiated Rate |
$2,901.00 |
| 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 |
$601.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$400.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$682.20
|
| Rate for Payer: Caremore Medicare Advantage |
$400.82
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Central Health Plan Commercial |
$909.60
|
| Rate for Payer: Cigna of CA PPO |
$841.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$601.23
|
| Rate for Payer: Dignity Health Media |
$400.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$440.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$541.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$400.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$400.82
|
| Rate for Payer: Galaxy Health WC |
$966.45
|
| Rate for Payer: Global Benefits Group Commercial |
$682.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,023.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$852.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$657.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$400.82
|
| Rate for Payer: InnovAge PACE Commercial |
$601.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$758.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$400.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$537.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$537.10
|
| Rate for Payer: Multiplan Commercial |
$852.75
|
| Rate for Payer: Networks By Design Commercial |
$739.05
|
| Rate for Payer: Prime Health Services Commercial |
$966.45
|
| Rate for Payer: Prime Health Services Medicare |
$424.87
|
| Rate for Payer: Riverside University Health System MISP |
$440.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$682.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$568.50
|
| Rate for Payer: United Healthcare All Other HMO |
$568.50
|
| Rate for Payer: United Healthcare HMO Rider |
$568.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$568.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$601.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$440.90
|
| Rate for Payer: Vantage Medical Group Senior |
$400.82
|
|
|
HC CRYOCAUTERY OF CERVIX
|
Facility
|
IP
|
$1,137.00
|
|
|
Service Code
|
CPT 57511
|
| Hospital Charge Code |
900501637
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$227.40 |
| Max. Negotiated Rate |
$1,023.30 |
| Rate for Payer: Cash Price |
$511.65
|
| Rate for Payer: Central Health Plan Commercial |
$909.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$454.80
|
| Rate for Payer: Galaxy Health WC |
$966.45
|
| Rate for Payer: Global Benefits Group Commercial |
$682.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,023.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$758.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$433.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$227.40
|
| Rate for Payer: Multiplan Commercial |
$852.75
|
| Rate for Payer: Networks By Design Commercial |
$739.05
|
| Rate for Payer: Prime Health Services Commercial |
$966.45
|
|
|
HC CRYOGLOBULINS QUAL
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
900910978
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$55.92 |
| Rate for Payer: Adventist Health Medi-Cal |
$6.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.92
|
| Rate for Payer: Blue Distinction Transplant |
$12.60
|
| Rate for Payer: Blue Shield of California Commercial |
$12.98
|
| Rate for Payer: Blue Shield of California EPN |
$10.21
|
| Rate for Payer: Caremore Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Cash Price |
$9.45
|
| Rate for Payer: Central Health Plan Commercial |
$16.80
|
| Rate for Payer: Cigna of CA HMO |
$13.44
|
| Rate for Payer: Cigna of CA PPO |
$15.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.70
|
| Rate for Payer: Dignity Health Media |
$6.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.73
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.47
|
| Rate for Payer: Galaxy Health WC |
$17.85
|
| Rate for Payer: Global Benefits Group Commercial |
$12.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.47
|
| Rate for Payer: InnovAge PACE Commercial |
$9.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$15.75
|
| Rate for Payer: Networks By Design Commercial |
$13.65
|
| Rate for Payer: Prime Health Services Commercial |
$17.85
|
| Rate for Payer: Prime Health Services Medicare |
$6.86
|
| Rate for Payer: Riverside University Health System MISP |
$7.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.24
|
| Rate for Payer: United Healthcare All Other HMO |
$5.24
|
| Rate for Payer: United Healthcare HMO Rider |
$5.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.47
|
|
