|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,014.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$920.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$854.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
|
|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
OP
|
$1,449.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$104.69 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$594.09
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$552.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$910.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,424.40
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Cigna of CA HMO |
$927.36
|
| Rate for Payer: Cigna of CA PPO |
$1,072.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$910.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,014.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,502.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1,001.86
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,493.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$910.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$920.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$979.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,220.45
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Multiplan WC |
$1,424.40
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$910.78
|
| Rate for Payer: Preferred Health Network WC |
$1,453.47
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
| Rate for Payer: Prime Health Services Medicare |
$965.43
|
| Rate for Payer: Prime Health Services WC |
$1,409.87
|
| Rate for Payer: Riverside University Health System MISP |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$869.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$869.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$910.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,366.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$910.78
|
|
|
HC I & D PILONIDAL CYST SIMPLE
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
900501002
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,304.10 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,159.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,014.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,304.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$920.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$854.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.80
|
| Rate for Payer: Multiplan Commercial |
$1,086.75
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
|
|
HC IDR CORDIS VISTA BRITE TIPN
|
Facility
|
IP
|
$7,000.00
|
|
|
Service Code
|
CPT 0220T
|
| Hospital Charge Code |
909010220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,400.00 |
| Max. Negotiated Rate |
$6,300.00 |
| Rate for Payer: Adventist Health Commercial |
$1,400.00
|
| Rate for Payer: Cash Price |
$3,150.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,600.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,900.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,800.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,800.00
|
| Rate for Payer: Galaxy Health WC |
$5,950.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,200.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,300.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,445.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,130.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,400.00
|
| Rate for Payer: Multiplan Commercial |
$5,250.00
|
| Rate for Payer: Networks By Design Commercial |
$4,550.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,950.00
|
|
|
HC IDR CORDIS VISTA BRITE TIPN
|
Facility
|
OP
|
$7,000.00
|
|
|
Service Code
|
CPT 0220T
|
| Hospital Charge Code |
909010220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,400.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$16,512.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24,769.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18,163.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,512.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$3,150.00
|
| Rate for Payer: Cash Price |
$3,150.00
|
| Rate for Payer: Cash Price |
$3,150.00
|
| Rate for Payer: Central Health Plan Commercial |
$5,600.00
|
| Rate for Payer: Cigna of CA HMO |
$4,480.00
|
| Rate for Payer: Cigna of CA PPO |
$5,180.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24,769.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$18,163.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16,512.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,900.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$27,245.94
|
| Rate for Payer: EPIC Health Plan Senior |
$18,163.96
|
| Rate for Payer: Galaxy Health WC |
$5,950.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,200.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,300.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27,080.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,512.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,445.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,541.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23,117.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,400.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22,127.00
|
| Rate for Payer: Multiplan Commercial |
$5,250.00
|
| Rate for Payer: Networks By Design Commercial |
$4,550.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,512.69
|
| Rate for Payer: Prime Health Services Commercial |
$5,950.00
|
| Rate for Payer: Prime Health Services Medicare |
$17,503.45
|
| Rate for Payer: Riverside University Health System MISP |
$18,163.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,200.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,500.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$16,512.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24,769.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18,163.96
|
| Rate for Payer: Vantage Medical Group Senior |
$16,512.69
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
OP
|
$9,960.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$8,964.00 |
| Rate for Payer: Adventist Health Commercial |
$4,083.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,284.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,387.03
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,968.00
|
| Rate for Payer: Cigna of CA HMO |
$6,374.40
|
| Rate for Payer: Cigna of CA PPO |
$7,370.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,972.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$8,466.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,976.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,964.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,324.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,654.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,992.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$7,470.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$6,474.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Preferred Health Network WC |
$2,435.74
|
| Rate for Payer: Prime Health Services Commercial |
$8,466.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,976.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,976.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
OP
|
$9,960.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$307.36 |
| Max. Negotiated Rate |
$8,964.00 |
| Rate for Payer: Adventist Health Commercial |
$1,992.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,284.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,314.64
|
| Rate for Payer: Blue Shield of California EPN |
$3,974.04
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,968.00
|
| Rate for Payer: Cigna of CA HMO |
$6,374.40
|
| Rate for Payer: Cigna of CA PPO |
