|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
IP
|
$12,186.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,437.20 |
| Max. Negotiated Rate |
$10,967.40 |
| Rate for Payer: Adventist Health Commercial |
$2,437.20
|
| Rate for Payer: Cash Price |
$5,483.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,748.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,530.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,874.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,874.40
|
| Rate for Payer: Galaxy Health WC |
$10,358.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,311.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,967.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,738.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,189.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,437.20
|
| Rate for Payer: Multiplan Commercial |
$9,139.50
|
| Rate for Payer: Networks By Design Commercial |
$7,920.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,358.10
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
OP
|
$12,186.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$217.72 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,437.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,156.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$10,943.70
|
| 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 |
$5,483.70
|
| Rate for Payer: Cash Price |
$5,483.70
|
| Rate for Payer: Cash Price |
$5,483.70
|
| Rate for Payer: Central Health Plan Commercial |
$9,748.80
|
| Rate for Payer: Cigna of CA HMO |
$7,799.04
|
| Rate for Payer: Cigna of CA PPO |
$9,017.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,530.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$10,358.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,311.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,967.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$217.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,738.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,437.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$9,139.50
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$7,920.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Preferred Health Network WC |
$11,167.04
|
| Rate for Payer: Prime Health Services Commercial |
$10,358.10
|
| Rate for Payer: Prime Health Services Medicare |
$7,586.27
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,872.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,311.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,093.00
|
| 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 |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC INSRTN PERITNL VENOUS SHUNT
|
Facility
|
OP
|
$14,435.00
|
|
|
Service Code
|
CPT 49425
|
| Hospital Charge Code |
909009425
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,015.61 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,887.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,269.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,939.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,826.25
|
| 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 |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$6,495.75
|
| Rate for Payer: Cash Price |
$6,495.75
|
| Rate for Payer: Cash Price |
$6,495.75
|
| Rate for Payer: Central Health Plan Commercial |
$11,548.00
|
| Rate for Payer: Cigna of CA HMO |
$9,238.40
|
| Rate for Payer: Cigna of CA PPO |
$10,681.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,269.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,269.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12,269.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,104.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,774.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,774.00
|
| Rate for Payer: Galaxy Health WC |
$12,269.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,661.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,991.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,015.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,166.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,121.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,516.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,887.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,104.50
|
| Rate for Payer: Multiplan Commercial |
$10,826.25
|
| Rate for Payer: Networks By Design Commercial |
$9,382.75
|
| Rate for Payer: Prime Health Services Commercial |
$12,269.75
|
| Rate for Payer: Riverside University Health System MISP |
$5,774.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,661.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,217.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,269.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,269.75
|
| Rate for Payer: Vantage Medical Group Senior |
$12,269.75
|
|
|
HC INSRTN PERITNL VENOUS SHUNT
|
Facility
|
IP
|
$14,435.00
|
|
|
Service Code
|
CPT 49425
|
| Hospital Charge Code |
909009425
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,887.00 |
| Max. Negotiated Rate |
$12,991.50 |
| Rate for Payer: Adventist Health Commercial |
$2,887.00
|
| Rate for Payer: Cash Price |
$6,495.75
|
| Rate for Payer: Central Health Plan Commercial |
$11,548.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,104.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,774.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,774.00
|
| Rate for Payer: Galaxy Health WC |
$12,269.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,661.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,991.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,166.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,516.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,887.00
|
| Rate for Payer: Multiplan Commercial |
$10,826.25
|
| Rate for Payer: Networks By Design Commercial |
$9,382.75
|
| Rate for Payer: Prime Health Services Commercial |
$12,269.75
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
OP
|
$15,189.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$446.98 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$3,037.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| 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 |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,151.20
