|
HC HEP B HIGH RISK ADMINISTRATION
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890238
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC HEP B HIGH RISK ADMINISTRATION
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890238
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.96
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC HEP B IMMUNE GLOBULIN
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890236
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC HEP B IMMUNE GLOBULIN
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890236
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.96
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC HEP B LOW RISK ADMINISTRATION
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890239
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.96
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| 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: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC HEP B LOW RISK ADMINISTRATION
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890239
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC HERMETIC CATH DRAIN LUMBAR KIT
|
Facility
|
IP
|
$632.91
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.58 |
| Max. Negotiated Rate |
$569.62 |
| Rate for Payer: Adventist Health Commercial |
$126.58
|
| Rate for Payer: Blue Shield of California Commercial |
$507.59
|
| Rate for Payer: Blue Shield of California EPN |
$318.99
|
| Rate for Payer: Cash Price |
$284.81
|
| Rate for Payer: Central Health Plan Commercial |
$506.33
|
| Rate for Payer: Cigna of CA HMO |
$443.04
|
| Rate for Payer: Cigna of CA PPO |
$443.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$443.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.16
|
| Rate for Payer: EPIC Health Plan Senior |
$253.16
|
| Rate for Payer: Galaxy Health WC |
$537.97
|
| Rate for Payer: Global Benefits Group Commercial |
$379.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$569.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$401.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$373.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.58
|
| Rate for Payer: Multiplan Commercial |
$474.68
|
| Rate for Payer: Networks By Design Commercial |
$316.45
|
| Rate for Payer: Prime Health Services Commercial |
$537.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$237.53
|
| Rate for Payer: United Healthcare All Other HMO |
$231.20
|
| Rate for Payer: United Healthcare HMO Rider |
$226.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$207.28
|
|
|
HC HERMETIC CATH DRAIN LUMBAR KIT
|
Facility
|
OP
|
$632.91
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.58 |
| Max. Negotiated Rate |
$569.62 |
| Rate for Payer: Adventist Health Commercial |
$126.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$537.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$348.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$474.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$288.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.09
|
| Rate for Payer: Blue Shield of California Commercial |
$507.59
|
| Rate for Payer: Blue Shield of California EPN |
$318.99
|
| Rate for Payer: Cash Price |
$284.81
|
| Rate for Payer: Central Health Plan Commercial |
$506.33
|
| Rate for Payer: Cigna of CA HMO |
$443.04
|
| Rate for Payer: Cigna of CA PPO |
$443.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$537.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$537.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$537.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$443.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.16
|
| Rate for Payer: EPIC Health Plan Senior |
$253.16
|
| Rate for Payer: Galaxy Health WC |
$537.97
|
| Rate for Payer: Global Benefits Group Commercial |
$379.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$569.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$401.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$229.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$373.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$443.04
|
| Rate for Payer: Multiplan Commercial |
$474.68
|
| Rate for Payer: Networks By Design Commercial |
$316.45
|
| Rate for Payer: Prime Health Services Commercial |
$537.97
|
| Rate for Payer: Riverside University Health System MISP |
$253.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$379.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$379.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$237.53
|
| Rate for Payer: United Healthcare All Other HMO |
$231.20
|
| Rate for Payer: United Healthcare HMO Rider |
$226.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$207.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$537.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$537.97
|
| Rate for Payer: Vantage Medical Group Senior |
$537.97
|
|
|
HC HERMETIC VENTRCLR CATH SET 6MM
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
901698859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$337.39
|
| Rate for Payer: Blue Shield of California Commercial |
$367.72
|
| Rate for Payer: Blue Shield of California EPN |
$231.42
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC HERMETIC VENTRCLR CATH SET 6MM
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
901698859
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC HERNIA REDUCTION
|
Facility
|
OP
|
$16,106.00
|
