|
HC DRAIN ABSCESS CYST HEM VISTIB
|
Facility
|
IP
|
$1,480.00
|
|
|
Service Code
|
CPT 40800
|
| Hospital Charge Code |
900501236
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$296.00 |
| Max. Negotiated Rate |
$1,332.00 |
| Rate for Payer: Cash Price |
$666.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,184.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$592.00
|
| Rate for Payer: Galaxy Health WC |
$1,258.00
|
| Rate for Payer: Global Benefits Group Commercial |
$888.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,332.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$987.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.00
|
| Rate for Payer: Multiplan Commercial |
$1,110.00
|
| Rate for Payer: Networks By Design Commercial |
$962.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,258.00
|
|
|
HC DRAIN ABSCESS CYST HEM VISTIB
|
Facility
|
OP
|
$1,480.00
|
|
|
Service Code
|
CPT 40800
|
| Hospital Charge Code |
900501236
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$94.09 |
| Max. Negotiated Rate |
$2,696.00 |
| 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 |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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 |
$888.00
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$666.00
|
| Rate for Payer: Cash Price |
$666.00
|
| Rate for Payer: Cash Price |
$666.00
|
| Rate for Payer: Cash Price |
$666.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,184.00
|
| Rate for Payer: Cigna of CA PPO |
$1,095.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$1,258.00
|
| Rate for Payer: Global Benefits Group Commercial |
$888.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,332.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,110.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$987.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$1,110.00
|
| Rate for Payer: Networks By Design Commercial |
$962.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,258.00
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$888.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$740.00
|
| Rate for Payer: United Healthcare All Other HMO |
$740.00
|
| Rate for Payer: United Healthcare HMO Rider |
$740.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$740.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC DRAIN ABSCESS/HEMATOMA,NASAL
|
Facility
|
OP
|
$1,184.00
|
|
|
Service Code
|
CPT 30020
|
| Hospital Charge Code |
900501594
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.21 |
| 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 |
$1,031.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.44
|
| 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 |
$710.40
|
| Rate for Payer: Caremore Medicare Advantage |
$687.44
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Central Health Plan Commercial |
$947.20
|
| Rate for Payer: Cigna of CA PPO |
$876.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Media |
$687.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$1,006.40
|
| Rate for Payer: Global Benefits Group Commercial |
$710.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,065.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$888.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$687.44
|
| Rate for Payer: InnovAge PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$789.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$888.00
|
| Rate for Payer: Networks By Design Commercial |
$769.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,006.40
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Riverside University Health System MISP |
$756.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$710.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$592.00
|
| Rate for Payer: United Healthcare All Other HMO |
$592.00
|
| Rate for Payer: United Healthcare HMO Rider |
$592.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$592.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC DRAIN ABSCESS/HEMATOMA,NASAL
|
Facility
|
IP
|
$1,184.00
|
|
|
Service Code
|
CPT 30020
|
| Hospital Charge Code |
900501594
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$236.80 |
| Max. Negotiated Rate |
$1,065.60 |
| Rate for Payer: Cash Price |
$532.80
|
| Rate for Payer: Central Health Plan Commercial |
$947.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$473.60
|
| Rate for Payer: Galaxy Health WC |
$1,006.40
|
| Rate for Payer: Global Benefits Group Commercial |
$710.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,065.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$789.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$236.80
|
| Rate for Payer: Multiplan Commercial |
$888.00
|
| Rate for Payer: Networks By Design Commercial |
$769.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,006.40
|
|
|
HC DRAIN ABSCESS PALATE UVULA
|
Facility
|
IP
|
$936.00
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
900501466
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$187.20 |
| Max. Negotiated Rate |
$842.40 |
| Rate for Payer: Cash Price |
$421.20
|
| Rate for Payer: Central Health Plan Commercial |
$748.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$374.40
|
| Rate for Payer: Galaxy Health WC |
$795.60
|
| Rate for Payer: Global Benefits Group Commercial |
$561.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$842.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$624.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$356.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.20
|
| Rate for Payer: Multiplan Commercial |
$702.00
|
| Rate for Payer: Networks By Design Commercial |
$608.40
|
| Rate for Payer: Prime Health Services Commercial |
$795.60
|
|
|
HC DRAIN ABSCESS PALATE UVULA
|
Facility
|
OP
|
$936.00
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
900501466
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$561.60
|
| Rate for Payer: Blue Shield of California Commercial |
$588.74
|
| Rate for Payer: Blue Shield of California EPN |
$457.70
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$421.20
|
| Rate for Payer: Cash Price |
$421.20
|
| Rate for Payer: Central Health Plan Commercial |
$748.80
|
| Rate for Payer: Cigna of CA HMO |
$599.04
|
| Rate for Payer: Cigna of CA PPO |
$692.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$795.60
|
| Rate for Payer: Global Benefits Group Commercial |