|
| Rate for Payer: Cigna of CA HMO |
$9,720.96
|
| Rate for Payer: Cigna of CA PPO |
$11,239.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,632.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$12,910.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,670.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$446.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,645.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$11,391.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$9,872.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$12,910.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,594.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
IP
|
$15,189.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,037.80 |
| Max. Negotiated Rate |
$13,670.10 |
| Rate for Payer: Adventist Health Commercial |
$3,037.80
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,151.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,632.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,075.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,075.60
|
| Rate for Payer: Galaxy Health WC |
$12,910.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,670.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,645.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,961.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.80
|
| Rate for Payer: Multiplan Commercial |
$11,391.75
|
| Rate for Payer: Networks By Design Commercial |
$9,872.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,910.65
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
OP
|
$15,189.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$13,670.10 |
| Rate for Payer: Adventist Health Commercial |
$3,037.80
|
| 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 |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| 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 |
$6,372.03
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,151.20
|
| Rate for Payer: Cigna of CA HMO |
$9,720.96
|
| Rate for Payer: Cigna of CA PPO |
$11,239.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,632.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$12,910.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,670.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,645.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,365.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$11,391.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$9,872.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$12,910.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,594.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,594.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,594.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,594.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
IP
|
$15,189.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,037.80 |
| Max. Negotiated Rate |
$13,670.10 |
| Rate for Payer: Adventist Health Commercial |
$3,037.80
|
| Rate for Payer: Cash Price |
$6,835.05
|
| Rate for Payer: Central Health Plan Commercial |
$12,151.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,632.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,075.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,075.60
|
| Rate for Payer: Galaxy Health WC |
$12,910.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,670.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,645.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,961.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,037.80
|
| Rate for Payer: Multiplan Commercial |
$11,391.75
|
| Rate for Payer: Networks By Design Commercial |
$9,872.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,910.65
|
|
|
HC INS SUBQ CAR RHYTHM MTR W PRGM
|
Facility
|
OP
|
$14,325.00
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
906813406
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,865.00 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$2,865.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$10,643.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,643.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$16,754.51
|
| Rate for Payer: Blue Shield of California Commercial |
$6,228.07
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$6,446.25
|
| Rate for Payer: Cash Price |
$6,446.25
|
| Rate for Payer: Cash Price |
$6,446.25
|
| Rate for Payer: Central Health Plan Commercial |
$11,460.00
|
| Rate for Payer: Cigna of CA HMO |
$9,168.00
|
| Rate for Payer: Cigna of CA PPO |
$10,600.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,707.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,643.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,027.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,561.82
|
| Rate for Payer: EPIC Health Plan Senior |
$11,707.88
|
| Rate for Payer: Galaxy Health WC |
$12,176.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,595.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,892.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17,455.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,319.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,096.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,190.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,900.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,865.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,262.33
|
| Rate for Payer: Multiplan Commercial |
$10,743.75
|
| Rate for Payer: Multiplan WC |
$16,754.51
|
| Rate for Payer: Networks By Design Commercial |
$9,311.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,643.53
|
| Rate for Payer: Preferred Health Network WC |
$17,096.44
|
| Rate for Payer: Prime Health Services Commercial |
$12,176.25
|
| Rate for Payer: Prime Health Services Medicare |
$11,282.14
|
| Rate for Payer: Prime Health Services WC |
$16,583.55
|
| Rate for Payer: Riverside University Health System MISP |
