|
HC ECMO SERVICE EACH 4 HOURS
|
Facility
|
OP
|
$3,552.00
|
|
| Hospital Charge Code |
900190020
|
|
Hospital Revenue Code
|
419
|
| Min. Negotiated Rate |
$336.00 |
| Max. Negotiated Rate |
$3,196.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,157.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,019.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,953.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,953.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,131.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,234.21
|
| Rate for Payer: Blue Shield of California EPN |
$1,736.93
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Cash Price |
$1,598.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,841.60
|
| Rate for Payer: Cigna of CA HMO |
$2,273.28
|
| Rate for Payer: Cigna of CA PPO |
$2,628.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,019.20
|
| Rate for Payer: Dignity Health Media |
$3,019.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,019.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,420.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,420.80
|
| Rate for Payer: Galaxy Health WC |
$3,019.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,131.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,196.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,664.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,243.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,369.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,353.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$710.40
|
| Rate for Payer: Multiplan Commercial |
$2,664.00
|
| Rate for Payer: Networks By Design Commercial |
$2,308.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,019.20
|
| Rate for Payer: Riverside University Health System MISP |
$1,420.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,131.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,131.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,019.20
|
| Rate for Payer: Vantage Medical Group Senior |
$3,019.20
|
|
|
HC ECOG IMPLTD BRN NPGT 30 DYS
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
900695836
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$1,935.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$47.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$643.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$70.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$51.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$614.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.49
|
| Rate for Payer: Blue Distinction Transplant |
$72.60
|
| Rate for Payer: Blue Shield of California Commercial |
$74.78
|
| Rate for Payer: Blue Shield of California EPN |
$58.81
|
| Rate for Payer: Caremore Medicare Advantage |
$47.12
|
| Rate for Payer: Cash Price |
$54.45
|
| Rate for Payer: Cash Price |
$54.45
|
| Rate for Payer: Cash Price |
$54.45
|
| Rate for Payer: Central Health Plan Commercial |
$96.80
|
| Rate for Payer: Cigna of CA HMO |
$77.44
|
| Rate for Payer: Cigna of CA PPO |
$89.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$70.68
|
| Rate for Payer: Dignity Health Media |
$47.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$47.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$47.12
|
| Rate for Payer: Galaxy Health WC |
$102.85
|
| Rate for Payer: Global Benefits Group Commercial |
$72.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$90.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$77.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$77.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47.12
|
| Rate for Payer: InnovAge PACE Commercial |
$70.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$176.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$63.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63.14
|
| Rate for Payer: Multiplan Commercial |
$90.75
|
| Rate for Payer: Networks By Design Commercial |
$78.65
|
| Rate for Payer: Prime Health Services Commercial |
$102.85
|
| Rate for Payer: Prime Health Services Medicare |
$49.95
|
| Rate for Payer: Riverside University Health System MISP |
$51.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,935.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,323.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$70.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.83
|
| Rate for Payer: Vantage Medical Group Senior |
$47.12
|
|
|
HC ECOG IMPLTD BRN NPGT 30 DYS
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
CPT 95836
|
| Hospital Charge Code |
900695836
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$24.20 |
| Max. Negotiated Rate |
$108.90 |
| Rate for Payer: Cash Price |
$54.45
|
| Rate for Payer: Central Health Plan Commercial |
$96.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.40
|
| Rate for Payer: Galaxy Health WC |
$102.85
|
| Rate for Payer: Global Benefits Group Commercial |
$72.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$90.75
|
| Rate for Payer: Networks By Design Commercial |
$78.65
|
| Rate for Payer: Prime Health Services Commercial |
$102.85
|
|
|
HC ED ENDOSK INCLUD TISSUE SHAPNG
|
Facility
|
OP
|
$4,992.00
|
|
|
Service Code
|
CPT L6450
|
| Hospital Charge Code |
905356450
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,747.20 |
| Max. Negotiated Rate |
$4,492.80 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,243.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,745.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,745.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,417.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,949.27
|
| Rate for Payer: Blue Distinction Transplant |
$2,995.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,744.00
|
| Rate for Payer: Blue Shield of California EPN |
$2,715.65
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,993.60
|
| Rate for Payer: Cigna of CA HMO |
$3,494.40
|
| Rate for Payer: Cigna of CA PPO |
$3,494.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,243.20
|
| Rate for Payer: Dignity Health Media |