$7,370.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,972.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$8,466.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,976.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,964.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$307.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,324.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,992.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$7,470.00
|
| Rate for Payer: Networks By Design Commercial |
$6,474.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$8,466.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,976.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,976.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,980.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,980.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,980.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,980.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
IP
|
$9,960.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,992.00 |
| Max. Negotiated Rate |
$8,964.00 |
| Rate for Payer: Adventist Health Commercial |
$1,992.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,968.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,972.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,984.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,984.00
|
| Rate for Payer: Galaxy Health WC |
$8,466.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,976.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,964.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,324.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,876.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,992.00
|
| Rate for Payer: Multiplan Commercial |
$7,470.00
|
| Rate for Payer: Networks By Design Commercial |
$6,474.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,466.00
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
OP
|
$9,960.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$8,964.00 |
| Rate for Payer: Adventist Health Commercial |
$1,992.00
|
| 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 |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,387.03
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,968.00
|
| Rate for Payer: Cigna of CA HMO |
$6,374.40
|
| Rate for Payer: Cigna of CA PPO |
$7,370.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,972.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$8,466.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,976.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,964.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,324.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,654.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,992.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$7,470.00
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$6,474.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Preferred Health Network WC |
$2,435.74
|
| Rate for Payer: Prime Health Services Commercial |
$8,466.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,976.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,980.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,980.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,980.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,980.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
IP
|
$9,960.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,992.00 |
| Max. Negotiated Rate |
$8,964.00 |
| Rate for Payer: Adventist Health Commercial |
$1,992.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,968.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,972.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,984.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,984.00
|
| Rate for Payer: Galaxy Health WC |
$8,466.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,976.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,964.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,324.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,876.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,992.00
|
| Rate for Payer: Multiplan Commercial |
$7,470.00
|
| Rate for Payer: Networks By Design Commercial |
$6,474.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,466.00
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
IP
|
$9,960.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,992.00 |
| Max. Negotiated Rate |
$8,964.00 |
| Rate for Payer: Adventist Health Commercial |
$1,992.00
|
| Rate for Payer: Cash Price |
$4,482.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,968.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,972.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,984.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,984.00
|
| Rate for Payer: Galaxy Health WC |
$8,466.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,976.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,964.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,324.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,876.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,992.00
|
| Rate for Payer: Multiplan Commercial |
$7,470.00
|
| Rate for Payer: Networks By Design Commercial |
$6,474.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,466.00
|
|
|
HC I & D THYROGLOSSAL DUCT CYST
|
Facility
|
OP
|
$4,689.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$128.74 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$937.80
|
| 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 |
$2,993.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,995.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,998.82
|
| Rate for Payer: Cash Price |
$2,110.05
|
| Rate for Payer: Cash Price |
$2,110.05
|
| Rate for Payer: Cash Price |
$2,110.05
|
| Rate for Payer: Cash Price |
$2,110.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,751.20
|
| Rate for Payer: Cigna of CA HMO |
$3,000.96
|
| Rate for Payer: Cigna of CA PPO |
$3,469.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,195.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,995.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,282.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,292.74
|
| Rate for Payer: EPIC Health Plan Senior |
$2,195.16
|
| Rate for Payer: Galaxy Health WC |
$3,985.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,813.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,220.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,272.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,977.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$128.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,145.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$937.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,674.10
|
| Rate for Payer: Multiplan Commercial |
$3,516.75
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$3,047.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$3,985.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,115.34
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,195.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,813.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,344.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,344.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,344.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,344.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,995.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Vantage Medical Group Senior |
$1,995.60
|
|
|
HC I & D THYROGLOSSAL DUCT CYST
|
Facility
|
IP
|
$4,689.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$937.80 |
| Max. Negotiated Rate |
$4,220.10 |
| Rate for Payer: Adventist Health Commercial |
$937.80
|
| Rate for Payer: Cash Price |
$2,110.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,751.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,282.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,875.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,875.60