$11,707.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,595.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,162.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$10,643.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,965.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,707.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10,643.53
|
|
|
HC INS SUBQ CAR RHYTHM MTR W PRGM
|
Facility
|
IP
|
$14,325.00
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
906813406
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,865.00 |
| Max. Negotiated Rate |
$12,892.50 |
| Rate for Payer: Adventist Health Commercial |
$2,865.00
|
| Rate for Payer: Cash Price |
$6,446.25
|
| Rate for Payer: Central Health Plan Commercial |
$11,460.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,027.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,730.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,730.00
|
| Rate for Payer: Galaxy Health WC |
$12,176.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,595.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,892.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,096.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,451.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,865.00
|
| Rate for Payer: Multiplan Commercial |
$10,743.75
|
| Rate for Payer: Networks By Design Commercial |
$9,311.25
|
| Rate for Payer: Prime Health Services Commercial |
$12,176.25
|
|
|
HC INST ANTINEOPLSTC PHRM/BIOLGC AGT RNL PLVS
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT C9789
|
| Hospital Charge Code |
910100789
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,574.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,361.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,731.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,574.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,461.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,158.57
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,361.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,731.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,574.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,597.51
|
| Rate for Payer: EPIC Health Plan Senior |
$1,731.67
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,581.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,574.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,203.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,109.49
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,574.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,668.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,731.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,574.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,361.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,731.67
|
| Rate for Payer: Vantage Medical Group Senior |
$1,574.25
|
|
|
HC INST ANTINEOPLSTC PHRM/BIOLGC AGT RNL PLVS
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT C9789
|
| Hospital Charge Code |
910100789
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,434.10 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC INSTILL RX AGENT VIA NEPH TUBE
|
Facility
|
OP
|
$1,046.00
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
907201118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$204.92 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$209.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$321.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.35
|
| 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 |
$492.37
|
| 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 |
$470.70
|
| Rate for Payer: Cash Price |
$470.70
|
| Rate for Payer: Cash Price |
$470.70
|
| Rate for Payer: Central Health Plan Commercial |
$836.80
|
| Rate for Payer: Cigna of CA HMO |
$669.44
|
| Rate for Payer: Cigna of CA PPO |
$774.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$482.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$353.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$321.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$732.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$530.23
|
| Rate for Payer: EPIC Health Plan Senior |
$353.49
|
| Rate for Payer: Galaxy Health WC |
$889.10
|
| Rate for Payer: Global Benefits Group Commercial |
$627.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$941.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$527.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$204.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$321.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$664.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$226.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$449.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$430.61
|
| Rate for Payer: Multiplan Commercial |
$784.50
|
| Rate for Payer: Multiplan WC |
$492.37
|
| Rate for Payer: Networks By Design Commercial |
$679.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$321.35
|
| Rate for Payer: Preferred Health Network WC |
$502.42
|
| Rate for Payer: Prime Health Services Commercial |
$889.10
|
| Rate for Payer: Prime Health Services Medicare |
$340.63
|
| Rate for Payer: Prime Health Services WC |
$487.35
|
| Rate for Payer: Riverside University Health System MISP |
$353.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$627.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$523.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$321.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$482.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$353.49
|
| Rate for Payer: Vantage Medical Group Senior |
$321.35
|
|
|
HC INSTILL RX AGENT VIA NEPH TUBE
|
Facility
|
IP
|
$1,046.00
|
|
|
Service Code
|
CPT 50391
|
| Hospital Charge Code |
907201118
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$209.20 |
| Max. Negotiated Rate |
$941.40 |
| Rate for Payer: Adventist Health Commercial |
$209.20
|
| Rate for Payer: Cash Price |
$470.70
|
| Rate for Payer: Central Health Plan Commercial |
$836.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$732.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$418.40
|
| Rate for Payer: EPIC Health Plan Senior |
$418.40
|
| Rate for Payer: Galaxy Health WC |
$889.10
|
| Rate for Payer: Global Benefits Group Commercial |
