|
HC IMPROVE RESP FX - 15 MIN
|
Facility
|
IP
|
$547.00
|
|
|
Service Code
|
CPT G0238
|
| Hospital Charge Code |
900201803
|
|
Hospital Revenue Code
|
419
|
| Min. Negotiated Rate |
$109.40 |
| Max. Negotiated Rate |
$492.30 |
| Rate for Payer: Adventist Health Commercial |
$109.40
|
| Rate for Payer: Cash Price |
$246.15
|
| Rate for Payer: Central Health Plan Commercial |
$437.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$382.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$218.80
|
| Rate for Payer: EPIC Health Plan Senior |
$218.80
|
| Rate for Payer: Galaxy Health WC |
$464.95
|
| Rate for Payer: Global Benefits Group Commercial |
$328.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$492.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$347.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$322.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.40
|
| Rate for Payer: Multiplan Commercial |
$410.25
|
| Rate for Payer: Networks By Design Commercial |
$355.55
|
| Rate for Payer: Prime Health Services Commercial |
$464.95
|
|
|
HC IMPROVE RESP FX - 15 MIN
|
Facility
|
OP
|
$547.00
|
|
|
Service Code
|
CPT G0238
|
| Hospital Charge Code |
900201803
|
|
Hospital Revenue Code
|
419
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$536.00 |
| Rate for Payer: Adventist Health Commercial |
$109.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$37.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$246.15
|
| Rate for Payer: Cash Price |
$246.15
|
| Rate for Payer: Cash Price |
$246.15
|
| Rate for Payer: Central Health Plan Commercial |
$437.60
|
| Rate for Payer: Cigna of CA HMO |
$350.08
|
| Rate for Payer: Cigna of CA PPO |
$404.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$382.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.38
|
| Rate for Payer: EPIC Health Plan Senior |
$40.92
|
| Rate for Payer: Galaxy Health WC |
$464.95
|
| Rate for Payer: Global Benefits Group Commercial |
$328.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$492.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$61.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$347.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$52.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$49.85
|
| Rate for Payer: Multiplan Commercial |
$410.25
|
| Rate for Payer: Networks By Design Commercial |
$355.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$37.20
|
| Rate for Payer: Prime Health Services Commercial |
$464.95
|
| Rate for Payer: Prime Health Services Medicare |
$39.43
|
| Rate for Payer: Riverside University Health System MISP |
$40.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$328.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$328.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$536.00
|
| Rate for Payer: United Healthcare All Other HMO |
$502.00
|
| Rate for Payer: United Healthcare HMO Rider |
$449.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$441.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$37.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC IMRT TREATMENT DELIVERY COMPLEX
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
909177386
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$4,821.79 |
| Rate for Payer: Adventist Health Commercial |
$1,020.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,420.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,335.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,805.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,825.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,468.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,821.79
|
| Rate for Payer: Blue Shield of California Commercial |
$3,213.00
|
| Rate for Payer: Blue Shield of California EPN |
$2,024.70
|
| Rate for Payer: Cash Price |
$2,295.00
|
| Rate for Payer: Cash Price |
$2,295.00
|
| Rate for Payer: Cash Price |
$2,295.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,080.00
|
| Rate for Payer: Cigna of CA HMO |
$3,264.00
|
| Rate for Payer: Cigna of CA PPO |
$3,774.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,335.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,335.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,335.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,570.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,040.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,040.00
|
| Rate for Payer: Galaxy Health WC |
$4,335.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,060.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,590.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,238.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,851.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,009.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,570.00
|
| Rate for Payer: Multiplan Commercial |
$3,825.00
|
| Rate for Payer: Networks By Design Commercial |
$3,315.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,335.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,040.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,060.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,335.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,335.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4,335.00
|
|
|
HC IMRT TREATMENT DELIVERY COMPLEX
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
909177386
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,020.00 |
| Max. Negotiated Rate |
$4,590.00 |
| Rate for Payer: Adventist Health Commercial |
$1,020.00
|
| Rate for Payer: Cash Price |
$2,295.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,080.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,570.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,040.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,040.00
|
| Rate for Payer: Galaxy Health WC |
$4,335.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,060.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,590.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,238.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,009.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.00
|
| Rate for Payer: Multiplan Commercial |
$3,825.00
|
| Rate for Payer: Networks By Design Commercial |
$3,315.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,335.00
|
|
|
HC IMRT TREATMENT DELIVERY SIMPLE
|
Facility
|
OP
|
$4,249.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