$4,243.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,243.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,996.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,996.80
|
| Rate for Payer: Galaxy Health WC |
$4,243.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,995.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,492.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,744.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,747.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,329.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,198.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,046.72
|
| Rate for Payer: Multiplan Commercial |
$3,744.00
|
| Rate for Payer: Networks By Design Commercial |
$2,496.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,243.20
|
| Rate for Payer: Riverside University Health System MISP |
$1,996.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,995.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,995.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,496.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,496.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,496.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,496.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,243.20
|
| Rate for Payer: Vantage Medical Group Senior |
$4,243.20
|
|
|
HC ED ENDOSK INCLUD TISSUE SHAPNG
|
Facility
|
IP
|
$4,992.00
|
|
|
Service Code
|
CPT L6450
|
| Hospital Charge Code |
905356450
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$998.40 |
| Max. Negotiated Rate |
$4,492.80 |
| Rate for Payer: Blue Shield of California EPN |
$2,665.73
|
| Rate for Payer: Cash Price |
$2,246.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,993.60
|
| Rate for Payer: Cigna of CA HMO |
$3,494.40
|
| Rate for Payer: Cigna of CA PPO |
$3,494.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,996.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,996.80
|
| Rate for Payer: Galaxy Health WC |
$4,243.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,995.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,492.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,329.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,901.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$998.40
|
| Rate for Payer: Multiplan Commercial |
$3,744.00
|
| Rate for Payer: Networks By Design Commercial |
$2,496.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,243.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,884.98
|
| Rate for Payer: United Healthcare All Other HMO |
$1,841.05
|
| Rate for Payer: United Healthcare HMO Rider |
$1,801.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,647.36
|
|
|
HC ED EVAL & MGMT
|
Facility
|
OP
|
$1,175.00
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
900509281
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$28.84 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$122.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$110.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$705.00
|
| Rate for Payer: Caremore Medicare Advantage |
$110.93
|
| Rate for Payer: Cash Price |
$528.75
|
| Rate for Payer: Cash Price |
$528.75
|
| Rate for Payer: Cash Price |
$528.75
|
| Rate for Payer: Cash Price |
$528.75
|
| Rate for Payer: Central Health Plan Commercial |
$940.00
|
| Rate for Payer: Cigna of CA PPO |
$869.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.40
|
| Rate for Payer: Dignity Health Media |
$110.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$122.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$110.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$110.93
|
| Rate for Payer: Galaxy Health WC |
$998.75
|
| Rate for Payer: Global Benefits Group Commercial |
$705.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,057.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$881.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$181.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$110.93
|
| Rate for Payer: InnovAge PACE Commercial |
$166.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$783.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$148.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$148.65
|
| Rate for Payer: Multiplan Commercial |
$881.25
|
| Rate for Payer: Networks By Design Commercial |
$763.75
|
| Rate for Payer: Prime Health Services Commercial |
$998.75
|
| Rate for Payer: Prime Health Services Medicare |
$117.59
|
| Rate for Payer: Riverside University Health System MISP |
$122.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$705.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,148.00
|
| Rate for Payer: United Healthcare All Other HMO |
$734.00
|
| Rate for Payer: United Healthcare HMO Rider |
$754.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$689.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$122.02
|
| Rate for Payer: Vantage Medical Group Senior |
$110.93
|
|
|
HC ED EVAL & MGMT
|
Facility
|
IP
|
$1,175.00
|
|
|
Service Code
|
CPT 99281
|
| Hospital Charge Code |
900509281
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$235.00 |
| Max. Negotiated Rate |
$1,057.50 |
| Rate for Payer: Cash Price |
$528.75
|
| Rate for Payer: Central Health Plan Commercial |
$940.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.00
|
| Rate for Payer: Galaxy Health WC |
$998.75
|
| Rate for Payer: Global Benefits Group Commercial |
$705.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,057.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$783.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$447.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$235.00
|
| Rate for Payer: Multiplan Commercial |
$881.25
|
| Rate for Payer: Networks By Design Commercial |
$763.75
|
| Rate for Payer: Prime Health Services Commercial |
$998.75
|
|
|
HC ED EVAL & MGMT HIGH
|
Facility
|
IP
|
$6,200.00
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
900509285
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,240.00 |
| Max. Negotiated Rate |
$5,580.00 |