$561.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$842.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$702.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$503.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: InnovAge PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$624.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$702.00
|
| Rate for Payer: Networks By Design Commercial |
$608.40
|
| Rate for Payer: Prime Health Services Commercial |
$795.60
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Riverside University Health System MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$561.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$561.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$468.00
|
| Rate for Payer: United Healthcare All Other HMO |
$468.00
|
| Rate for Payer: United Healthcare HMO Rider |
$468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$468.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC DRAIN ABSCESS PALATE UVULA
|
Facility
|
OP
|
$936.00
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
900501466
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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 |
$561.60
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$421.20
|
| Rate for Payer: Cash Price |
$421.20
|
| Rate for Payer: Cash Price |
$421.20
|
| Rate for Payer: Cash Price |
$421.20
|
| Rate for Payer: Central Health Plan Commercial |
$748.80
|
| Rate for Payer: Cigna of CA PPO |
$692.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: Dignity Health Media |
$305.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$795.60
|
| Rate for Payer: Global Benefits Group Commercial |
$561.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$842.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$702.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$305.19
|
| Rate for Payer: InnovAge PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$624.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$702.00
|
| Rate for Payer: Networks By Design Commercial |
$608.40
|
| Rate for Payer: Prime Health Services Commercial |
$795.60
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Riverside University Health System MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$561.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$468.00
|
| Rate for Payer: United Healthcare All Other HMO |
$468.00
|
| Rate for Payer: United Healthcare HMO Rider |
$468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$468.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC DRAIN ABSCESS PALATE UVULA
|
Facility
|
IP
|
$936.00
|
|
|
Service Code
|
CPT 42000
|
| Hospital Charge Code |
900501466
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$187.20 |
| Max. Negotiated Rate |
$842.40 |
| Rate for Payer: Cash Price |
$421.20
|
| Rate for Payer: Central Health Plan Commercial |
$748.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$374.40
|
| Rate for Payer: Galaxy Health WC |
$795.60
|
| Rate for Payer: Global Benefits Group Commercial |
$561.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$842.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$624.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$356.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.20
|
| Rate for Payer: Multiplan Commercial |
$702.00
|
| Rate for Payer: Networks By Design Commercial |
$608.40
|
| Rate for Payer: Prime Health Services Commercial |
$795.60
|
|
|
HC DRAINAGE BAG FOR DUET SYSTEM
|
Facility
|
OP
|
$307.44
|
|
| Hospital Charge Code |
901698471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.49 |
| Max. Negotiated Rate |
$276.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$186.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$148.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$181.64
|
| Rate for Payer: Blue Distinction Transplant |
$184.46
|
| Rate for Payer: Blue Shield of California Commercial |
$193.38
|
| Rate for Payer: Blue Shield of California EPN |
$150.34
|
| Rate for Payer: Cash Price |
$138.35
|
| Rate for Payer: Central Health Plan Commercial |
$245.95
|
| Rate for Payer: Cigna of CA HMO |
$196.76
|
| Rate for Payer: Cigna of CA PPO |
$227.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.32
|
| Rate for Payer: Dignity Health Media |
$261.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$122.98
|
| Rate for Payer: Galaxy Health WC |
$261.32
|
| Rate for Payer: Global Benefits Group Commercial |
$184.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$276.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$230.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.49
|
| Rate for Payer: Multiplan Commercial |
$230.58
|
| Rate for Payer: Networks By Design Commercial |
$199.84
|
| Rate for Payer: Prime Health Services Commercial |
$261.32
|
| Rate for Payer: Riverside University Health System MISP |
$122.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$153.72
|
| Rate for Payer: United Healthcare All Other HMO |
$153.72
|
| Rate for Payer: United Healthcare HMO Rider |
$153.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$153.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.32
|
| Rate for Payer: Vantage Medical Group Senior |
$261.32
|
|
|
HC DRAINAGE BAG FOR DUET SYSTEM
|
Facility
|
IP
|
$307.44
|
|
| Hospital Charge Code |
901698471
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.49 |
| Max. Negotiated Rate |
$276.70 |
| Rate for Payer: Cash Price |
$138.35
|
| Rate for Payer: Central Health Plan Commercial |
$245.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$122.98
|
| Rate for Payer: Galaxy Health WC |
$261.32
|
| Rate for Payer: Global Benefits Group Commercial |
$184.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$276.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.49
|
| Rate for Payer: Multiplan Commercial |
$230.58
|
| Rate for Payer: Networks By Design Commercial |
$199.84
|
| Rate for Payer: Prime Health Services Commercial |
$261.32
|
|
|
HC DRAINAGE BAG INTRACRANIAL PRES
|
Facility
|
OP
|
$259.70
|
|
| Hospital Charge Code |
901698697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.94 |
| Max. Negotiated Rate |
$233.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$157.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$220.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$142.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$125.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$153.43
|
| Rate for Payer: Blue Distinction Transplant |
$155.82
|
| Rate for Payer: Blue Shield of California Commercial |