|
|
Service Code
|
CPT 49999
|
| Hospital Charge Code |
909020037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$14,495.40 |
| Rate for Payer: Adventist Health Commercial |
$3,221.20
|
| 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 |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,685.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,884.80
|
| Rate for Payer: Cigna of CA HMO |
$10,307.84
|
| Rate for Payer: Cigna of CA PPO |
$11,918.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,274.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$13,690.10
|
| Rate for Payer: Global Benefits Group Commercial |
$9,663.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,495.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,227.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,254.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,221.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$12,079.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$10,468.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$13,690.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,663.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,053.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,053.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,053.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,053.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC HERNIA REDUCTION
|
Facility
|
IP
|
$16,106.00
|
|
|
Service Code
|
CPT 49999
|
| Hospital Charge Code |
909020037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,221.20 |
| Max. Negotiated Rate |
$14,495.40 |
| Rate for Payer: Adventist Health Commercial |
$3,221.20
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,884.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,274.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,442.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,442.40
|
| Rate for Payer: Galaxy Health WC |
$13,690.10
|
| Rate for Payer: Global Benefits Group Commercial |
$9,663.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,495.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,227.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,502.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,221.20
|
| Rate for Payer: Multiplan Commercial |
$12,079.50
|
| Rate for Payer: Networks By Design Commercial |
$10,468.90
|
| Rate for Payer: Prime Health Services Commercial |
$13,690.10
|
|
|
HC HERNIA REDUCTION
|
Facility
|
IP
|
$16,106.00
|
|
|
Service Code
|
CPT 49999
|
| Hospital Charge Code |
909020037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,221.20 |
| Max. Negotiated Rate |
$14,495.40 |
| Rate for Payer: Adventist Health Commercial |
$3,221.20
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,884.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,274.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,442.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,442.40
|
| Rate for Payer: Galaxy Health WC |
$13,690.10
|
| Rate for Payer: Global Benefits Group Commercial |
$9,663.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,495.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,227.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,502.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,221.20
|
| Rate for Payer: Multiplan Commercial |
$12,079.50
|
| Rate for Payer: Networks By Design Commercial |
$10,468.90
|
| Rate for Payer: Prime Health Services Commercial |
$13,690.10
|
|
|
HC HERNIA REDUCTION
|
Facility
|
OP
|
$16,106.00
|
|
|
Service Code
|
CPT 49999
|
| Hospital Charge Code |
909020037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,166.53 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$3,221.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,166.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,166.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,798.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,368.86
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,898.06
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Cash Price |
$7,247.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,884.80
|
| Rate for Payer: Cigna of CA HMO |
$10,307.84
|
| Rate for Payer: Cigna of CA PPO |
$11,918.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,283.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,166.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,274.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,924.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1,283.18
|
| Rate for Payer: Galaxy Health WC |
$13,690.10
|
| Rate for Payer: Global Benefits Group Commercial |
$9,663.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,495.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,913.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,227.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,633.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,221.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,563.15
|
| Rate for Payer: Multiplan Commercial |
$12,079.50
|
| Rate for Payer: Multiplan WC |
$1,898.06
|
| Rate for Payer: Networks By Design Commercial |
$10,468.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,166.53
|
| Rate for Payer: Preferred Health Network WC |
$1,936.80
|
| Rate for Payer: Prime Health Services Commercial |
$13,690.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,236.52
|
| Rate for Payer: Prime Health Services WC |
