|
HC INTRANASAL BX
|
Facility
|
IP
|
$4,171.00
|
|
|
Service Code
|
CPT 30100
|
| Hospital Charge Code |
900803395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$834.20 |
| Max. Negotiated Rate |
$3,753.90 |
| Rate for Payer: Adventist Health Commercial |
$834.20
|
| Rate for Payer: Cash Price |
$1,876.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,919.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,668.40
|
| Rate for Payer: Galaxy Health WC |
$3,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,648.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,460.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.20
|
| Rate for Payer: Multiplan Commercial |
$3,128.25
|
| Rate for Payer: Networks By Design Commercial |
$2,711.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,545.35
|
|
|
HC INTRANASAL BX
|
Facility
|
OP
|
$4,171.00
|
|
|
Service Code
|
CPT 30100
|
| Hospital Charge Code |
900803395
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$834.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,995.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,995.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$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 |
$2,998.82
|
| 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 |
$1,876.95
|
| Rate for Payer: Cash Price |
$1,876.95
|
| Rate for Payer: Cash Price |
$1,876.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,336.80
|
| Rate for Payer: Cigna of CA HMO |
$2,669.44
|
| Rate for Payer: Cigna of CA PPO |
$3,086.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,195.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,995.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,919.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,292.74
|
| Rate for Payer: EPIC Health Plan Senior |
$2,195.16
|
| Rate for Payer: Galaxy Health WC |
$3,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,502.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,753.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,272.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,648.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,793.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$834.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,674.10
|
| Rate for Payer: Multiplan Commercial |
$3,128.25
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$2,711.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$3,545.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,115.34
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,195.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,502.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,085.50
|
| 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: Upland Medical Group Pediatric |
$1,995.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Vantage Medical Group Senior |
$1,995.60
|
|
|
HC INTRA OP EPICARDIAL/ENDO MAP
|
Facility
|
IP
|
$887.00
|
|
|
Service Code
|
CPT 93631
|
| Hospital Charge Code |
906811306
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$177.40 |
| Max. Negotiated Rate |
$798.30 |
| Rate for Payer: Adventist Health Commercial |
$177.40
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Central Health Plan Commercial |
$709.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$620.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$354.80
|
| Rate for Payer: EPIC Health Plan Senior |
$354.80
|
| Rate for Payer: Galaxy Health WC |
$753.95
|
| Rate for Payer: Global Benefits Group Commercial |
$532.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$798.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$563.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$523.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.40
|
| Rate for Payer: Multiplan Commercial |
$665.25
|
| Rate for Payer: Networks By Design Commercial |
$576.55
|
| Rate for Payer: Prime Health Services Commercial |
$753.95
|
|
|
HC INTRA OP EPICARDIAL/ENDO MAP
|
Facility
|
OP
|
$887.00
|
|
|
Service Code
|
CPT 93631
|
| Hospital Charge Code |
906811306
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$177.40 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$177.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$901.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$753.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$487.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$665.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Cash Price |
$399.15
|
| Rate for Payer: Central Health Plan Commercial |
$709.60
|
| Rate for Payer: Cigna of CA HMO |
$567.68
|
| Rate for Payer: Cigna of CA PPO |
$656.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$753.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$753.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$753.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$620.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$354.80
|
| Rate for Payer: EPIC Health Plan Senior |
$354.80
|
| Rate for Payer: Galaxy Health WC |
$753.95
|
| Rate for Payer: Global Benefits Group Commercial |
$532.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$798.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$966.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$563.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,067.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$523.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$620.90
|
| Rate for Payer: Multiplan Commercial |
$665.25
|
| Rate for Payer: Networks By Design Commercial |
$576.55
|
| Rate for Payer: Prime Health Services Commercial |
$753.95
|
| Rate for Payer: Riverside University Health System MISP |
$354.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$532.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$532.20
|
| 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: Vantage Medical Group Commercial/Exchange |
$753.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$753.95
|
| Rate for Payer: Vantage Medical Group Senior |
$753.95
|
|
|
HC INTRAOP NEURO TESTING, EA 15 MIN
|
Facility
|
OP
|
$1,052.00
|
|
|
Service Code
|
CPT 95940
|
| Hospital Charge Code |
900600299
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$46.53 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Adventist Health Commercial |
$210.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$181.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$894.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$578.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$789.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$177.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$611.95