|
| Rate for Payer: Galaxy Health WC |
$3,985.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,813.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,220.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,977.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,766.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$937.80
|
| Rate for Payer: Multiplan Commercial |
$3,516.75
|
| Rate for Payer: Networks By Design Commercial |
$3,047.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,985.65
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$6,832.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$581.00 |
| Max. Negotiated Rate |
$6,164.32 |
| Rate for Payer: Adventist Health Commercial |
$1,366.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,735.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,038.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,331.49
|
| Rate for Payer: Blue Shield of California EPN |
$2,725.97
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,465.60
|
| Rate for Payer: Cigna of CA HMO |
$4,372.48
|
| Rate for Payer: Cigna of CA PPO |
$5,055.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,782.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$5,807.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,099.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,148.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,338.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,480.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,366.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$5,124.00
|
| Rate for Payer: Networks By Design Commercial |
$4,440.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,807.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,099.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,099.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$6,832.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,366.40 |
| Max. Negotiated Rate |
$6,148.80 |
| Rate for Payer: Adventist Health Commercial |
$1,366.40
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,465.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,782.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,732.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,732.80
|
| Rate for Payer: Galaxy Health WC |
$5,807.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,099.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,148.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,338.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,030.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,366.40
|
| Rate for Payer: Multiplan Commercial |
$5,124.00
|
| Rate for Payer: Networks By Design Commercial |
$4,440.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,807.20
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$6,832.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,164.32 |
| Rate for Payer: Adventist Health Commercial |
$1,366.40
|
| 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 |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,465.60
|
| Rate for Payer: Cigna of CA HMO |
$4,372.48
|
| Rate for Payer: Cigna of CA PPO |
$5,055.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,782.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Galaxy Health WC |
$5,807.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,099.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,148.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,338.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,480.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,016.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,366.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan Commercial |
$5,124.00
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: Networks By Design Commercial |
$4,440.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Commercial |
$5,807.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,099.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,416.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,416.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,416.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,416.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$6,832.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,366.40 |
| Max. Negotiated Rate |
$6,148.80 |
| Rate for Payer: Adventist Health Commercial |
$1,366.40
|
| Rate for Payer: Cash Price |
$3,074.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,465.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,782.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,732.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,732.80
|
| Rate for Payer: Galaxy Health WC |
$5,807.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,099.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,148.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,338.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,030.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,366.40
|
| Rate for Payer: Multiplan Commercial |
$5,124.00
|
| Rate for Payer: Networks By Design Commercial |
$4,440.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,807.20
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$594.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Central Health Plan Commercial |
$528.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$462.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.00
|
| Rate for Payer: EPIC Health Plan Senior |
$264.00
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$594.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$419.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$389.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.00
|
| Rate for Payer: Multiplan Commercial |
$495.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$760.68 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$461.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$464.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$461.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$543.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$755.73
|
| Rate for Payer: Blue Shield of California Commercial |
$415.80
|
| Rate for Payer: Blue Shield of California EPN |
$262.02
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Central Health Plan Commercial |
$528.00
|
| Rate for Payer: Cigna of CA HMO |
$422.40
|
| Rate for Payer: Cigna of CA PPO |
$488.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$691.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$461.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$462.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$760.68
|
| Rate for Payer: EPIC Health Plan Senior |
$507.12
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$594.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$756.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$180.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$461.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$419.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$199.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$645.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$617.77
|
| Rate for Payer: Multiplan Commercial |
$495.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$461.02
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
| Rate for Payer: Prime Health Services Medicare |
$488.68
|
| Rate for Payer: Riverside University Health System MISP |
$507.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$396.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$396.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$461.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$691.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.12
|
| Rate for Payer: Vantage Medical Group Senior |
$461.02