$1,878.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,283.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,663.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,053.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,166.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,749.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,283.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,166.53
|
|
|
HC HERPES SIMPLEX TYPE 1
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
900913660
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.68 |
| Max. Negotiated Rate |
$133.39 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$13.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$96.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$96.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.39
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.76
|
| Rate for Payer: EPIC Health Plan Senior |
$14.51
|
| Rate for Payer: EPIC Health Plan Senior |
$14.51
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.63
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$20.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.67
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13.19
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$13.98
|
| Rate for Payer: Prime Health Services Medicare |
$13.98
|
| Rate for Payer: Riverside University Health System MISP |
$14.51
|
| Rate for Payer: Riverside University Health System MISP |
$14.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.68
|
| Rate for Payer: United Healthcare All Other HMO |
$10.68
|
| Rate for Payer: United Healthcare All Other HMO |
$10.68
|
| Rate for Payer: United Healthcare HMO Rider |
$10.68
|
| Rate for Payer: United Healthcare HMO Rider |
$10.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.68
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$13.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC HERPES SIMPLEX TYPE 1
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
900913660
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC HERPES SIMPLEX TYPE 2
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
900913661
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$195.62 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$19.35
|
| Rate for Payer: Adventist Health Medi-Cal |
$19.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.62
|
| Rate for Payer: Blue Shield of California Commercial |
$61.74
|
| Rate for Payer: Blue Shield of California Commercial |
$84.42
|
| Rate for Payer: Blue Shield of California EPN |
$38.91
|
| Rate for Payer: Blue Shield of California EPN |
$53.20
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$44.10
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$68.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.93
|
| Rate for Payer: EPIC Health Plan Senior |
$21.29
|
| Rate for Payer: EPIC Health Plan Senior |
$21.29
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.73
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$62.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.93
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19.35
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Prime Health Services Medicare |
$20.51
|
| Rate for Payer: Prime Health Services Medicare |
$20.51
|
| Rate for Payer: Riverside University Health System MISP |
$21.29
|
| Rate for Payer: Riverside University Health System MISP |
$21.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.68
|
| Rate for Payer: United Healthcare All Other HMO |
$15.68
|
| Rate for Payer: United Healthcare All Other HMO |
$15.68
|
| Rate for Payer: United Healthcare HMO Rider |
$15.68
|
| Rate for Payer: United Healthcare HMO Rider |
$15.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.68
|
| Rate for Payer: Upland Medical Group Pediatric |
$19.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$19.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.29
|
| Rate for Payer: Vantage Medical Group Senior |
$19.35
|
| Rate for Payer: Vantage Medical Group Senior |
$19.35
|
|
|
HC HERPES SIMPLEX TYPE 2
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
900913661
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Central Health Plan Commercial |
$107.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$120.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$100.50
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC HFO FINGER EXT W/CLOCK SPRING
|
Facility
|
OP
|
$113.00
|
|
|
Service Code
|
CPT L3929
|
| Hospital Charge Code |
903203928
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$37.01 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Adventist Health Commercial |
$46.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.73
|
| Rate for Payer: Blue Shield of California Commercial |
$90.63
|
| Rate for Payer: Blue Shield of California EPN |
$56.95
|
| Rate for Payer: Cash Price |
$50.85
|
| Rate for Payer: Cash Price |
$50.85
|
| Rate for Payer: Central Health Plan Commercial |
$90.40
|
| Rate for Payer: Cigna of CA HMO |
$79.10
|
| Rate for Payer: Cigna of CA PPO |
$79.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.20
|
| Rate for Payer: EPIC Health Plan Senior |
$45.20
|
| Rate for Payer: Galaxy Health WC |
$96.05
|
| Rate for Payer: Global Benefits Group Commercial |
$67.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$113.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$125.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$46.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$79.10