|
| Rate for Payer: Blue Shield of California Commercial |
$662.76
|
| Rate for Payer: Blue Shield of California EPN |
$417.64
|
| Rate for Payer: Cash Price |
$473.40
|
| Rate for Payer: Cash Price |
$473.40
|
| Rate for Payer: Cash Price |
$473.40
|
| Rate for Payer: Central Health Plan Commercial |
$841.60
|
| Rate for Payer: Cigna of CA HMO |
$673.28
|
| Rate for Payer: Cigna of CA PPO |
$778.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$894.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$894.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$894.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$736.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$420.80
|
| Rate for Payer: EPIC Health Plan Senior |
$420.80
|
| Rate for Payer: Galaxy Health WC |
$894.20
|
| Rate for Payer: Global Benefits Group Commercial |
$631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$946.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$46.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$668.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$51.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$620.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$736.40
|
| Rate for Payer: Multiplan Commercial |
$789.00
|
| Rate for Payer: Networks By Design Commercial |
$683.80
|
| Rate for Payer: Prime Health Services Commercial |
$894.20
|
| Rate for Payer: Riverside University Health System MISP |
$420.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$631.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$631.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$894.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$894.20
|
| Rate for Payer: Vantage Medical Group Senior |
$894.20
|
|
|
HC INTRAOP NEURO TESTING, EA 15 MIN
|
Facility
|
IP
|
$1,052.00
|
|
|
Service Code
|
CPT 95940
|
| Hospital Charge Code |
900600299
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$210.40 |
| Max. Negotiated Rate |
$946.80 |
| Rate for Payer: Adventist Health Commercial |
$210.40
|
| Rate for Payer: Cash Price |
$473.40
|
| Rate for Payer: Central Health Plan Commercial |
$841.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$736.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$420.80
|
| Rate for Payer: EPIC Health Plan Senior |
$420.80
|
| Rate for Payer: Galaxy Health WC |
$894.20
|
| Rate for Payer: Global Benefits Group Commercial |
$631.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$946.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$668.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$620.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.40
|
| Rate for Payer: Multiplan Commercial |
$789.00
|
| Rate for Payer: Networks By Design Commercial |
$683.80
|
| Rate for Payer: Prime Health Services Commercial |
$894.20
|
|
|
HC INTRAORAL I&D ABSCESS SUBMAND
|
Facility
|
IP
|
$9,433.00
|
|
|
Service Code
|
CPT 41008
|
| Hospital Charge Code |
900501403
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,886.60 |
| Max. Negotiated Rate |
$8,489.70 |
| Rate for Payer: Adventist Health Commercial |
$1,886.60
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,546.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,603.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,773.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,773.20
|
| Rate for Payer: Galaxy Health WC |
$8,018.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,659.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,489.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,989.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,565.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,886.60
|
| Rate for Payer: Multiplan Commercial |
$7,074.75
|
| Rate for Payer: Networks By Design Commercial |
$6,131.45
|
| Rate for Payer: Prime Health Services Commercial |
$8,018.05
|
|
|
HC INTRAORAL I&D ABSCESS SUBMAND
|
Facility
|
OP
|
$9,433.00
|
|
|
Service Code
|
CPT 41008
|
| Hospital Charge Code |
900501403
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,489.70 |
| Rate for Payer: Adventist Health Commercial |
$3,867.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,574.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,546.40
|
| Rate for Payer: Cigna of CA HMO |
$6,037.12
|
| Rate for Payer: Cigna of CA PPO |
$6,980.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,603.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$8,018.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,659.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,489.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,989.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$415.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,886.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$7,074.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$6,131.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,018.05
|
| Rate for Payer: Prime Health Services Medicare |
$4,520.08
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,690.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,659.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,659.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC INTRAORAL I&D ABSCESS SUBMAND
|
Facility
|
IP
|
$9,433.00
|
|
|
Service Code
|
CPT 41008
|
| Hospital Charge Code |
900501403
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,886.60 |
| Max. Negotiated Rate |
$8,489.70 |
| Rate for Payer: Adventist Health Commercial |
$1,886.60
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,546.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,603.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,773.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,773.20
|
| Rate for Payer: Galaxy Health WC |
$8,018.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,659.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,489.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,989.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,565.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,886.60
|
| Rate for Payer: Multiplan Commercial |
$7,074.75
|
| Rate for Payer: Networks By Design Commercial |
$6,131.45
|
| Rate for Payer: Prime Health Services Commercial |
$8,018.05
|
|
|
HC INTRAORAL I&D ABSCESS SUBMAND
|
Facility
|
OP
|
$9,433.00
|
|
|
Service Code
|
CPT 41008
|
| Hospital Charge Code |
900501403
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$8,489.70 |
| Rate for Payer: Adventist Health Commercial |
$1,886.60
|