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$534.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$480.60 |
| Rate for Payer: Adventist Health Commercial |
$106.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$219.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$399.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$96.42
|
| Rate for Payer: Blue Shield of California Commercial |
$336.42
|
| Rate for Payer: Blue Shield of California EPN |
$212.00
|
| Rate for Payer: Cash Price |
$240.30
|
| Rate for Payer: Cash Price |
$240.30
|
| Rate for Payer: Central Health Plan Commercial |
$427.20
|
| Rate for Payer: Cigna of CA HMO |
$341.76
|
| Rate for Payer: Cigna of CA PPO |
$395.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$373.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$453.90
|
| Rate for Payer: Global Benefits Group Commercial |
$320.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$480.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$92.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$339.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$400.50
|
| Rate for Payer: Networks By Design Commercial |
$347.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$219.12
|
| Rate for Payer: Prime Health Services Commercial |
$453.90
|
| Rate for Payer: Prime Health Services Medicare |
$232.27
|
| Rate for Payer: Riverside University Health System MISP |
$241.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$320.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$320.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$534.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$106.80 |
| Max. Negotiated Rate |
$480.60 |
| Rate for Payer: Adventist Health Commercial |
$106.80
|
| Rate for Payer: Cash Price |
$240.30
|
| Rate for Payer: Central Health Plan Commercial |
$427.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$373.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$213.60
|
| Rate for Payer: EPIC Health Plan Senior |
$213.60
|
| Rate for Payer: Galaxy Health WC |
$453.90
|
| Rate for Payer: Global Benefits Group Commercial |
$320.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$480.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$339.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$315.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.80
|
| Rate for Payer: Multiplan Commercial |
$400.50
|
| Rate for Payer: Networks By Design Commercial |
$347.10
|
| Rate for Payer: Prime Health Services Commercial |
$453.90
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,788.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$68.42 |
| Max. Negotiated Rate |
$2,509.20 |
| Rate for Payer: Adventist Health Commercial |
$557.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$70.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,533.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,091.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,756.44
|
| Rate for Payer: Blue Shield of California EPN |
$1,106.84
|
| Rate for Payer: Cash Price |
$1,254.60
|
| Rate for Payer: Cash Price |
$1,254.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,230.40
|
| Rate for Payer: Cigna of CA HMO |
$1,784.32
|
| Rate for Payer: Cigna of CA PPO |
$2,063.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,369.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,369.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,951.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,115.20
|
| Rate for Payer: Galaxy Health WC |
$2,369.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,509.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,770.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,012.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,951.60
|
| Rate for Payer: Multiplan Commercial |
$2,091.00
|
| Rate for Payer: Networks By Design Commercial |
$1,812.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,369.80
|
| Rate for Payer: Riverside University Health System MISP |
$1,115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,672.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,394.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,394.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,394.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,394.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,369.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,369.80
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,788.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$557.60 |
| Max. Negotiated Rate |
$2,509.20 |
| Rate for Payer: Adventist Health Commercial |
$557.60
|
| Rate for Payer: Cash Price |
$1,254.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,951.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,115.20
|
| Rate for Payer: Galaxy Health WC |
$2,369.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,509.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,770.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,644.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.60
|
| Rate for Payer: Multiplan Commercial |
$2,091.00
|
| Rate for Payer: Networks By Design Commercial |
$1,812.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,369.80
|
|
|
HC ILEOSCOPY STOMA W/BALLOON DILATION
|
Facility
|
IP
|
$6,574.00
|
|
|
Service Code
|
CPT 44381
|
| Hospital Charge Code |
950442410
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,314.80 |
| Max. Negotiated Rate |
$5,916.60 |
| Rate for Payer: Adventist Health Commercial |
$1,314.80
|
| Rate for Payer: Cash Price |
$2,958.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,259.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,601.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,629.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,629.60
|
| Rate for Payer: Galaxy Health WC |
$5,587.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,944.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,916.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,174.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,878.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,314.80
|
| Rate for Payer: Multiplan Commercial |
$4,930.50
|
| Rate for Payer: Networks By Design Commercial |
$4,273.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,587.90
|
|
|
HC ILEOSCOPY STOMA W/BALLOON DILATION
|
Facility
|
OP
|
$6,574.00
|
|
|
Service Code
|
CPT 44381
|
| Hospital Charge Code |
950442410
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,314.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: Adventist Health Commercial |
$1,314.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,468.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| 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 |
$2,958.30
|
| Rate for Payer: Cash Price |
$2,958.30
|
| Rate for Payer: Cash Price |
$2,958.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,259.20
|
| Rate for Payer: Cigna of CA HMO |
$4,207.36
|
| Rate for Payer: Cigna of CA PPO |
$4,864.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,601.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$5,587.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,944.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,916.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,174.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,314.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,930.50
|
| Rate for Payer: Networks By Design Commercial |
$4,273.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Prime Health Services Commercial |
$5,587.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,616.12
|
| Rate for Payer: Riverside University Health System MISP |
$2,714.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,944.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,961.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,287.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