$627.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$941.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$664.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$617.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.20
|
| Rate for Payer: Multiplan Commercial |
$784.50
|
| Rate for Payer: Networks By Design Commercial |
$679.90
|
| Rate for Payer: Prime Health Services Commercial |
$889.10
|
|
|
HC INST WAVE FREE RATIO WO STRESS AGENT
|
Facility
|
IP
|
$12,398.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906803801
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,479.60 |
| Max. Negotiated Rate |
$11,158.20 |
| Rate for Payer: Adventist Health Commercial |
$2,479.60
|
| Rate for Payer: Cash Price |
$5,579.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,918.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,678.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,959.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,959.20
|
| Rate for Payer: Galaxy Health WC |
$10,538.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,438.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,158.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,872.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,314.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,479.60
|
| Rate for Payer: Multiplan Commercial |
$9,298.50
|
| Rate for Payer: Networks By Design Commercial |
$8,058.70
|
| Rate for Payer: Prime Health Services Commercial |
$10,538.30
|
|
|
HC INST WAVE FREE RATIO WO STRESS AGENT
|
Facility
|
OP
|
$12,398.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
906803801
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$11,158.20 |
| Rate for Payer: Adventist Health Commercial |
$2,479.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,529.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,003.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,211.92
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,579.10
|
| Rate for Payer: Cash Price |
$5,579.10
|
| Rate for Payer: Cash Price |
$5,579.10
|
| Rate for Payer: Cash Price |
$5,579.10
|
| Rate for Payer: Central Health Plan Commercial |
$9,918.40
|
| Rate for Payer: Cigna of CA HMO |
$7,934.72
|
| Rate for Payer: Cigna of CA PPO |
$9,174.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,678.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$10,538.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,438.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,158.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,872.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,479.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$9,298.50
|
| Rate for Payer: Networks By Design Commercial |
$8,058.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$10,538.30
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,438.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,438.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC INSULIN
|
Facility
|
IP
|
$179.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
900912130
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.80 |
| Max. Negotiated Rate |
$161.10 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Central Health Plan Commercial |
$143.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.60
|
| Rate for Payer: EPIC Health Plan Senior |
$71.60
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.80
|
| Rate for Payer: Multiplan Commercial |
$134.25
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
|
|
HC INSULIN
|
Facility
|
OP
|
$179.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
900912130
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$161.10 |
| Rate for Payer: Adventist Health Commercial |
$35.80
|
| Rate for Payer: Adventist Health Commercial |
$9.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.43
|
| Rate for Payer: Adventist Health Medi-Cal |
$11.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$83.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$83.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$83.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.62
|
| Rate for Payer: Blue Shield of California Commercial |
$30.87
|
| Rate for Payer: Blue Shield of California Commercial |
$112.77
|
| Rate for Payer: Blue Shield of California EPN |
$19.45
|
| Rate for Payer: Blue Shield of California EPN |
$71.06
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Cash Price |
$80.55
|
| Rate for Payer: Central Health Plan Commercial |
$143.20
|
| Rate for Payer: Central Health Plan Commercial |
$39.20
|
| Rate for Payer: Cigna of CA HMO |
$31.36
|
| Rate for Payer: Cigna of CA HMO |
$114.56
|
| Rate for Payer: Cigna of CA PPO |
$36.26
|
| Rate for Payer: Cigna of CA PPO |
$132.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$34.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.86
|
| Rate for Payer: EPIC Health Plan Senior |
$12.57
|
| Rate for Payer: EPIC Health Plan Senior |
$12.57
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Galaxy Health WC |
$152.15
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Global Benefits Group Commercial |
$107.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.32
|
| Rate for Payer: Multiplan Commercial |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$134.25
|
| Rate for Payer: Networks By Design Commercial |
$116.35
|
| Rate for Payer: Networks By Design Commercial |
$31.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.43
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11.43
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: Prime Health Services Commercial |
$152.15
|
| Rate for Payer: Prime Health Services Medicare |
$12.12
|
| Rate for Payer: Prime Health Services Medicare |
$12.12
|
| Rate for Payer: Riverside University Health System MISP |
$12.57
|
| Rate for Payer: Riverside University Health System MISP |
$12.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.26
|
| Rate for Payer: United Healthcare All Other HMO |
$9.26
|
| Rate for Payer: United Healthcare All Other HMO |
$9.26
|
| Rate for Payer: United Healthcare HMO Rider |
$9.26
|
| Rate for Payer: United Healthcare HMO Rider |
$9.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.26