| 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 |
$6,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,264.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Cash Price |
$4,244.85
|
| Rate for Payer: Central Health Plan Commercial |
$7,546.40
|
| Rate for Payer: Cigna of CA HMO |
$6,037.12
|
| Rate for Payer: Cigna of CA PPO |
$6,980.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,690.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,264.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,603.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,035.98
|
| Rate for Payer: EPIC Health Plan Senior |
$4,690.65
|
| Rate for Payer: Galaxy Health WC |
$8,018.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,659.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,489.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,993.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,989.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$415.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,584.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,886.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,714.07
|
| Rate for Payer: Multiplan Commercial |
$7,074.75
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$6,131.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,264.23
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,018.05
|
| Rate for Payer: Prime Health Services Medicare |
$4,520.08
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,690.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,659.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,716.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,716.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,716.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,716.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,264.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,690.65
|
| Rate for Payer: Vantage Medical Group Senior |
$4,264.23
|
|
|
HC INTRAORAL I&D OF ABSC LINGUAL
|
Facility
|
IP
|
$10,189.00
|
|
|
Service Code
|
CPT 41007
|
| Hospital Charge Code |
900501146
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,037.80 |
| Max. Negotiated Rate |
$9,170.10 |
| Rate for Payer: Adventist Health Commercial |
$2,037.80
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Central Health Plan Commercial |
$8,151.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,132.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,075.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,075.60
|
| Rate for Payer: Galaxy Health WC |
$8,660.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,170.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,470.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,011.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,037.80
|
| Rate for Payer: Multiplan Commercial |
$7,641.75
|
| Rate for Payer: Networks By Design Commercial |
$6,622.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,660.65
|
|
|
HC INTRAORAL I&D OF ABSC LINGUAL
|
Facility
|
OP
|
$10,189.00
|
|
|
Service Code
|
CPT 41007
|
| Hospital Charge Code |
900501146
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$398.96 |
| Max. Negotiated Rate |
$9,170.10 |
| Rate for Payer: Adventist Health Commercial |
$2,037.80
|
| 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 |
$2,993.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,995.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,998.82
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Central Health Plan Commercial |
$8,151.20
|
| Rate for Payer: Cigna of CA HMO |
$6,520.96
|
| Rate for Payer: Cigna of CA PPO |
$7,539.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,195.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,995.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,132.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,292.74
|
| Rate for Payer: EPIC Health Plan Senior |
$2,195.16
|
| Rate for Payer: Galaxy Health WC |
$8,660.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,170.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,272.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,470.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$398.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,145.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,037.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,674.10
|
| Rate for Payer: Multiplan Commercial |
$7,641.75
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$6,622.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$8,660.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,115.34
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,195.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,094.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,094.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,094.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,094.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,995.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Vantage Medical Group Senior |
$1,995.60
|
|
|
HC INTRAORAL I&D OF ABSC LINGUAL
|
Facility
|
IP
|
$10,189.00
|
|
|
Service Code
|
CPT 41007
|
| Hospital Charge Code |
900501146
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$2,037.80 |
| Max. Negotiated Rate |
$9,170.10 |
| Rate for Payer: Adventist Health Commercial |
$2,037.80
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Central Health Plan Commercial |
$8,151.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,132.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,075.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,075.60
|
| Rate for Payer: Galaxy Health WC |
$8,660.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,170.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,470.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,011.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,037.80
|
| Rate for Payer: Multiplan Commercial |
$7,641.75
|
| Rate for Payer: Networks By Design Commercial |
$6,622.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,660.65
|
|
|
HC INTRAORAL I&D OF ABSC LINGUAL
|
Facility
|
OP
|
$10,189.00
|
|
|
Service Code
|
CPT 41007
|
| Hospital Charge Code |
900501146
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$398.96 |
| Max. Negotiated Rate |
$9,170.10 |
| Rate for Payer: Adventist Health Commercial |
$4,177.49
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,471.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,995.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,998.82