909177385
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$849.80 |
| Max. Negotiated Rate |
$4,017.38 |
| Rate for Payer: Adventist Health Commercial |
$849.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,415.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,611.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,186.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,889.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,017.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2,676.87
|
| Rate for Payer: Blue Shield of California EPN |
$1,686.85
|
| Rate for Payer: Cash Price |
$1,912.05
|
| Rate for Payer: Cash Price |
$1,912.05
|
| Rate for Payer: Cash Price |
$1,912.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,399.20
|
| Rate for Payer: Cigna of CA HMO |
$2,719.36
|
| Rate for Payer: Cigna of CA PPO |
$3,144.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,611.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,611.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,611.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,974.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,699.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,699.60
|
| Rate for Payer: Galaxy Health WC |
$3,611.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,549.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,824.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,698.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,542.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,506.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$849.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,974.30
|
| Rate for Payer: Multiplan Commercial |
$3,186.75
|
| Rate for Payer: Networks By Design Commercial |
$2,761.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,611.65
|
| Rate for Payer: Riverside University Health System MISP |
$1,699.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,549.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,748.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,759.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,332.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,221.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,611.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,611.65
|
| Rate for Payer: Vantage Medical Group Senior |
$3,611.65
|
|
|
HC IMRT TREATMENT DELIVERY SIMPLE
|
Facility
|
IP
|
$4,249.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
909177385
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$849.80 |
| Max. Negotiated Rate |
$3,824.10 |
| Rate for Payer: Adventist Health Commercial |
$849.80
|
| Rate for Payer: Cash Price |
$1,912.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,399.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,974.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,699.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,699.60
|
| Rate for Payer: Galaxy Health WC |
$3,611.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,549.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,824.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,698.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,506.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$849.80
|
| Rate for Payer: Multiplan Commercial |
$3,186.75
|
| Rate for Payer: Networks By Design Commercial |
$2,761.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,611.65
|
|
|
HC IN111 PENTETRTID/OCTRE/LT 6MCI
|
Facility
|
IP
|
$19,095.00
|
|
|
Service Code
|
CPT A9572
|
| Hospital Charge Code |
909301570
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3,819.00 |
| Max. Negotiated Rate |
$17,185.50 |
| Rate for Payer: Adventist Health Commercial |
$3,819.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15,314.19
|
| Rate for Payer: Blue Shield of California EPN |
$9,623.88
|
| Rate for Payer: Cash Price |
$8,592.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,276.00
|
| Rate for Payer: Cigna of CA HMO |
$13,366.50
|
| Rate for Payer: Cigna of CA PPO |
$13,366.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,366.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,638.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,638.00
|
| Rate for Payer: Galaxy Health WC |
$16,230.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,457.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,185.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,125.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,266.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,819.00
|
| Rate for Payer: Multiplan Commercial |
$14,321.25
|
| Rate for Payer: Networks By Design Commercial |
$9,547.50
|
| Rate for Payer: Prime Health Services Commercial |
$16,230.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,166.35
|
| Rate for Payer: United Healthcare All Other HMO |
$6,975.40
|
| Rate for Payer: United Healthcare HMO Rider |
$6,824.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,253.61
|
|
|
HC IN111 PENTETRTID/OCTRE/LT 6MCI
|
Facility
|
OP
|
$19,095.00
|
|
|
Service Code
|
CPT A9572
|
| Hospital Charge Code |
909301570
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,000.94 |
| Max. Negotiated Rate |
$22,246.36 |
| Rate for Payer: Adventist Health Commercial |
$3,819.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,000.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,501.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,201.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,826.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,246.36
|
| Rate for Payer: Blue Shield of California Commercial |
$12,106.23
|
| Rate for Payer: Blue Shield of California EPN |
$7,618.90
|
| Rate for Payer: Cash Price |
$8,592.75
|
| Rate for Payer: Cash Price |
$8,592.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,276.00
|
| Rate for Payer: Cigna of CA HMO |
$13,366.50
|
| Rate for Payer: Cigna of CA PPO |
$13,366.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,501.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,201.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,366.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,301.55
|
| Rate for Payer: EPIC Health Plan Senior |
$2,201.03
|
| Rate for Payer: Galaxy Health WC |