| Rate for Payer: Cash Price |
$2,790.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,960.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,480.00
|
| Rate for Payer: Galaxy Health WC |
$5,270.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,580.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,362.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,240.00
|
| Rate for Payer: Multiplan Commercial |
$4,650.00
|
| Rate for Payer: Networks By Design Commercial |
$4,030.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,270.00
|
|
|
HC ED EVAL & MGMT HIGH
|
Facility
|
OP
|
$6,200.00
|
|
|
Service Code
|
CPT 99285
|
| Hospital Charge Code |
900509285
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$205.35 |
| Max. Negotiated Rate |
$6,003.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,203.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$882.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$802.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,720.00
|
| Rate for Payer: Caremore Medicare Advantage |
$802.53
|
| Rate for Payer: Cash Price |
$2,790.00
|
| Rate for Payer: Cash Price |
$2,790.00
|
| Rate for Payer: Cash Price |
$2,790.00
|
| Rate for Payer: Cash Price |
$2,790.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,960.00
|
| Rate for Payer: Cigna of CA PPO |
$4,588.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,203.80
|
| Rate for Payer: Dignity Health Media |
$802.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$882.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,083.42
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$802.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$802.53
|
| Rate for Payer: Galaxy Health WC |
$5,270.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,580.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,650.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,316.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$802.53
|
| Rate for Payer: InnovAge PACE Commercial |
$1,203.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,135.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$802.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,240.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,075.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,075.39
|
| Rate for Payer: Multiplan Commercial |
$4,650.00
|
| Rate for Payer: Networks By Design Commercial |
$4,030.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,270.00
|
| Rate for Payer: Prime Health Services Medicare |
$850.68
|
| Rate for Payer: Riverside University Health System MISP |
$882.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,720.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,003.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,845.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,146.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,203.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$882.78
|
| Rate for Payer: Vantage Medical Group Senior |
$802.53
|
|
|
HC ED EVAL & MGMT LOW
|
Facility
|
IP
|
$2,650.00
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
900509283
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$530.00 |
| Max. Negotiated Rate |
$2,385.00 |
| Rate for Payer: Cash Price |
$1,192.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.00
|
| Rate for Payer: Galaxy Health WC |
$2,252.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,590.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,385.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,767.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,009.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$530.00
|
| Rate for Payer: Multiplan Commercial |
$1,987.50
|
| Rate for Payer: Networks By Design Commercial |
$1,722.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,252.50
|
|
|
HC ED EVAL & MGMT LOW
|
Facility
|
OP
|
$2,650.00
|
|
|
Service Code
|
CPT 99283
|
| Hospital Charge Code |
900509283
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.74 |
| Max. Negotiated Rate |
$3,218.00 |
| 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 |
$534.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$392.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$356.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,590.00
|
| Rate for Payer: Caremore Medicare Advantage |
$356.49
|
| Rate for Payer: Cash Price |
$1,192.50
|
| Rate for Payer: Cash Price |
$1,192.50
|
| Rate for Payer: Cash Price |
$1,192.50
|
| Rate for Payer: Cash Price |
$1,192.50
|
| Rate for Payer: Central Health Plan Commercial |
$2,120.00
|
| Rate for Payer: Cigna of CA PPO |
$1,961.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$534.74
|
| Rate for Payer: Dignity Health Media |
$356.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$392.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$481.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$356.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$356.49
|
| Rate for Payer: Galaxy Health WC |
$2,252.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,590.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,385.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,987.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$584.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$356.49
|
| Rate for Payer: InnovAge PACE Commercial |
$534.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,767.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$356.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$530.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$477.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$477.70
|
| Rate for Payer: Multiplan Commercial |
$1,987.50
|
| Rate for Payer: Networks By Design Commercial |
$1,722.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,252.50
|
| Rate for Payer: Prime Health Services Medicare |
$377.88
|
| Rate for Payer: Riverside University Health System MISP |