$163.35
|
| Rate for Payer: Blue Shield of California EPN |
$126.99
|
| Rate for Payer: Cash Price |
$116.87
|
| Rate for Payer: Central Health Plan Commercial |
$207.76
|
| Rate for Payer: Cigna of CA HMO |
$166.21
|
| Rate for Payer: Cigna of CA PPO |
$192.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$220.74
|
| Rate for Payer: Dignity Health Media |
$220.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$103.88
|
| Rate for Payer: Galaxy Health WC |
$220.74
|
| Rate for Payer: Global Benefits Group Commercial |
$155.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.73
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$194.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$90.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$173.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.94
|
| Rate for Payer: Multiplan Commercial |
$194.78
|
| Rate for Payer: Networks By Design Commercial |
$168.80
|
| Rate for Payer: Prime Health Services Commercial |
$220.74
|
| Rate for Payer: Riverside University Health System MISP |
$103.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$129.85
|
| Rate for Payer: United Healthcare All Other HMO |
$129.85
|
| Rate for Payer: United Healthcare HMO Rider |
$129.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$129.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.74
|
| Rate for Payer: Vantage Medical Group Senior |
$220.74
|
|
|
HC DRAINAGE BAG INTRACRANIAL PRES
|
Facility
|
IP
|
$259.70
|
|
| Hospital Charge Code |
901698697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.94 |
| Max. Negotiated Rate |
$233.73 |
| Rate for Payer: Cash Price |
$116.87
|
| Rate for Payer: Central Health Plan Commercial |
$207.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.88
|
| Rate for Payer: Galaxy Health WC |
$220.74
|
| Rate for Payer: Global Benefits Group Commercial |
$155.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$233.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$173.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.94
|
| Rate for Payer: Multiplan Commercial |
$194.78
|
| Rate for Payer: Networks By Design Commercial |
$168.80
|
| Rate for Payer: Prime Health Services Commercial |
$220.74
|
|
|
HC DRAINAGE BAG MONITORR ICP
|
Facility
|
OP
|
$460.58
|
|
| Hospital Charge Code |
901698777
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.12 |
| Max. Negotiated Rate |
$414.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$279.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$391.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$253.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$253.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$223.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$272.11
|
| Rate for Payer: Blue Distinction Transplant |
$276.35
|
| Rate for Payer: Blue Shield of California Commercial |
$289.70
|
| Rate for Payer: Blue Shield of California EPN |
$225.22
|
| Rate for Payer: Cash Price |
$207.26
|
| Rate for Payer: Central Health Plan Commercial |
$368.46
|
| Rate for Payer: Cigna of CA HMO |
$294.77
|
| Rate for Payer: Cigna of CA PPO |
$340.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$391.49
|
| Rate for Payer: Dignity Health Media |
$391.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$391.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.23
|
| Rate for Payer: EPIC Health Plan Transplant |
$184.23
|
| Rate for Payer: Galaxy Health WC |
$391.49
|
| Rate for Payer: Global Benefits Group Commercial |
$276.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.52
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$345.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$161.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$307.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.12
|
| Rate for Payer: Multiplan Commercial |
$345.44
|
| Rate for Payer: Networks By Design Commercial |
$299.38
|
| Rate for Payer: Prime Health Services Commercial |
$391.49
|
| Rate for Payer: Riverside University Health System MISP |
$184.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$276.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$276.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.29
|
| Rate for Payer: United Healthcare All Other HMO |
$230.29
|
| Rate for Payer: United Healthcare HMO Rider |
$230.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$230.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$391.49
|
| Rate for Payer: Vantage Medical Group Senior |
$391.49
|
|
|
HC DRAINAGE BAG MONITORR ICP
|
Facility
|
IP
|
$460.58
|
|
| Hospital Charge Code |
901698777
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.12 |
| Max. Negotiated Rate |
$414.52 |
| Rate for Payer: Cash Price |
$207.26
|
| Rate for Payer: Central Health Plan Commercial |
$368.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.23
|
| Rate for Payer: Galaxy Health WC |
$391.49
|
| Rate for Payer: Global Benefits Group Commercial |
$276.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$307.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.12
|
| Rate for Payer: Multiplan Commercial |
$345.44
|
| Rate for Payer: Networks By Design Commercial |
$299.38
|
| Rate for Payer: Prime Health Services Commercial |
$391.49
|
|
|
HC DRAINAGE OF EYE
|
Facility
|
OP
|
$7,667.00
|
|
|
Service Code
|
CPT 65800
|
| Hospital Charge Code |
900501746
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$149.26 |
| Max. Negotiated Rate |
$6,900.30 |
| 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 |
$4,367.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,911.63
|
| 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 |
$4,600.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,911.63
|
| Rate for Payer: Cash Price |
$3,450.15
|
| Rate for Payer: Cash Price |
$3,450.15
|
| Rate for Payer: Cash Price |
$3,450.15
|
| Rate for Payer: Cash Price |
$3,450.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,133.60
|
| Rate for Payer: Cigna of CA PPO |
$5,673.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Dignity Health Media |
$2,911.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,202.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,930.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,911.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,911.63
|
| Rate for Payer: Galaxy Health WC |