$16,230.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,457.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,185.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,000.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,125.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,801.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,819.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,681.26
|
| Rate for Payer: Multiplan Commercial |
$14,321.25
|
| Rate for Payer: Networks By Design Commercial |
$9,547.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,000.94
|
| Rate for Payer: Prime Health Services Commercial |
$16,230.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.00
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,457.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,457.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,166.35
|
| Rate for Payer: United Healthcare All Other HMO |
$6,975.40
|
| Rate for Payer: United Healthcare HMO Rider |
$6,824.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,253.61
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,000.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,501.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.03
|
| Rate for Payer: Vantage Medical Group Senior |
$2,201.03
|
|
|
HC IN111 PROSTASCINT UP TO 10 MCI
|
Facility
|
IP
|
$8,469.00
|
|
|
Service Code
|
CPT A9507
|
| Hospital Charge Code |
909301255
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,693.80 |
| Max. Negotiated Rate |
$7,622.10 |
| Rate for Payer: Adventist Health Commercial |
$1,693.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,792.14
|
| Rate for Payer: Blue Shield of California EPN |
$4,268.38
|
| Rate for Payer: Cash Price |
$3,811.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,775.20
|
| Rate for Payer: Cigna of CA HMO |
$5,928.30
|
| Rate for Payer: Cigna of CA PPO |
$5,928.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,928.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,387.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,387.60
|
| Rate for Payer: Galaxy Health WC |
$7,198.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,081.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,622.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,377.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,996.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,693.80
|
| Rate for Payer: Multiplan Commercial |
$6,351.75
|
| Rate for Payer: Networks By Design Commercial |
$4,234.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,198.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,178.42
|
| Rate for Payer: United Healthcare All Other HMO |
$3,093.73
|
| Rate for Payer: United Healthcare HMO Rider |
$3,026.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,773.60
|
|
|
HC IN111 PROSTASCINT UP TO 10 MCI
|
Facility
|
OP
|
$8,469.00
|
|
|
Service Code
|
CPT A9507
|
| Hospital Charge Code |
909301255
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,693.80 |
| Max. Negotiated Rate |
$7,622.10 |
| Rate for Payer: Adventist Health Commercial |
$1,693.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,730.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,595.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,903.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,730.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,805.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,749.11
|
| Rate for Payer: Blue Shield of California Commercial |
$5,369.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,379.13
|
| Rate for Payer: Cash Price |
$3,811.05
|
| Rate for Payer: Cash Price |
$3,811.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,775.20
|
| Rate for Payer: Cigna of CA HMO |
$5,928.30
|
| Rate for Payer: Cigna of CA PPO |
$5,928.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,595.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,903.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,730.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,928.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,854.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,903.32
|
| Rate for Payer: Galaxy Health WC |
$7,198.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,081.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,622.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,837.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,873.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,730.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,377.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,279.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,422.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,693.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,318.59
|
| Rate for Payer: Multiplan Commercial |
$6,351.75
|
| Rate for Payer: Networks By Design Commercial |
$4,234.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,730.29
|
| Rate for Payer: Prime Health Services Commercial |
$7,198.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,834.11
|
| Rate for Payer: Riverside University Health System MISP |
$1,903.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,081.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,081.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,178.42
|
| Rate for Payer: United Healthcare All Other HMO |
$3,093.73
|
| Rate for Payer: United Healthcare HMO Rider |
$3,026.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,773.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,730.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,595.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,903.32
|
| Rate for Payer: Vantage Medical Group Senior |
$1,730.29
|
|
|
HC IN111 ZEVALIN UP TO 5 MCI
|
Facility
|
IP
|
$20,828.00
|
|
|
Service Code
|
CPT A9542
|
| Hospital Charge Code |
909301342
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$4,165.60 |
| Max. Negotiated Rate |
$18,745.20 |
| Rate for Payer: Adventist Health Commercial |
$4,165.60
|
| Rate for Payer: Cash Price |
$9,372.60
|
| Rate for Payer: Central Health Plan Commercial |
$16,662.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,579.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,331.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,331.20
|
| Rate for Payer: Galaxy Health WC |
$17,703.80
|
| Rate for Payer: Global Benefits Group Commercial |