$392.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,590.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,218.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,824.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,200.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,011.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$534.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$392.14
|
| Rate for Payer: Vantage Medical Group Senior |
$356.49
|
|
|
HC ED EVAL & MGMT MINOR
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
900509282
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$36.48 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$960.00
|
| Rate for Payer: Caremore Medicare Advantage |
$204.35
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,280.00
|
| Rate for Payer: Cigna of CA PPO |
$1,184.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.52
|
| Rate for Payer: Dignity Health Media |
$204.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$204.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$204.35
|
| Rate for Payer: Galaxy Health WC |
$1,360.00
|
| Rate for Payer: Global Benefits Group Commercial |
$960.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,440.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,200.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$335.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.35
|
| Rate for Payer: InnovAge PACE Commercial |
$306.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.83
|
| Rate for Payer: Multiplan Commercial |
$1,200.00
|
| Rate for Payer: Networks By Design Commercial |
$1,040.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,360.00
|
| Rate for Payer: Prime Health Services Medicare |
$216.61
|
| Rate for Payer: Riverside University Health System MISP |
$224.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$960.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,148.00
|
| Rate for Payer: United Healthcare All Other HMO |
$734.00
|
| Rate for Payer: United Healthcare HMO Rider |
$754.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$689.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.78
|
| Rate for Payer: Vantage Medical Group Senior |
$204.35
|
|
|
HC ED EVAL & MGMT MINOR
|
Facility
|
IP
|
$1,600.00
|
|
|
Service Code
|
CPT 99282
|
| Hospital Charge Code |
900509282
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$320.00 |
| Max. Negotiated Rate |
$1,440.00 |
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$640.00
|
| Rate for Payer: Galaxy Health WC |
$1,360.00
|
| Rate for Payer: Global Benefits Group Commercial |
$960.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,440.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$609.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.00
|
| Rate for Payer: Multiplan Commercial |
$1,200.00
|
| Rate for Payer: Networks By Design Commercial |
$1,040.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,360.00
|
|
|
HC ED EVAL & MGMT MODERATE
|
Facility
|
IP
|
$4,050.00
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
900509284
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$810.00 |
| Max. Negotiated Rate |
$3,645.00 |
| Rate for Payer: Cash Price |
$1,822.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,240.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,620.00
|
| Rate for Payer: Galaxy Health WC |
$3,442.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,430.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,645.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,701.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,543.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$810.00
|
| Rate for Payer: Multiplan Commercial |
$3,037.50
|
| Rate for Payer: Networks By Design Commercial |
$2,632.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,442.50
|
|
|
HC ED EVAL & MGMT MODERATE
|
Facility
|
OP
|
$4,050.00
|
|
|
Service Code
|
CPT 99284
|
| Hospital Charge Code |
900509284
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$102.28 |
| Max. Negotiated Rate |
$6,003.00 |
| 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 |
$830.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$553.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,430.00
|
| Rate for Payer: Caremore Medicare Advantage |
$553.39
|
| Rate for Payer: Cash Price |
$1,822.50
|
| Rate for Payer: Cash Price |
$1,822.50
|
| Rate for Payer: Cash Price |
$1,822.50
|
| Rate for Payer: Cash Price |
$1,822.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,240.00
|
| Rate for Payer: Cigna of CA PPO |
$2,997.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$830.08
|
| Rate for Payer: Dignity Health Media |
$553.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$608.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$747.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$553.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$553.39
|
| Rate for Payer: Galaxy Health WC |
$3,442.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,430.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,645.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,037.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$907.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$553.39
|
| Rate for Payer: InnovAge PACE Commercial |
$830.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,701.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$553.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$810.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$741.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$741.54
|
| Rate for Payer: Multiplan Commercial |
$3,037.50
|
| Rate for Payer: Networks By Design Commercial |
$2,632.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,442.50
|
| Rate for Payer: Prime Health Services Medicare |
$586.59
|
| Rate for Payer: Riverside University Health System MISP |
$608.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,430.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,003.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,845.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,146.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$830.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$608.73