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Cash Price |
$4,585.05
|
| Rate for Payer: Central Health Plan Commercial |
$8,151.20
|
| Rate for Payer: Cigna of CA HMO |
$6,520.96
|
| Rate for Payer: Cigna of CA PPO |
$7,539.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,195.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,995.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,132.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,292.74
|
| Rate for Payer: EPIC Health Plan Senior |
$2,195.16
|
| Rate for Payer: Galaxy Health WC |
$8,660.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,113.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,170.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,272.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,470.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$398.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,145.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,037.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,674.10
|
| Rate for Payer: Multiplan Commercial |
$7,641.75
|
| Rate for Payer: Multiplan WC |
$2,998.82
|
| Rate for Payer: Networks By Design Commercial |
$6,622.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,995.60
|
| Rate for Payer: Preferred Health Network WC |
$3,060.02
|
| Rate for Payer: Prime Health Services Commercial |
$8,660.65
|
| Rate for Payer: Prime Health Services Medicare |
$2,115.34
|
| Rate for Payer: Prime Health Services WC |
$2,968.22
|
| Rate for Payer: Riverside University Health System MISP |
$2,195.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,113.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,113.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,995.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,993.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,195.16
|
| Rate for Payer: Vantage Medical Group Senior |
$1,995.60
|
|
|
HC INTRAORAL INCISION OF ABSCESS
|
Facility
|
OP
|
$5,819.00
|
|
|
Service Code
|
CPT 41000
|
| Hospital Charge Code |
900501290
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$108.93 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,163.80
|
| 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 |
$1,040.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$693.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,030.97
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,655.20
|
| Rate for Payer: Cigna of CA HMO |
$3,724.16
|
| Rate for Payer: Cigna of CA PPO |
$4,306.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$693.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,073.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.56
|
| Rate for Payer: EPIC Health Plan Senior |
$763.04
|
| Rate for Payer: Galaxy Health WC |
$4,946.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,491.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,237.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,137.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$693.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,695.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$108.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,163.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.52
|
| Rate for Payer: Multiplan Commercial |
$4,364.25
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: Networks By Design Commercial |
$3,782.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$693.67
|
| Rate for Payer: Preferred Health Network WC |
$1,052.01
|
| Rate for Payer: Prime Health Services Commercial |
$4,946.15
|
| Rate for Payer: Prime Health Services Medicare |
$735.29
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$763.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,491.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,909.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,909.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,909.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,909.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$693.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Vantage Medical Group Senior |
$693.67
|
|
|
HC INTRAORAL INCISION OF ABSCESS
|
Facility
|
IP
|
$5,819.00
|
|
|
Service Code
|
CPT 41000
|
| Hospital Charge Code |
900501290
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,163.80 |
| Max. Negotiated Rate |
$5,237.10 |
| Rate for Payer: Adventist Health Commercial |
$1,163.80
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,655.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,073.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,327.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,327.60
|
| Rate for Payer: Galaxy Health WC |
$4,946.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,491.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,237.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,695.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,433.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,163.80
|
| Rate for Payer: Multiplan Commercial |
$4,364.25
|
| Rate for Payer: Networks By Design Commercial |
$3,782.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,946.15
|
|
|
HC INTRAORAL INCISION OF ABSCESS
|
Facility
|
OP
|
$5,819.00
|
|
|
Service Code
|
CPT 41000
|
| Hospital Charge Code |
900501290
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$108.93 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$2,385.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$661.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$693.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,030.97
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,655.20
|
| Rate for Payer: Cigna of CA HMO |
$3,724.16
|
| Rate for Payer: Cigna of CA PPO |
$4,306.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$693.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,073.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,144.56
|
| Rate for Payer: EPIC Health Plan Senior |
$763.04
|
| Rate for Payer: Galaxy Health WC |
$4,946.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,491.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,237.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,137.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$693.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,695.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$108.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$745.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,163.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$929.52
|
| Rate for Payer: Multiplan Commercial |
$4,364.25