|
| Rate for Payer: Multiplan Commercial |
$84.75
|
| Rate for Payer: Networks By Design Commercial |
$56.50
|
| Rate for Payer: Prime Health Services Commercial |
$96.05
|
| Rate for Payer: Riverside University Health System MISP |
$45.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.41
|
| Rate for Payer: United Healthcare All Other HMO |
$41.28
|
| Rate for Payer: United Healthcare HMO Rider |
$40.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.05
|
| Rate for Payer: Vantage Medical Group Senior |
$96.05
|
|
|
HC HFO FINGER EXT W/CLOCK SPRING
|
Facility
|
IP
|
$113.00
|
|
|
Service Code
|
CPT L3929
|
| Hospital Charge Code |
903203928
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$22.60 |
| Max. Negotiated Rate |
$101.70 |
| Rate for Payer: Adventist Health Commercial |
$22.60
|
| Rate for Payer: Blue Shield of California Commercial |
$90.63
|
| Rate for Payer: Blue Shield of California EPN |
$56.95
|
| Rate for Payer: Cash Price |
$50.85
|
| Rate for Payer: Central Health Plan Commercial |
$90.40
|
| Rate for Payer: Cigna of CA HMO |
$79.10
|
| Rate for Payer: Cigna of CA PPO |
$79.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$79.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.20
|
| Rate for Payer: EPIC Health Plan Senior |
$45.20
|
| Rate for Payer: Galaxy Health WC |
$96.05
|
| Rate for Payer: Global Benefits Group Commercial |
$67.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$101.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.60
|
| Rate for Payer: Multiplan Commercial |
$84.75
|
| Rate for Payer: Networks By Design Commercial |
$73.45
|
| Rate for Payer: Prime Health Services Commercial |
$96.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.41
|
| Rate for Payer: United Healthcare All Other HMO |
$41.28
|
| Rate for Payer: United Healthcare HMO Rider |
$40.39
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.01
|
|
|
HC HFO FINGER EXT W/WRIST SUPPORT
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT L3931
|
| Hospital Charge Code |
903203930
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$86.46 |
| Max. Negotiated Rate |
$279.19 |
| Rate for Payer: Adventist Health Commercial |
$108.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$224.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.57
|
| Rate for Payer: Blue Shield of California Commercial |
$211.73
|
| Rate for Payer: Blue Shield of California EPN |
$133.06
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Central Health Plan Commercial |
$211.20
|
| Rate for Payer: Cigna of CA HMO |
$184.80
|
| Rate for Payer: Cigna of CA PPO |
$184.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$224.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$224.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$184.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.60
|
| Rate for Payer: EPIC Health Plan Senior |
$105.60
|
| Rate for Payer: Galaxy Health WC |
$224.40
|
| Rate for Payer: Global Benefits Group Commercial |
$158.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$237.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$252.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$167.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$279.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$155.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$184.80
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
| Rate for Payer: Networks By Design Commercial |
$132.00
|
| Rate for Payer: Prime Health Services Commercial |
$224.40
|
| Rate for Payer: Riverside University Health System MISP |
$105.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$158.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$158.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.08
|
| Rate for Payer: United Healthcare All Other HMO |
$96.44
|
| Rate for Payer: United Healthcare HMO Rider |
$94.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$224.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.40
|
| Rate for Payer: Vantage Medical Group Senior |
$224.40
|
|
|
HC HFO FINGER EXT W/WRIST SUPPORT
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT L3931
|
| Hospital Charge Code |
903203930
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$237.60 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Blue Shield of California Commercial |
$211.73
|
| Rate for Payer: Blue Shield of California EPN |
$133.06
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Central Health Plan Commercial |
$211.20
|
| Rate for Payer: Cigna of CA HMO |
$184.80
|
| Rate for Payer: Cigna of CA PPO |
$184.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$184.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.60
|
| Rate for Payer: EPIC Health Plan Senior |
$105.60
|
| Rate for Payer: Galaxy Health WC |
$224.40
|
| Rate for Payer: Global Benefits Group Commercial |
$158.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$237.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$167.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$155.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.80
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
| Rate for Payer: Networks By Design Commercial |
$171.60
|
| Rate for Payer: Prime Health Services Commercial |
$224.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$99.08
|