|
| Rate for Payer: Vantage Medical Group Senior |
$553.39
|
|
|
HC ED EXP INTRFC OUTSIDE LKNG HNG
|
Facility
|
IP
|
$8,341.00
|
|
|
Service Code
|
CPT L6205
|
| Hospital Charge Code |
905356205
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,668.20 |
| Max. Negotiated Rate |
$7,506.90 |
| Rate for Payer: Blue Shield of California EPN |
$4,454.09
|
| Rate for Payer: Cash Price |
$3,753.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,672.80
|
| Rate for Payer: Cigna of CA HMO |
$5,838.70
|
| Rate for Payer: Cigna of CA PPO |
$5,838.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,336.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,336.40
|
| Rate for Payer: Galaxy Health WC |
$7,089.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,004.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,506.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,563.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,177.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,668.20
|
| Rate for Payer: Multiplan Commercial |
$6,255.75
|
| Rate for Payer: Networks By Design Commercial |
$4,170.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,089.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,149.56
|
| Rate for Payer: United Healthcare All Other HMO |
$3,076.16
|
| Rate for Payer: United Healthcare HMO Rider |
$3,009.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,752.53
|
|
|
HC ED EXP INTRFC OUTSIDE LKNG HNG
|
Facility
|
OP
|
$8,341.00
|
|
|
Service Code
|
CPT L6205
|
| Hospital Charge Code |
905356205
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,919.35 |
| Max. Negotiated Rate |
$7,506.90 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,089.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,587.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,587.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,038.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,927.86
|
| Rate for Payer: Blue Distinction Transplant |
$5,004.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,255.75
|
| Rate for Payer: Blue Shield of California EPN |
$4,537.50
|
| Rate for Payer: Cash Price |
$3,753.45
|
| Rate for Payer: Cash Price |
$3,753.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,672.80
|
| Rate for Payer: Cigna of CA HMO |
$5,838.70
|
| Rate for Payer: Cigna of CA PPO |
$5,838.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,089.85
|
| Rate for Payer: Dignity Health Media |
$7,089.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,089.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,336.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,336.40
|
| Rate for Payer: Galaxy Health WC |
$7,089.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,004.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,506.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,255.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,919.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,563.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,915.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,419.81
|
| Rate for Payer: Multiplan Commercial |
$6,255.75
|
| Rate for Payer: Networks By Design Commercial |
$4,170.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,089.85
|
| Rate for Payer: Riverside University Health System MISP |
$3,336.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,004.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,004.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,170.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,170.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,170.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,170.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,089.85
|
| Rate for Payer: Vantage Medical Group Senior |
$7,089.85
|
|
|
HC ED EXTERN POWER SWITCH CONTROL
|
Facility
|
OP
|
$18,797.00
|
|
|
Service Code
|
CPT L6940
|
| Hospital Charge Code |
905356940
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$6,578.95 |
| Max. Negotiated Rate |
$16,917.30 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,977.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,338.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,338.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,101.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,105.27
|
| Rate for Payer: Blue Distinction Transplant |
$11,278.20
|
| Rate for Payer: Blue Shield of California Commercial |
$14,097.75
|
| Rate for Payer: Blue Shield of California EPN |
$10,225.57
|
| Rate for Payer: Cash Price |
$8,458.65
|
| Rate for Payer: Cash Price |
$8,458.65
|
| Rate for Payer: Central Health Plan Commercial |
$15,037.60
|
| Rate for Payer: Cigna of CA HMO |
$13,157.90
|
| Rate for Payer: Cigna of CA PPO |
$13,157.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,977.45
|
| Rate for Payer: Dignity Health Media |
$15,977.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,977.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,518.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,518.80
|
| Rate for Payer: Galaxy Health WC |
$15,977.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11,278.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,917.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14,097.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,578.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,537.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,505.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,706.77
|
| Rate for Payer: Multiplan Commercial |
$14,097.75
|
| Rate for Payer: Networks By Design Commercial |
$9,398.50
|
| Rate for Payer: Prime Health Services Commercial |
$15,977.45
|
| Rate for Payer: Riverside University Health System MISP |
$7,518.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,278.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,278.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,398.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,398.50