|
| Rate for Payer: Multiplan WC |
$1,030.97
|
| Rate for Payer: Networks By Design Commercial |
$3,782.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$693.67
|
| Rate for Payer: Preferred Health Network WC |
$1,052.01
|
| Rate for Payer: Prime Health Services Commercial |
$4,946.15
|
| Rate for Payer: Prime Health Services Medicare |
$735.29
|
| Rate for Payer: Prime Health Services WC |
$1,020.45
|
| Rate for Payer: Riverside University Health System MISP |
$763.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,491.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,491.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$693.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,040.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.04
|
| Rate for Payer: Vantage Medical Group Senior |
$693.67
|
|
|
HC INTRAORAL INCISION OF ABSCESS
|
Facility
|
IP
|
$5,819.00
|
|
|
Service Code
|
CPT 41000
|
| Hospital Charge Code |
900501290
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,163.80 |
| Max. Negotiated Rate |
$5,237.10 |
| Rate for Payer: Adventist Health Commercial |
$1,163.80
|
| Rate for Payer: Cash Price |
$2,618.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,655.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,073.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,327.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,327.60
|
| Rate for Payer: Galaxy Health WC |
$4,946.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,491.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,237.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,695.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,433.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,163.80
|
| Rate for Payer: Multiplan Commercial |
$4,364.25
|
| Rate for Payer: Networks By Design Commercial |
$3,782.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,946.15
|
|
|
HC INTRAORAL INC OF ABSCESS SUBLINGUAL
|
Facility
|
IP
|
$738.00
|
|
|
Service Code
|
CPT 41005
|
| Hospital Charge Code |
900501910
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$147.60 |
| Max. Negotiated Rate |
$664.20 |
| Rate for Payer: Adventist Health Commercial |
$147.60
|
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Central Health Plan Commercial |
$590.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$516.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.20
|
| Rate for Payer: EPIC Health Plan Senior |
$295.20
|
| Rate for Payer: Galaxy Health WC |
$627.30
|
| Rate for Payer: Global Benefits Group Commercial |
$442.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$664.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$468.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$435.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.60
|
| Rate for Payer: Multiplan Commercial |
$553.50
|
| Rate for Payer: Networks By Design Commercial |
$479.70
|
| Rate for Payer: Prime Health Services Commercial |
$627.30
|
|
|
HC INTRAORAL INC OF ABSCESS SUBLINGUAL
|
Facility
|
OP
|
$738.00
|
|
|
Service Code
|
CPT 41005
|
| Hospital Charge Code |
900501910
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$102.56 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$147.60
|
| 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 |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Cash Price |
$332.10
|
| Rate for Payer: Central Health Plan Commercial |
$590.40
|
| Rate for Payer: Cigna of CA HMO |
$472.32
|
| Rate for Payer: Cigna of CA PPO |
$546.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$516.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Galaxy Health WC |
$627.30
|
| Rate for Payer: Global Benefits Group Commercial |
$442.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$664.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$468.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$102.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$327.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$553.50
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$479.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$627.30
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$442.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$369.00
|
| Rate for Payer: United Healthcare All Other HMO |
$369.00
|
| Rate for Payer: United Healthcare HMO Rider |
$369.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$369.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC INTRAOSSEOUS INFUSION
|
Facility
|
IP
|
$1,934.00
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
900501143
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$386.80 |
| Max. Negotiated Rate |
$1,740.60 |
| Rate for Payer: Adventist Health Commercial |
$386.80
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,547.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,353.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$773.60
|
| Rate for Payer: EPIC Health Plan Senior |
$773.60
|
| Rate for Payer: Galaxy Health WC |
$1,643.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,160.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,740.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,228.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,141.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$386.80
|
| Rate for Payer: Multiplan Commercial |
$1,450.50
|
| Rate for Payer: Networks By Design Commercial |
$1,257.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,643.90
|
|
|
HC INTRAOSSEOUS INFUSION
|
Facility
|
IP
|
$1,934.00
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
900501143
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$386.80 |
| Max. Negotiated Rate |
$1,740.60 |
| Rate for Payer: Adventist Health Commercial |
$386.80
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,547.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,353.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$773.60
|
| Rate for Payer: EPIC Health Plan Senior |
$773.60
|
| Rate for Payer: Galaxy Health WC |
$1,643.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,160.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,740.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,228.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,141.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$386.80
|
| Rate for Payer: Multiplan Commercial |
$1,450.50
|
| Rate for Payer: Networks By Design Commercial |
$1,257.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,643.90
|
|
|
HC INTRAOSSEOUS INFUSION
|
Facility
|
OP
|
$1,934.00
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