$12,496.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,745.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,225.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,288.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,165.60
|
| Rate for Payer: Multiplan Commercial |
$15,621.00
|
| Rate for Payer: Networks By Design Commercial |
$13,538.20
|
| Rate for Payer: Prime Health Services Commercial |
$17,703.80
|
|
|
HC IN111 ZEVALIN UP TO 5 MCI
|
Facility
|
OP
|
$20,828.00
|
|
|
Service Code
|
CPT A9542
|
| Hospital Charge Code |
909301342
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$4,165.60 |
| Max. Negotiated Rate |
$18,745.20 |
| Rate for Payer: Adventist Health Commercial |
$4,165.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,703.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,455.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,621.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,075.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.59
|
| Rate for Payer: Blue Shield of California Commercial |
$13,121.64
|
| Rate for Payer: Blue Shield of California EPN |
$8,268.72
|
| Rate for Payer: Cash Price |
$9,372.60
|
| Rate for Payer: Cash Price |
$9,372.60
|
| Rate for Payer: Central Health Plan Commercial |
$16,662.40
|
| Rate for Payer: Cigna of CA HMO |
$13,329.92
|
| Rate for Payer: Cigna of CA PPO |
$15,412.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,703.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,703.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,703.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,579.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,331.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,331.20
|
| Rate for Payer: Galaxy Health WC |
$17,703.80
|
| Rate for Payer: Global Benefits Group Commercial |
$12,496.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,745.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,003.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,225.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,631.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,288.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,165.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,579.60
|
| Rate for Payer: Multiplan Commercial |
$15,621.00
|
| Rate for Payer: Networks By Design Commercial |
$13,538.20
|
| Rate for Payer: Prime Health Services Commercial |
$17,703.80
|
| Rate for Payer: Riverside University Health System MISP |
$8,331.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,496.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,496.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,414.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,414.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,414.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10,414.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,703.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,703.80
|
| Rate for Payer: Vantage Medical Group Senior |
$17,703.80
|
|
|
HC INACT POLIO ADMINISTRATION
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
902890241
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$9.84
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.96
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC INACT POLIO ADMINISTRATION
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
902890241
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Adventist Health Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC INCISE/DRAIN TEAR GLAND
|
Facility
|
OP
|
$3,762.00
|
|
|
Service Code
|
CPT 68400
|
| Hospital Charge Code |
900501642
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,542.42
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$723.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,282.15
|
| 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 |
$1,960.77
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,009.60
|
| Rate for Payer: Cigna of CA HMO |
$2,407.68
|
| Rate for Payer: Cigna of CA PPO |
$2,783.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,410.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,282.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,633.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,115.55
|
| Rate for Payer: EPIC Health Plan Senior |
$1,410.37
|
| Rate for Payer: Galaxy Health WC |
$3,197.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,257.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,385.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,102.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,388.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$69.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,378.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,718.08
|
| Rate for Payer: Multiplan Commercial |
$2,821.50
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: Networks By Design Commercial |
$2,445.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Preferred Health Network WC |
$2,000.79
|
| Rate for Payer: Prime Health Services Commercial |
$3,197.70
|
| Rate for Payer: Prime Health Services Medicare |
$1,359.08
|
| Rate for Payer: Prime Health Services WC |
$1,940.77
|
| Rate for Payer: Riverside University Health System MISP |
$1,410.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,257.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,257.20
|
| 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 |
$1,282.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Vantage Medical Group Senior |
$1,282.15
|
|
|
HC INCISE/DRAIN TEAR GLAND
|
Facility
|
OP
|
$3,762.00
|
|
|
Service Code
|
CPT 68400
|
| Hospital Charge Code |
900501642
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$752.40
|
| 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 |
$1,923.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,282.15
|
| 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 |
$1,960.77
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,009.60
|
| Rate for Payer: Cigna of CA HMO |
$2,407.68
|
| Rate for Payer: Cigna of CA PPO |
$2,783.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,410.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,282.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,633.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,115.55
|
| Rate for Payer: EPIC Health Plan Senior |
$1,410.37
|
| Rate for Payer: Galaxy Health WC |