|
| Rate for Payer: United Healthcare HMO Rider |
$9,398.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,398.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,977.45
|
| Rate for Payer: Vantage Medical Group Senior |
$15,977.45
|
|
|
HC ED EXTERN POWER SWITCH CONTROL
|
Facility
|
IP
|
$18,797.00
|
|
|
Service Code
|
CPT L6940
|
| Hospital Charge Code |
905356940
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,759.40 |
| Max. Negotiated Rate |
$16,917.30 |
| Rate for Payer: Blue Shield of California EPN |
$10,037.60
|
| Rate for Payer: Cash Price |
$8,458.65
|
| Rate for Payer: Central Health Plan Commercial |
$15,037.60
|
| Rate for Payer: Cigna of CA HMO |
$13,157.90
|
| Rate for Payer: Cigna of CA PPO |
$13,157.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,518.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,518.80
|
| Rate for Payer: Galaxy Health WC |
$15,977.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11,278.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,917.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,537.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,161.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,759.40
|
| Rate for Payer: Multiplan Commercial |
$14,097.75
|
| Rate for Payer: Networks By Design Commercial |
$9,398.50
|
| Rate for Payer: Prime Health Services Commercial |
$15,977.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,097.75
|
| Rate for Payer: United Healthcare All Other HMO |
$6,932.33
|
| Rate for Payer: United Healthcare HMO Rider |
$6,781.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,203.01
|
|
|
HC ED EXTER POWER LOCK HINGE MYOE
|
Facility
|
OP
|
$23,343.00
|
|
|
Service Code
|
CPT L6945
|
| Hospital Charge Code |
905356945
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$8,170.05 |
| Max. Negotiated Rate |
$21,008.70 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,841.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,838.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,838.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,302.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,791.04
|
| Rate for Payer: Blue Distinction Transplant |
$14,005.80
|
| Rate for Payer: Blue Shield of California Commercial |
$17,507.25
|
| Rate for Payer: Blue Shield of California EPN |
$12,698.59
|
| Rate for Payer: Cash Price |
$10,504.35
|
| Rate for Payer: Cash Price |
$10,504.35
|
| Rate for Payer: Central Health Plan Commercial |
$18,674.40
|
| Rate for Payer: Cigna of CA HMO |
$16,340.10
|
| Rate for Payer: Cigna of CA PPO |
$16,340.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,841.55
|
| Rate for Payer: Dignity Health Media |
$19,841.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,841.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,337.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,337.20
|
| Rate for Payer: Galaxy Health WC |
$19,841.55
|
| Rate for Payer: Global Benefits Group Commercial |
$14,005.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,008.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17,507.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,170.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,569.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,638.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,570.63
|
| Rate for Payer: Multiplan Commercial |
$17,507.25
|
| Rate for Payer: Networks By Design Commercial |
$11,671.50
|
| Rate for Payer: Prime Health Services Commercial |
$19,841.55
|
| Rate for Payer: Riverside University Health System MISP |
$9,337.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,005.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,005.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,671.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11,671.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11,671.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,671.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,841.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19,841.55
|
|
|
HC ED EXTER POWER LOCK HINGE MYOE
|
Facility
|
IP
|
$23,343.00
|
|
|
Service Code
|
CPT L6945
|
| Hospital Charge Code |
905356945
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$4,668.60 |
| Max. Negotiated Rate |
$21,008.70 |
| Rate for Payer: Blue Shield of California EPN |
$12,465.16
|
| Rate for Payer: Cash Price |
$10,504.35
|
| Rate for Payer: Central Health Plan Commercial |
$18,674.40
|
| Rate for Payer: Cigna of CA HMO |
$16,340.10
|
| Rate for Payer: Cigna of CA PPO |
$16,340.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,337.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,337.20
|
| Rate for Payer: Galaxy Health WC |
$19,841.55
|
| Rate for Payer: Global Benefits Group Commercial |
$14,005.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,008.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,569.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,893.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,668.60
|
| Rate for Payer: Multiplan Commercial |
$17,507.25
|
| Rate for Payer: Networks By Design Commercial |
$11,671.50
|
| Rate for Payer: Prime Health Services Commercial |
$19,841.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,814.32
|
| Rate for Payer: United Healthcare All Other HMO |
$8,608.90
|
| Rate for Payer: United Healthcare HMO Rider |
$8,422.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,703.19
|
|
|
HC ED FAMILY THERAPY WITH PATIENT
|
Facility
|
OP
|
$460.00
|
|
|
Service Code
|
CPT 90847
|
| Hospital Charge Code |
907804116
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$92.00 |
| Max. Negotiated Rate |
$797.64 |
| Rate for Payer: Adventist Health Medi-Cal |
$199.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$797.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$298.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$219.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$199.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$222.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$271.77