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$11.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.57
|
| Rate for Payer: Vantage Medical Group Senior |
$11.43
|
| Rate for Payer: Vantage Medical Group Senior |
$11.43
|
|
|
HC INTACT PTH
|
Facility
|
OP
|
$202.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
900910942
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.44 |
| Max. Negotiated Rate |
$417.46 |
| Rate for Payer: Adventist Health Commercial |
$40.40
|
| Rate for Payer: Adventist Health Commercial |
$152.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$41.28
|
| Rate for Payer: Adventist Health Medi-Cal |
$41.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$302.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$302.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$300.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$300.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$417.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$417.46
|
| Rate for Payer: Blue Shield of California Commercial |
$480.69
|
| Rate for Payer: Blue Shield of California Commercial |
$127.26
|
| Rate for Payer: Blue Shield of California EPN |
$302.91
|
| Rate for Payer: Blue Shield of California EPN |
$80.19
|
| Rate for Payer: Cash Price |
$343.35
|
| Rate for Payer: Cash Price |
$343.35
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Central Health Plan Commercial |
$161.60
|
| Rate for Payer: Central Health Plan Commercial |
$610.40
|
| Rate for Payer: Cigna of CA HMO |
$488.32
|
| Rate for Payer: Cigna of CA HMO |
$129.28
|
| Rate for Payer: Cigna of CA PPO |
$564.62
|
| Rate for Payer: Cigna of CA PPO |
$149.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$141.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$534.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.11
|
| Rate for Payer: EPIC Health Plan Senior |
$45.41
|
| Rate for Payer: EPIC Health Plan Senior |
$45.41
|
| Rate for Payer: Galaxy Health WC |
$648.55
|
| Rate for Payer: Galaxy Health WC |
$171.70
|
| Rate for Payer: Global Benefits Group Commercial |
$457.80
|
| Rate for Payer: Global Benefits Group Commercial |
$121.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$686.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$181.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$67.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$67.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$128.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$484.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$55.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$55.32
|
| Rate for Payer: Multiplan Commercial |
$572.25
|
| Rate for Payer: Multiplan Commercial |
$151.50
|
| Rate for Payer: Networks By Design Commercial |
$131.30
|
| Rate for Payer: Networks By Design Commercial |
$495.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$41.28
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$41.28
|
| Rate for Payer: Prime Health Services Commercial |
$648.55
|
| Rate for Payer: Prime Health Services Commercial |
$171.70
|
| Rate for Payer: Prime Health Services Medicare |
$43.76
|
| Rate for Payer: Prime Health Services Medicare |
$43.76
|
| Rate for Payer: Riverside University Health System MISP |
$45.41
|
| Rate for Payer: Riverside University Health System MISP |
$45.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$121.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$457.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$457.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.44
|
| Rate for Payer: United Healthcare All Other HMO |
$33.44
|
| Rate for Payer: United Healthcare All Other HMO |
$33.44
|
| Rate for Payer: United Healthcare HMO Rider |
$33.44
|
| Rate for Payer: United Healthcare HMO Rider |
$33.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.44
|
| Rate for Payer: Upland Medical Group Pediatric |
$41.28
|
| Rate for Payer: Upland Medical Group Pediatric |
$41.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.41
|
| Rate for Payer: Vantage Medical Group Senior |
$41.28
|
| Rate for Payer: Vantage Medical Group Senior |
$41.28
|
|
|
HC INTACT PTH
|
Facility
|
IP
|
$763.00
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
900910942
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$152.60 |
| Max. Negotiated Rate |
$686.70 |
| Rate for Payer: Adventist Health Commercial |
$152.60
|
| Rate for Payer: Cash Price |
$343.35
|
| Rate for Payer: Central Health Plan Commercial |
$610.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$534.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.20
|
| Rate for Payer: EPIC Health Plan Senior |
$305.20
|
| Rate for Payer: Galaxy Health WC |
$648.55
|
| Rate for Payer: Global Benefits Group Commercial |
$457.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$686.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$484.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$450.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.60
|
| Rate for Payer: Multiplan Commercial |
$572.25
|
| Rate for Payer: Networks By Design Commercial |
$495.95
|
| Rate for Payer: Prime Health Services Commercial |
$648.55
|
|
|
HC INT AUDITORY MEATUS
|
Facility
|
OP
|
$957.00
|
|
|
Service Code
|
CPT 70134
|
| Hospital Charge Code |
909001133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$78.84 |
| Max. Negotiated Rate |
$1,159.59 |
| Rate for Payer: Adventist Health Commercial |
$191.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$702.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$189.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$702.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$154.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.48
|
| Rate for Payer: Blue Shield of California Commercial |
$602.91
|
| Rate for Payer: Blue Shield of California EPN |
$379.93
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Central Health Plan Commercial |
$765.60
|
| Rate for Payer: Cigna of CA HMO |
$612.48
|
| Rate for Payer: Cigna of CA PPO |
$708.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$773.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$669.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,159.59