$6,516.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,600.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,900.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,750.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,775.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,911.63
|
| Rate for Payer: InnovAge PACE Commercial |
$4,367.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,113.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,911.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,533.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,901.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,901.58
|
| Rate for Payer: Multiplan Commercial |
$5,750.25
|
| Rate for Payer: Networks By Design Commercial |
$4,983.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,516.95
|
| Rate for Payer: Prime Health Services Medicare |
$3,086.33
|
| Rate for Payer: Riverside University Health System MISP |
$3,202.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,600.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,833.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,833.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,833.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,833.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2,911.63
|
|
|
HC DRAINAGE OF EYE
|
Facility
|
IP
|
$7,667.00
|
|
|
Service Code
|
CPT 65800
|
| Hospital Charge Code |
900501746
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,533.40 |
| Max. Negotiated Rate |
$6,900.30 |
| Rate for Payer: Cash Price |
$3,450.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,133.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,066.80
|
| Rate for Payer: Galaxy Health WC |
$6,516.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,600.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,900.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,113.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,921.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,533.40
|
| Rate for Payer: Multiplan Commercial |
$5,750.25
|
| Rate for Payer: Networks By Design Commercial |
$4,983.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,516.95
|
|
|
HC DRAINAGE OF SALIVARY GLAND
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 42320
|
| Hospital Charge Code |
900501363
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$197.20 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Central Health Plan Commercial |
$788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$394.40
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$887.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$375.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.20
|
| Rate for Payer: Multiplan Commercial |
$739.50
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
|
|
HC DRAINAGE OF SALIVARY GLAND
|
Facility
|
IP
|
$986.00
|
|
|
Service Code
|
CPT 42320
|
| Hospital Charge Code |
900501363
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$197.20 |
| Max. Negotiated Rate |
$887.40 |
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Central Health Plan Commercial |
$788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$394.40
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$887.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$375.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.20
|
| Rate for Payer: Multiplan Commercial |
$739.50
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
|
|
HC DRAINAGE OF SALIVARY GLAND
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 42320
|
| Hospital Charge Code |
900501363
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$168.36 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$687.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.44
|
| 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 |
$591.60
|
| Rate for Payer: Blue Shield of California Commercial |
$620.19
|
| Rate for Payer: Blue Shield of California EPN |
$482.15
|
| Rate for Payer: Caremore Medicare Advantage |
$687.44
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Central Health Plan Commercial |
$788.80
|
| Rate for Payer: Cigna of CA HMO |
$631.04
|
| Rate for Payer: Cigna of CA PPO |
$729.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Media |
$687.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$887.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$739.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,134.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$687.44
|
| Rate for Payer: InnovAge PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$739.50
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Riverside University Health System MISP |
$756.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$591.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$591.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other HMO |
$493.00
|
| Rate for Payer: United Healthcare HMO Rider |
$493.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$493.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC DRAINAGE OF SALIVARY GLAND
|
Facility
|
OP
|
$986.00
|
|
|
Service Code
|
CPT 42320
|
| Hospital Charge Code |
900501363
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$168.36 |
| 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 |
$1,031.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$687.44
|
| 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 |
$591.60
|
| Rate for Payer: Caremore Medicare Advantage |
$687.44
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Cash Price |
$443.70
|
| Rate for Payer: Central Health Plan Commercial |
$788.80
|
| Rate for Payer: Cigna of CA PPO |
$729.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Dignity Health Media |
$687.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$756.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Galaxy Health WC |
$838.10
|
| Rate for Payer: Global Benefits Group Commercial |
$591.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$887.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$739.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$687.44
|
| Rate for Payer: InnovAge PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$657.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Multiplan Commercial |
$739.50
|
| Rate for Payer: Networks By Design Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Commercial |
$838.10
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Riverside University Health System MISP |
$756.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$591.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other HMO |
$493.00
|