|
| Rate for Payer: Blue Distinction Transplant |
$276.00
|
| Rate for Payer: Blue Shield of California Commercial |
$289.34
|
| Rate for Payer: Blue Shield of California EPN |
$224.94
|
| Rate for Payer: Caremore Medicare Advantage |
$199.21
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Central Health Plan Commercial |
$368.00
|
| Rate for Payer: Cigna of CA HMO |
$294.40
|
| Rate for Payer: Cigna of CA PPO |
$340.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$298.82
|
| Rate for Payer: Dignity Health Media |
$199.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$219.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$268.93
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$199.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$199.21
|
| Rate for Payer: Galaxy Health WC |
$391.00
|
| Rate for Payer: Global Benefits Group Commercial |
$276.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$345.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$326.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$328.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$199.21
|
| Rate for Payer: InnovAge PACE Commercial |
$298.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.00
|
| Rate for Payer: Managed Health Network (MHN) Behavioral |
$610.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$266.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$266.94
|
| Rate for Payer: Multiplan Commercial |
$345.00
|
| Rate for Payer: Networks By Design Commercial |
$299.00
|
| Rate for Payer: Prime Health Services Commercial |
$391.00
|
| Rate for Payer: Prime Health Services Medicare |
$211.16
|
| Rate for Payer: Riverside University Health System MISP |
$219.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$276.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$276.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$230.00
|
| Rate for Payer: United Healthcare All Other HMO |
$230.00
|
| Rate for Payer: United Healthcare HMO Rider |
$230.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$230.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$298.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$219.13
|
| Rate for Payer: Vantage Medical Group Senior |
$199.21
|
|
|
HC ED FAMILY THERAPY WITH PATIENT
|
Facility
|
IP
|
$460.00
|
|
|
Service Code
|
CPT 90847
|
| Hospital Charge Code |
907804116
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$92.00 |
| Max. Negotiated Rate |
$414.00 |
| Rate for Payer: Cash Price |
$207.00
|
| Rate for Payer: Central Health Plan Commercial |
$368.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.00
|
| Rate for Payer: Galaxy Health WC |
$391.00
|
| Rate for Payer: Global Benefits Group Commercial |
$276.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$414.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$92.00
|
| Rate for Payer: Multiplan Commercial |
$345.00
|
| Rate for Payer: Networks By Design Commercial |
$299.00
|
| Rate for Payer: Prime Health Services Commercial |
$391.00
|
|
|
HC EDI CATH 12FRX125CM
|
Facility
|
IP
|
$780.00
|
|
| Hospital Charge Code |
900800873
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.00 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Central Health Plan Commercial |
$624.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.00
|
| Rate for Payer: Galaxy Health WC |
$663.00
|
| Rate for Payer: Global Benefits Group Commercial |
$468.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$702.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$520.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.00
|
| Rate for Payer: Multiplan Commercial |
$585.00
|
| Rate for Payer: Networks By Design Commercial |
$507.00
|
| Rate for Payer: Prime Health Services Commercial |
$663.00
|
|
|
HC EDI CATH 12FRX125CM
|
Facility
|
OP
|
$780.00
|
|
| Hospital Charge Code |
900800873
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.00 |
| Max. Negotiated Rate |
$702.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$473.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$663.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$429.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$429.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$377.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$460.82
|
| Rate for Payer: Blue Distinction Transplant |
$468.00
|
| Rate for Payer: Blue Shield of California Commercial |
$490.62
|
| Rate for Payer: Blue Shield of California EPN |
$381.42
|
| Rate for Payer: Cash Price |
$351.00
|
| Rate for Payer: Central Health Plan Commercial |
$624.00
|
| Rate for Payer: Cigna of CA HMO |
$499.20
|
| Rate for Payer: Cigna of CA PPO |
$577.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$663.00
|
| Rate for Payer: Dignity Health Media |
$663.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$663.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$312.00
|
| Rate for Payer: Galaxy Health WC |
$663.00
|
| Rate for Payer: Global Benefits Group Commercial |
$468.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$702.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$585.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$273.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$520.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$156.00
|
| Rate for Payer: Multiplan Commercial |
$585.00
|
| Rate for Payer: Networks By Design Commercial |
$507.00
|
| Rate for Payer: Prime Health Services Commercial |
$663.00
|
| Rate for Payer: Riverside University Health System MISP |
$312.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$468.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$468.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$390.00
|
| Rate for Payer: United Healthcare All Other HMO |
$390.00
|
| Rate for Payer: United Healthcare HMO Rider |
$390.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$390.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$663.00
|
| Rate for Payer: Vantage Medical Group Senior |
$663.00
|
|