900501143
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$99.03 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$792.94
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$340.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$574.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$807.84
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,547.20
|
| Rate for Payer: Cigna of CA HMO |
$1,237.76
|
| Rate for Payer: Cigna of CA PPO |
$1,431.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$861.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$574.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,353.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.02
|
| Rate for Payer: EPIC Health Plan Senior |
$632.02
|
| Rate for Payer: Galaxy Health WC |
$1,643.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,160.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,740.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$942.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$574.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,228.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$617.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$386.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$769.91
|
| Rate for Payer: Multiplan Commercial |
$1,450.50
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$1,257.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$574.56
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$1,643.90
|
| Rate for Payer: Prime Health Services Medicare |
$609.03
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$632.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,160.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,160.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$574.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Vantage Medical Group Senior |
$574.56
|
|
|
HC INTRAOSSEOUS INFUSION
|
Facility
|
OP
|
$1,934.00
|
|
|
Service Code
|
CPT 36680
|
| Hospital Charge Code |
900501143
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$99.03 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$386.80
|
| 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 |
$861.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$574.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$807.84
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Cash Price |
$870.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,547.20
|
| Rate for Payer: Cigna of CA HMO |
$1,237.76
|
| Rate for Payer: Cigna of CA PPO |
$1,431.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$861.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$574.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,353.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.02
|
| Rate for Payer: EPIC Health Plan Senior |
$632.02
|
| Rate for Payer: Galaxy Health WC |
$1,643.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,160.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,740.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$942.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$574.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,228.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$99.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$617.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$386.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$769.91
|
| Rate for Payer: Multiplan Commercial |
$1,450.50
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$1,257.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$574.56
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$1,643.90
|
| Rate for Payer: Prime Health Services Medicare |
$609.03
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$632.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,160.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$967.00
|
| Rate for Payer: United Healthcare All Other HMO |
$967.00
|
| Rate for Payer: United Healthcare HMO Rider |
$967.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$967.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$574.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Vantage Medical Group Senior |
$574.56
|
|
|
HC INTRAVASC LITHO FEM AND POP VASC SAME ARTERY
|
Facility
|
OP
|
$17,142.00
|
|
|
Service Code
|
CPT 37279
|
| Hospital Charge Code |
906811845
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,428.40 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$3,428.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,570.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,428.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,856.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,300.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,971.50
|
| 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 |
$7,713.90
|
| Rate for Payer: Cash Price |
$7,713.90
|
| Rate for Payer: Central Health Plan Commercial |
$13,713.60
|
| Rate for Payer: Cigna of CA HMO |
$10,970.88
|
| Rate for Payer: Cigna of CA PPO |
$12,685.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,570.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,570.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,570.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,999.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,856.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,856.80
|
| Rate for Payer: Galaxy Health WC |
$14,570.70
|
| Rate for Payer: Global Benefits Group Commercial |
$10,285.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,427.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,885.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,222.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,113.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,428.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11,999.40
|
| Rate for Payer: Multiplan Commercial |
$12,856.50
|
| Rate for Payer: Networks By Design Commercial |
$11,142.30
|
| Rate for Payer: Prime Health Services Commercial |
$14,570.70
|
| Rate for Payer: Riverside University Health System MISP |
$6,856.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,285.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,571.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,571.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,571.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,571.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,570.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,570.70
|
| Rate for Payer: Vantage Medical Group Senior |
$14,570.70
|
|