| Rate for Payer: United Healthcare HMO Rider |
$493.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$493.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
HC DRAINAGE/ SCROTAL WALL ABSCESS
|
Facility
|
OP
|
$6,122.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
900501614
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$370.67 |
| Max. Negotiated Rate |
$5,509.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| 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 |
$3,673.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$2,754.90
|
| Rate for Payer: Cash Price |
$2,754.90
|
| Rate for Payer: Cash Price |
$2,754.90
|
| Rate for Payer: Cash Price |
$2,754.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,897.60
|
| Rate for Payer: Cigna of CA PPO |
$4,530.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$5,203.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,673.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,509.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,591.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,083.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$370.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,224.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$4,591.50
|
| Rate for Payer: Networks By Design Commercial |
$3,979.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,203.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,673.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,061.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,061.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,061.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,061.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC DRAINAGE/ SCROTAL WALL ABSCESS
|
Facility
|
IP
|
$6,122.00
|
|
|
Service Code
|
CPT 55100
|
| Hospital Charge Code |
900501614
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,224.40 |
| Max. Negotiated Rate |
$5,509.80 |
| Rate for Payer: Cash Price |
$2,754.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,897.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,448.80
|
| Rate for Payer: Galaxy Health WC |
$5,203.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,673.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,509.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,083.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,332.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,224.40
|
| Rate for Payer: Multiplan Commercial |
$4,591.50
|
| Rate for Payer: Networks By Design Commercial |
$3,979.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,203.70
|
|
|
HC DRAIN CATH PLCMT HEMATOMA/SEROMA/CYST
|
Facility
|
OP
|
$3,524.00
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
909020024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$253.23 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| 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 |
$2,114.40
|
| 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: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,585.80
|
| Rate for Payer: Cash Price |
$1,585.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,819.20
|
| Rate for Payer: Cigna of CA PPO |
$2,607.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$2,995.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,114.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,171.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,643.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,350.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$2,643.00
|
| Rate for Payer: Networks By Design Commercial |
$2,290.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,995.40
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,114.40
|
| 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 Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC DRAIN CATH PLCMT HEMATOMA/SEROMA/CYST
|
Facility
|
IP
|
$3,524.00
|
|
|
Service Code
|
CPT 10030
|
| Hospital Charge Code |
909020024
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$704.80 |
| Max. Negotiated Rate |
$3,171.60 |
| Rate for Payer: Cash Price |
$1,585.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,819.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,409.60
|
| Rate for Payer: Galaxy Health WC |
$2,995.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,114.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,171.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,350.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,342.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.80
|
| Rate for Payer: Multiplan Commercial |
$2,643.00
|
| Rate for Payer: Networks By Design Commercial |
$2,290.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,995.40
|
|
|
HC DRAIN CHEST ATRIUM
|
Facility
|
OP
|
$287.28
|
|
| Hospital Charge Code |
901600595
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.46 |
| Max. Negotiated Rate |
$258.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$174.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$158.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.73
|
| Rate for Payer: Blue Distinction Transplant |
$172.37
|
| Rate for Payer: Blue Shield of California Commercial |
$180.70
|
| Rate for Payer: Blue Shield of California EPN |
$140.48
|
| Rate for Payer: Cash Price |
$129.28
|
| Rate for Payer: Central Health Plan Commercial |
$229.82
|
| Rate for Payer: Cigna of CA HMO |
$183.86
|
| Rate for Payer: Cigna of CA PPO |
$212.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.19
|
| Rate for Payer: Dignity Health Media |
$244.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$114.91
|
| Rate for Payer: Galaxy Health WC |
$244.19
|
| Rate for Payer: Global Benefits Group Commercial |
$172.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$258.55
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$215.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$191.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.46
|
| Rate for Payer: Multiplan Commercial |
$215.46
|
| Rate for Payer: Networks By Design Commercial |
$186.73
|
| Rate for Payer: Prime Health Services Commercial |
$244.19
|
| Rate for Payer: Riverside University Health System MISP |
$114.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.64
|
| Rate for Payer: United Healthcare All Other HMO |
$143.64
|
| Rate for Payer: United Healthcare HMO Rider |
$143.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.19
|
| Rate for Payer: Vantage Medical Group Senior |
$244.19
|
|