|
| Rate for Payer: EPIC Health Plan Senior |
$773.06
|
| Rate for Payer: Galaxy Health WC |
$813.45
|
| Rate for Payer: Global Benefits Group Commercial |
$574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$861.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,152.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$78.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$702.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$607.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$983.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$941.73
|
| Rate for Payer: Multiplan Commercial |
$717.75
|
| Rate for Payer: Networks By Design Commercial |
$622.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$702.78
|
| Rate for Payer: Prime Health Services Commercial |
$813.45
|
| Rate for Payer: Prime Health Services Medicare |
$744.95
|
| Rate for Payer: Riverside University Health System MISP |
$773.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$574.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$574.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$193.23
|
| Rate for Payer: United Healthcare All Other HMO |
$193.23
|
| Rate for Payer: United Healthcare HMO Rider |
$193.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$193.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$702.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Vantage Medical Group Senior |
$702.78
|
|
|
HC INT AUDITORY MEATUS
|
Facility
|
IP
|
$957.00
|
|
|
Service Code
|
CPT 70134
|
| Hospital Charge Code |
909001133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$191.40 |
| Max. Negotiated Rate |
$861.30 |
| Rate for Payer: Adventist Health Commercial |
$191.40
|
| Rate for Payer: Cash Price |
$430.65
|
| Rate for Payer: Central Health Plan Commercial |
$765.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$669.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.80
|
| Rate for Payer: EPIC Health Plan Senior |
$382.80
|
| Rate for Payer: Galaxy Health WC |
$813.45
|
| Rate for Payer: Global Benefits Group Commercial |
$574.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$861.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$607.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$564.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.40
|
| Rate for Payer: Multiplan Commercial |
$717.75
|
| Rate for Payer: Networks By Design Commercial |
$622.05
|
| Rate for Payer: Prime Health Services Commercial |
$813.45
|
|
|
HC INT DEV EVAL CRTD SNS BAT MOD SYS WO PRGMG
|
Facility
|
IP
|
$403.00
|
|
|
Service Code
|
CPT 93145
|
| Hospital Charge Code |
906811868
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$362.70 |
| Rate for Payer: Adventist Health Commercial |
$80.60
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Central Health Plan Commercial |
$322.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$282.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$161.20
|
| Rate for Payer: EPIC Health Plan Senior |
$161.20
|
| Rate for Payer: Galaxy Health WC |
$342.55
|
| Rate for Payer: Global Benefits Group Commercial |
$241.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$362.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$255.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$237.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.60
|
| Rate for Payer: Multiplan Commercial |
$302.25
|
| Rate for Payer: Networks By Design Commercial |
$261.95
|
| Rate for Payer: Prime Health Services Commercial |
$342.55
|
|
|
HC INT DEV EVAL CRTD SNS BAT MOD SYS WO PRGMG
|
Facility
|
OP
|
$403.00
|
|
|
Service Code
|
CPT 93145
|
| Hospital Charge Code |
906811868
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$80.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$195.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$234.43
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Central Health Plan Commercial |
$322.40
|
| Rate for Payer: Cigna of CA HMO |
$261.95
|
| Rate for Payer: Cigna of CA PPO |
$298.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$282.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$342.55
|
| Rate for Payer: Global Benefits Group Commercial |
$241.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$362.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$255.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$302.25
|
| Rate for Payer: Networks By Design Commercial |
$261.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$241.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$241.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$201.50
|
| Rate for Payer: United Healthcare All Other HMO |
$201.50
|
| Rate for Payer: United Healthcare HMO Rider |
$201.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$201.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC INT DEV EVAL CRTD SNS BAT MOD SYS W PRGMG
|
Facility
|
OP
|
$403.00
|
|
|
Service Code
|
CPT 93146
|
| Hospital Charge Code |
906811869
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$80.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$195.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$234.43
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Central Health Plan Commercial |
$322.40
|
| Rate for Payer: Cigna of CA HMO |
$261.95
|
| Rate for Payer: Cigna of CA PPO |
$298.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$282.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$342.55
|
| Rate for Payer: Global Benefits Group Commercial |
$241.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$362.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$255.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$146.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$302.25
|
| Rate for Payer: Networks By Design Commercial |
$261.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$241.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$241.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$201.50
|
| Rate for Payer: United Healthcare All Other HMO |
$201.50
|
| Rate for Payer: United Healthcare HMO Rider |
$201.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$201.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