$3,197.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,257.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,385.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,102.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,388.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$69.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,378.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,718.08
|
| Rate for Payer: Multiplan Commercial |
$2,821.50
|
| Rate for Payer: Multiplan WC |
$1,960.77
|
| Rate for Payer: Networks By Design Commercial |
$2,445.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,282.15
|
| Rate for Payer: Preferred Health Network WC |
$2,000.79
|
| Rate for Payer: Prime Health Services Commercial |
$3,197.70
|
| Rate for Payer: Prime Health Services Medicare |
$1,359.08
|
| Rate for Payer: Prime Health Services WC |
$1,940.77
|
| Rate for Payer: Riverside University Health System MISP |
$1,410.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,257.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,881.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,881.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,881.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,881.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,282.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,923.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,410.37
|
| Rate for Payer: Vantage Medical Group Senior |
$1,282.15
|
|
|
HC INCISE/DRAIN TEAR GLAND
|
Facility
|
IP
|
$3,762.00
|
|
|
Service Code
|
CPT 68400
|
| Hospital Charge Code |
900501642
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$752.40 |
| Max. Negotiated Rate |
$3,385.80 |
| Rate for Payer: Adventist Health Commercial |
$752.40
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,009.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,633.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.80
|
| Rate for Payer: Galaxy Health WC |
$3,197.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,257.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,385.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,388.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,219.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.40
|
| Rate for Payer: Multiplan Commercial |
$2,821.50
|
| Rate for Payer: Networks By Design Commercial |
$2,445.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,197.70
|
|
|
HC INCISE/DRAIN TEAR GLAND
|
Facility
|
IP
|
$3,762.00
|
|
|
Service Code
|
CPT 68400
|
| Hospital Charge Code |
900501642
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$752.40 |
| Max. Negotiated Rate |
$3,385.80 |
| Rate for Payer: Adventist Health Commercial |
$752.40
|
| Rate for Payer: Cash Price |
$1,692.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,009.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,633.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,504.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,504.80
|
| Rate for Payer: Galaxy Health WC |
$3,197.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,257.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,385.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,388.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,219.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$752.40
|
| Rate for Payer: Multiplan Commercial |
$2,821.50
|
| Rate for Payer: Networks By Design Commercial |
$2,445.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,197.70
|
|
|
HC INCISIONAL BX SKIN SINGLE LSN
|
Facility
|
IP
|
$1,538.00
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
900511106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$307.60 |
| Max. Negotiated Rate |
$1,384.20 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,076.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$615.20
|
| Rate for Payer: EPIC Health Plan Senior |
$615.20
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$976.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$907.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
|
|
HC INCISIONAL BX SKIN SINGLE LSN
|
Facility
|
OP
|
$1,538.00
|
|
|
Service Code
|
CPT 11106
|
| Hospital Charge Code |
900511106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.73 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$307.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$950.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,045.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$950.57
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$1,239.24
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Cash Price |
$692.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,230.40
|
| Rate for Payer: Cigna of CA HMO |
$984.32
|
| Rate for Payer: Cigna of CA PPO |
$1,138.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,045.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$950.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,076.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,568.44
|
| Rate for Payer: EPIC Health Plan Senior |
$1,045.63
|
| Rate for Payer: Galaxy Health WC |
$1,307.30
|
| Rate for Payer: Global Benefits Group Commercial |
$922.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,384.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,558.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$950.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$976.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,330.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$307.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,273.76
|
| Rate for Payer: Multiplan Commercial |
$1,153.50
|
| Rate for Payer: Multiplan WC |
$1,239.24
|
| Rate for Payer: Networks By Design Commercial |
$999.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$950.57
|
| Rate for Payer: Preferred Health Network WC |
$1,264.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,307.30
|
| Rate for Payer: Prime Health Services Medicare |
$1,007.60
|
| Rate for Payer: Prime Health Services WC |
$1,226.59
|
| Rate for Payer: Riverside University Health System MISP |
$1,045.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$922.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$769.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$950.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,425.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,045.63