| Rate for Payer: United Healthcare All Other HMO |
$96.44
|
| Rate for Payer: United Healthcare HMO Rider |
$94.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86.46
|
|
|
HC HFO KNUCKLE BENDER OUTRIGGER
|
Facility
|
OP
|
$424.00
|
|
|
Service Code
|
CPT L3929
|
| Hospital Charge Code |
903200603
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$113.16 |
| Max. Negotiated Rate |
$381.60 |
| Rate for Payer: Adventist Health Commercial |
$173.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$360.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$233.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$318.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$246.64
|
| Rate for Payer: Blue Shield of California Commercial |
$340.05
|
| Rate for Payer: Blue Shield of California EPN |
$213.70
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Central Health Plan Commercial |
$339.20
|
| Rate for Payer: Cigna of CA HMO |
$296.80
|
| Rate for Payer: Cigna of CA PPO |
$296.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$360.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$360.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$360.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$296.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.60
|
| Rate for Payer: EPIC Health Plan Senior |
$169.60
|
| Rate for Payer: Galaxy Health WC |
$360.40
|
| Rate for Payer: Global Benefits Group Commercial |
$254.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$381.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$113.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$269.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$125.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$250.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$173.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$296.80
|
| Rate for Payer: Multiplan Commercial |
$318.00
|
| Rate for Payer: Networks By Design Commercial |
$212.00
|
| Rate for Payer: Prime Health Services Commercial |
$360.40
|
| Rate for Payer: Riverside University Health System MISP |
$169.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$254.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$254.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.13
|
| Rate for Payer: United Healthcare All Other HMO |
$154.89
|
| Rate for Payer: United Healthcare HMO Rider |
$151.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$138.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$360.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$360.40
|
| Rate for Payer: Vantage Medical Group Senior |
$360.40
|
|
|
HC HFO KNUCKLE BENDER OUTRIGGER
|
Facility
|
IP
|
$424.00
|
|
|
Service Code
|
CPT L3929
|
| Hospital Charge Code |
903200603
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$84.80 |
| Max. Negotiated Rate |
$381.60 |
| Rate for Payer: Adventist Health Commercial |
$84.80
|
| Rate for Payer: Blue Shield of California Commercial |
$340.05
|
| Rate for Payer: Blue Shield of California EPN |
$213.70
|
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Central Health Plan Commercial |
$339.20
|
| Rate for Payer: Cigna of CA HMO |
$296.80
|
| Rate for Payer: Cigna of CA PPO |
$296.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$296.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.60
|
| Rate for Payer: EPIC Health Plan Senior |
$169.60
|
| Rate for Payer: Galaxy Health WC |
$360.40
|
| Rate for Payer: Global Benefits Group Commercial |
$254.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$381.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$269.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$250.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.80
|
| Rate for Payer: Multiplan Commercial |
$318.00
|
| Rate for Payer: Networks By Design Commercial |
$275.60
|
| Rate for Payer: Prime Health Services Commercial |
$360.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.13
|
| Rate for Payer: United Healthcare All Other HMO |
$154.89
|
| Rate for Payer: United Healthcare HMO Rider |
$151.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$138.86
|
|
|
HC HFO,NO JOINT,PREFABRICATED
|
Facility
|
IP
|
$137.00
|
|
|
Service Code
|
CPT L3923
|
| Hospital Charge Code |
915353923
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$27.40 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Adventist Health Commercial |
$27.40
|
| Rate for Payer: Blue Shield of California Commercial |
$109.87
|
| Rate for Payer: Blue Shield of California EPN |
$69.05
|
| Rate for Payer: Cash Price |
$61.65
|
| Rate for Payer: Central Health Plan Commercial |
$109.60
|
| Rate for Payer: Cigna of CA HMO |
$95.90
|
| Rate for Payer: Cigna of CA PPO |
$95.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.80
|
| Rate for Payer: EPIC Health Plan Senior |
$54.80
|
| Rate for Payer: Galaxy Health WC |
$116.45
|
| Rate for Payer: Global Benefits Group Commercial |
$82.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$123.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.40
|
| Rate for Payer: Multiplan Commercial |
$102.75
|
| Rate for Payer: Networks By Design Commercial |
$89.05
|
| Rate for Payer: Prime Health Services Commercial |
$116.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.42
|
| Rate for Payer: United Healthcare All Other HMO |
$50.05
|
| Rate for Payer: United Healthcare HMO Rider |
$48.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.87
|
|