|
| Rate for Payer: Vantage Medical Group Senior |
$950.57
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
IP
|
$8,004.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,600.80 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,602.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,201.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,201.60
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,082.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,722.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
OP
|
$8,004.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$384.81 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| 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 |
$5,354.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| 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 |
$5,551.91
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: Cigna of CA HMO |
$5,122.56
|
| Rate for Payer: Cigna of CA PPO |
$5,922.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,602.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.43
|
| Rate for Payer: EPIC Health Plan Senior |
$3,926.96
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,854.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,082.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$384.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,837.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Multiplan WC |
$5,551.91
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Preferred Health Network WC |
$5,665.21
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,784.16
|
| Rate for Payer: Prime Health Services WC |
$5,495.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,926.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,802.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,002.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,002.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,002.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,002.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,569.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
OP
|
$8,004.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$384.81 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$3,281.64
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,114.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| 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 |
$5,551.91
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: Cigna of CA HMO |
$5,122.56
|
| Rate for Payer: Cigna of CA PPO |
$5,922.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,602.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.43
|
| Rate for Payer: EPIC Health Plan Senior |
$3,926.96
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,854.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,082.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$384.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,837.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Multiplan WC |
$5,551.91
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Preferred Health Network WC |
$5,665.21
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
| Rate for Payer: Prime Health Services Medicare |
$3,784.16
|
| Rate for Payer: Prime Health Services WC |
$5,495.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,926.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,802.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,802.40
|
| 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 |
$3,569.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC INCISION DRAIN DEEP RECTAL ABSCESS
|
Facility
|
IP
|
$8,004.00
|
|
|
Service Code
|
CPT 45020
|
| Hospital Charge Code |
900501241
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,600.80 |
| Max. Negotiated Rate |
$7,203.60 |
| Rate for Payer: Adventist Health Commercial |
$1,600.80
|
| Rate for Payer: Cash Price |
$3,601.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,403.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,602.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,201.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,201.60
|
| Rate for Payer: Galaxy Health WC |
$6,803.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,802.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,203.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,082.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,722.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,600.80
|
| Rate for Payer: Multiplan Commercial |
$6,003.00
|
| Rate for Payer: Networks By Design Commercial |
$5,202.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,803.40
|
|
|
HC INCISION/DRAIN FOREARM/WRIST
|
Facility
|
OP
|
$10,830.00
|
|
|
Service Code
|
CPT 25028
|
| Hospital Charge Code |
900501423
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,747.00 |
| Rate for Payer: Adventist Health Commercial |
$2,166.00
|
| 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 |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| 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 |
$6,568.63
|
| Rate for Payer: Cash Price |
$4,873.50
|
| Rate for Payer: Cash Price |
$4,873.50
|
| Rate for Payer: Cash Price |
$4,873.50
|
| Rate for Payer: Cash Price |
$4,873.50
|
| Rate for Payer: Central Health Plan Commercial |
$8,664.00
|
| Rate for Payer: Cigna of CA HMO |
$6,931.20
|
| Rate for Payer: Cigna of CA PPO |
$8,014.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,581.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Galaxy Health WC |
$9,205.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,498.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,747.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,877.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$865.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,166.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$8,122.50
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$7,039.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$9,205.50
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,498.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,415.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,415.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,415.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,415.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
